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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7808
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My eyelids are swollen on top and some on the bottom, red,

Resolved Question:

My eyelids are swollen on top and some on the bottom, red, a little itchy. This happened a month ago while I had a cold and it cleared up with the cold. I have never had this in the past and I do not in have known allergies. However, last Thursday the swollen eyelids came back. When the first case cleared up the skin pealed off. The skin appears dry and rough and red both over and under the eye. I use a MaryKay cream on my face and to wash which I have used for years. I do not wear any eye makeup. What should I do?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I do not believe this is related to your makeup

Customer:

ok

Dr. Rick :

It does, however, sound like you may have a few things going on. The first would be some mild allergies, maybe some dry eyes (although you didn't mention symptoms related to dry eyes) and possibly some blepharitis.

Dr. Rick :

Here is some information about a treatment you can do at home.

Customer:

ok so what do you suggest I do?

Dr. Rick :

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.


 


Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.


 


The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


 


Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.


 


Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.


 


 

Dr. Rick :

You might also try putting a little bit of hyrocortizone 1% cream on your lids 2x/day to calm thing down. This mild steroid cream is fairly safe to use.

Dr. Rick :

Does this make sense to you?

Customer:

Yes but will the hyrocortizone cream hurt my eyes? It was suggested by my chiropractor to use the Baby Shampoo scrub. What do you think causes this?

Dr. Rick :

It is just one of the many joys that we can come to expect with living too long :)

Dr. Rick :

Good advice from the chiropractor.....that usually doesn't happen in my experience.

Customer:

Also I do not have any secretion as mentioned

Dr. Rick :

Yes, that is common. But, on exam with the microscope it can be seen.

Customer:

SO I should use the eye drops and the eyelid scrub and the cream?

Dr. Rick :

Yes. The steroid cream is just to get you feeling better faster while the lid scrubs etc kick in.

Dr. Rick :

It will not solve the problem, just reduce the symptoms

Customer:

So what do you think may solve the problem?

Dr. Rick :

I think the treatment most likely to help, in the long run, is the baby shampoo lid scrubs and the natural tears

Customer:

Do you suggest a specific natural tears product?

Dr. Rick :

The least expensive is the best....they are all made of the same stuff.

Customer:

ok

Customer:

how can I get back in touch with you after I try this treatment, please?

Dr. Rick :

You can come back to this thread or just ask for me on the main eye page and we can pick up where we left off. While we were chatting I was talking to a customer from 6 weeks ago, following up on his treatment course....I do it all the time.

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


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Dr. Rick :

Does that sound good to you?

Customer:

Do you think this could be eyelid dermatitis?

Customer:

And would the treatment be the same?

Dr. Rick :

I'm currently taking my boys to Yellowstone National park and will be online only in the evenings/ early morning for the next week or so.

Customer:

ok

Dr. Rick :

I actually was thinking of eczema, but it doesn't usually cause as much swelling as you were talking about. In any event the steroid cream and sunlight exposure would help with that.

Customer:

ok what if it is eczema of the eyelid?

Dr. Rick :

They are teenagers so trying to get them going in the morning is like an act of Congress.

Customer:

for sure

Dr. Rick :

then the treatments discussed will help with that too, and so will getting outside in the sun.

Customer:

ok I am in the sun every day but I wear sunglasses.

Customer:

so I should try to expose the eye lid to the sun?

Customer:

also is there a special brand cream you would suggest?

Dr. Rick :

That would block the UV light....try going without the sunglasses for a few hours/day. But, in any event, I don't think eczema is your primary problem...it was just a thought.

Dr. Rick :

no, just the generic hydrocortizone 1% cream

Customer:

got it and thank you. I cant think of any other questions right now.

Dr. Rick :

ok.

Customer:

have a great trip - teenagers may need to work some in the summer too, right? Mine does

Dr. Rick :

Yup. The younger one does but the older one is kinda slow on the job thing.

Dr. Rick :

I also have 3 daughters....

Dr. Rick :

It is now safe to press that Pretty Green Button so that my poor, starving, barefoot, daughters can buy new shoes and, once again, feel safe from the mean, nasty snakes, as they walk through the tall grass.


 

Customer:

I bet they work

Dr. Rick :

That is why I have to work so hard on justanswer!

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7808
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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