Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Eyelid Irritation & Infections

Conditions & Treatments

Eyelid Irritation and Infections

Meibomian Surface Glands in a healthy lid. © Rhein Medical, Inc.

The eyelid can be the site of significant inflammatory and infectious conditions. Inflammation of the eyelid is called blepharitis, and can be due to multiple causes. Infections in the eyelid often start as a chalazion, commonly referred to as a stye.

Blepharitis

Blepharitis is a common condition involving chronic inflammation of the edges of the eyelids. It can cause irritation, mattering, itching, red eyelids, and dry eyes. It has several causes that vary between individuals:

Cross section of a healthy lower lid Meibomian Gland, with normal meibum flow (represented in yellow) onto the corneal surface. © Rhein Medical, Inc.
  • Meibomian gland dysfunction (MGD), or plugging up of the eyelid meibomian glands. The meibomian glands open on the edge of each eyelid through about 30 orifices (pores). They secrete meibum, which is an oily fluid that coats and lubricates the eye.
  • Buildup of meibomian gland secretions resulting in mattering and flaking.
  • Inflamed blood vessels on eyelids, often caused by ocular rosacea, a skin condition that can affect other areas of the face.
  • Possible low-grade infection from bacteria or microscopic parasites on eyelids.

Treatment of Blepharitis

  1. Warm Compresses: helps unclog the meibomian gland pores
    • Take a soft, clean washcloth and soak in warm water. Drape washcloth over both eyes for at least 5 minutes. Re-warm the washcloth with additional warm water if needed, taking care not to burn the skin
    • The above can be peformed with commercially available gel-packs and other reusable, reheatable packs placed over the eyes
    • Perform 2–3 times per day
  2. Lid Hygiene: reduces buildup of secretions on eyelids.
    • Wrap your finger in a clean washcloth, put a few drops of "No Tears" baby shampoo (e.g., Johnson's Baby Shampoo) on the washcloth. With eyes closed, gently brush the eyelids (where the eyelashes come out) for several seconds to a minute total for both eyes.
    • Above lid hygiene can be done with commercially available, over-the-counter prepackaged lid scrubs (eg, Ocusoft).
    • Perform 2–3 times per day
  3. Medical therapy: eye drops, ointments, and/or medications by mouth can help this condition.
  4. Probe penetrating a blocked swollen Meibomian Gland. © Rhein Medical, Inc.
  5. Meibomian gland probing: a simple, well-tolerated office procedure can significantly help those suffering from chronic blepharitis and eyelid irritations, as well as certain types of dry eye syndrome. A small probe is inserted individually into the glands of some or all of the eyelids, thereby opening up the obstructed pores and allowing the secretions to flow properly, thus improving patient symptoms. Download a patient brochure on this procedure.

Chalazion (or Stye)

The word ‘chalazion’ is derived from the Greek language, in which it means 'small lump'. A chalazion occurs when an eyelid gland, called Meibomian gland, becomes plugged up and subsequently becomes inflamed and swollen. The Meibomian glands are small oil producing glands found in the upper and lower eyelids. When the oily secretions become trapped in the gland, an inflammatory reaction can occur. Bacteria that normally live on the skin and eyelid can also become trapped inside the gland and cause a localized infection. When this occurs, there can be increased redness, swelling, and discomfort. Occasionally the entire eyelid can become swollen if the inflammation or infection spreads beyond a single gland.

When a chalazion is small, it may resolve on its own. If large, however, it may need to be treated.

Chalazia can be treated with any or a combination of the following methods:

  1. Warm compresses and eyelid pressure
    Warm compresses can be applied in a variety of ways. The simplest way is to hold a clean washcloth, soaked in hot water, against the closed lid. Do this for five to ten minutes, three or four times a day. Repeatedly soak the washcloth in hot water to maintain adequate heat. After applying the warm compress, gently press directly on the chalazion with one or two fingers and attempt to express the secretions from within it. The majority of chalazia will disappear within a week.
  2. Medications
    Steroid and/or antibiotic drops or ointments can be used for eye comfort while waiting for the chalazion to improve either on its own, or with the above treatment.
  3. Surgical incision or excision
    Large chalazia which do not respond to other treatments can be surgically opened. This is a quick procedure that is easily done in the doctor's examination room.

Chalazia usually respond well to treatment, although some people are prone to recurrences and may require continuing medication.