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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10561
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My lower eye lids are swollen , mostly in the morning (especially

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My lower eye lids are swollen , mostly in the morning (especially the left eye). After I take a shower, the swelling goes down. My optomologist suggested that I have dry eyes. My allergist said I had no classic symtoms of allergy. I use artificial tears and warm comresses. But I don't see a change. I take pills for high blood pressure and cholestoral. aAy idea of what could be causing this discomfort.
Hi. I'm online and happy to answer your question today. Our chat system seems to be broken at the moment but, don't worry, we can use the Q&A system to work on your question.

It sounds like you are suffering from an anterior segment/tear film issue. Many times, as we get older and especially after eye surgery the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes (sounds like you are getting some treatment for this already) allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time, which you have not been doing. You've just been addressing one thing at a time and that, I believe, is why your symptoms keep coming back

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 is 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.

Does this make sense to you?

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I'm glad to hear that the home treatment discussed above is helping and that things have improved so much :)

Let me know if there is anything else I can do for you.