Eyelid problems – get the right treatment

Your eyelid is a thin, movable layer of skin that covers and protects your eyes and helps to keep your eye surface lubricated.

Your eyelids can be affected by different types of conditions, although most are not usually serious. Problems such as lumps, flaky or sticky eyelids, and swelling are common, and most can often be treated with help from your pharmacy.

However, there are some cases when you should see your doctor or optician, such as pain or loss of vision. A pharmacist can help with minor eye problems.

When to get urgent help

Go to your nearest treatment center if you have any of the following:

• your eyelid is suddenly drooping
• a swollen eyelid that’s red, hot, and painful – it may feel tender or have blisters
• problems opening your eye or keeping it open
• pain in your eye itself – not in your eyelid
• changes to your vision – such as blurriness or seeing wavy flashing lights, zigzags or coloured spots
• loss of vision
• you have eye symptoms as well as a headache and you are nauseous (feel sick) or vomiting (are being sick)
• redness in the white part of your eye
• you have light sensitivity (photophobia)
• you have a fever (high temperature) or feel hot and shivery, or not very well
• you think your symptoms are due to an allergic reaction.

See your doctor if you’re worried about an eyelid problem, the symptoms aren’t getting any better or seem to be lasting a while, or you have yellow lumps or patches around your eyes.

Types of eyelid problems and treatments

Here are some of the types of symptoms caused by eyelid problems – some can be common in a few different conditions.

Don’t self-diagnose – a pharmacist, doctor or optician (eye doctor) can help you pinpoint the cause.

Blepharitis

What are the symptoms? Flaky or crusty skin where your eyelid and eyelashes meet; sore eyelids; eyelid swelling; itching eyes and eyelids; redness of your eyelids and eyes; sticky eyelids, especially first thing in the morning; a feeling of grittiness in your eye. More common in people who have skin conditions like acne or eczema.

Treatment: You can usually treat blepharitis with at-home measures, including:

• cleaning your eyes twice a day with cotton wool or a washcloth soaked in warm water and gently massaging your eyelids
• eyedrops (ask your pharmacist for advice on which products to use)
• not wearing eye make-up or contact lenses while you have blepharitis symptoms.

If your blepharitis doesn’t clear up with these methods, your doctor may prescribe antibiotic or anti-inflammatory eyedrops, creams, or tablets to help.

Stye

What are the symptoms? A painful, red lump on your upper or lower eyelid; swelling of your eyelid; painful eyelid. A stye is often caused by bacteria.

Treatment: You can often care for a stye with at-home treatments, such as:

• holding a warm compress against your eye for 10 minutes, several times a day
• keeping your eyelids clean and wiping away any discharge
• not wearing eye make-up or contact lenses while you have a stye
• not touching or rubbing your stye
• not trying to burst or pop the stye yourself.

If your stye does not clear up, your doctor may use a sterilized needle to burst it and remove the pus from inside, prescribe antibiotics to reduce infection, or remove the eyelash closest to your stye to help the stye drain.

Cyst (chalazion)

What are the symptoms? A red bump on your eyelid; eye watering; blurred vision; swollen eyelid; happens when the eyelid’s oil glands get blocked.

Treatment: An eyelid cyst will often go away on its own after a few weeks. At-home measures can help ease symptoms and encourage healing, such as:

• holding a warm compress against your cyst for 10-15 minutes, several times a day
• gently massaging your upper eyelid with a clean finger
• keeping your eyelids and cyst clean.

If your cyst does not resolve by itself, your doctor may make a small cut in your cyst to drain it or offer a steroid injection to lower inflammation.

Conjunctivitis (pink eye)

What are the symptoms? Discharge around your eyelids and eyelashes; eyes feeling gritty or burning; itchy eyelids and eyes; watery eyes; redness of your eyes and eyelids; difficulty opening your eyelids first thing in the morning; being sensitive to light; blurry vision. Can be caused by bacteria, a virus or an allergy.

Treatment: A bout of conjunctivitis will often get better without treatment within a couple of weeks. However, you can take a few self-care approaches to help ease symptoms in the meantime, such as:

• washing your eyelids with a washcloth or cotton pad soaked in warm water (use separate cloths or pads for each eye if both are affected)
• avoiding wearing eye make-up or contact lenses until your conjunctivitis has gone
• using OTC eyedrops or antihistamines (speak to your pharmacist for product advice)
• washing your hands after touching your eyes.

If at-home treatments don’t help, your doctor may prescribe antibiotics or antiviral medications to help clear it up, depending on the cause of your conjunctivitis.

Eyelid dermatitis

What are the symptoms? Stinging eyelids; itching eyelids; swollen eyelids; flaky eyelid skin; itchy eyelids and eyes; painful eyelids and eyes; rash or blisters on or around your eyelids.

Treatment: See your doctor. Depending on the cause of your eyelid dermatitis, your doctor may prescribe or recommend treatments, such as:

• oral or topical corticosteroids
• emollient washes
• topical calcineurin inhibitors.

You should also avoid wearing eye make-up while you have dermatitis symptoms on your eyelids.

Drooping eyelid (ptosis)

What are the symptoms? Sagging/drooping of the upper eyelid; trouble keeping your eyelids open; watery eyes; eyes feeling tired and achy; reduced vision. Usually develops when the muscle that lifts the upper lid isn’t working, often due to a stretched tendon, and is more common as you age.

Treatment: If your drooping eyelid is causing vision impairment, your doctor may recommend surgery to shorten the tendons or muscles that lift your eyelid, to correct the problem.

In some cases, using prescription eyedrops designed to aid the muscle that lifts your eyelid can help.

Xanthelasma

What are the symptoms? Small yellow patches of skin on and around your eyelids.
Xanthelasma is often caused by high cholesterol.

Treatment: To help prevent the condition from returning, your doctor will usually recommend cholesterol-lowering lifestyle measures, such as getting regular exercise, eating a healthy diet low in saturated fats, and quitting smoking.

You should never try to pick off or squeeze the yellow bumps that develop with xanthelasma. To help get rid of these patches, your doctor will likely recommend a treatment such as:

• cryotherapy
• laser surgery
• laser-based therapies (such as radiofrequency ablation, diode lasers, and laser ablation)
• chemical peels.

You will usually need several rounds of treatment to entirely get rid of your xanthelasma patches.

Ectropion and entropion

What are the symptoms? Lower eyelid turning outwards (ectropion) or inwards (entropion); feeling of discomfort or pain in your eyes; eyes feeling dry; a gritty feeling in your eyes; sore eyes; red eyes; excessive eye watering; light sensitivity.

Treatment: Treatments can help your ectropion or entropion symptoms, but these are short-term fixes, including:

• wearing soft contact lenses to protect your cornea (outer layer of the eye)
• botox injections or temporary stitches to help correct your eyelid position
• wearing transparent skin tape to hold your eyelid in the correct place
• artificial teardrops
• ointments.

The main treatment for helping ectropion and entropion in the long-term is surgery to correctly position your eyelids.

Blepharospasm

What are the symptoms? Twitching eyelids; increased blinking; involuntary blinking; sore and painful eyes; dry eyes; light sensitivity; watery eyes; a gritty or burning feeling in your eyes. The cause is not known but the condition tends to affect people over age 50.

Treatment: Although blepharospasm symptoms can be treated and managed, there’s currently no cure to get rid of the condition entirely.

Treatment approaches for blepharospasm generally include:

• botox injections into the muscles around your eyes
• stress management
• using moisturizing drops
• wearing tinted lenses to help reduce sensitivity to light
• surgery.

Can you prevent them?

It’s not always possible to prevent eyelid problems. However, taking certain steps can help reduce your risk of some eyelid-related conditions. You could try:

• keeping your face clean
• using a tissue, rather than your hands, to rub your eye if it’s itchy
• removing eye make-up before you go to bed
• using artificial tear drops to help prevent dry eyes (speak to your optician for advice before doing so)
• not sharing cosmetics or washcloths
• taking steps to manage allergies and avoiding triggers
• using eye products designed for sensitive skin
• washing your hands before putting in or removing your contact lenses
• throwing away expired (out-of-date) eye make-up.