How come only the very edge of my upper lid is inflammed?

[Arcaeon]

Hey all


I think I know what causes my dry eye, it is my upper eyelid inflammation, however the weird thing is it is only the very edge of my eyelid just before the margin that is always inflammed. See in this picture the upper eyelid :

http://img177.imageshack.us/img177/9971/19034932hj3.jpg

My opthomologist said it is allergic conjunctivitis however I dont get itching, discharge , watering anything like that and never have.

I am trying some antihistamines at the moment and its quite hard to say if they are working, its been two months but might have to give them some more time... Im slightly dubious about the allergies thing though. Anyone here got similar type of inflammation ?? I just dont understand what could possibly be causing my eyelid to be inflammed on the edges like it is .... any ideas?

[acarol]

My upper eye lids are like this too. Don't have allergies (that i know of anyway). I was diagonised with MGD and have dry eyes too. Don't know why my upper eye lids are red looking though

[jlg_uk]

Same thing here.

It's no longer really possible for me to have pics linked here on the board, but am happy to share them with you if you didn't see them.

I consider my margins to look reasonably normal (not deep red or anything), but I have redness both inside my eye lids (particularly the edges) and also pinkness the other side of my lashes away from the eye (similar to you).

I've looked back through photos over the years and seemed to have at least had the outward signs of this years before getting DES problems, but I feel it is likely related. I'm currently leaning towards a dermatological cause of my DES, as my skin is fair and sensitive and this seems to tie into what I can see.

[jlg_uk]

Also just to say the whites of my eyes are pretty white like yours. Are you fair skinned, prone to surnburn etc?

100th post!

[Arcaeon]

I read your post jlg_uk and I am eerily similar to you in terms of symptoms, I even got misdiagnosed as having migraines as well (?!?!) a couple of years ago when I first started getting the problems. I get the halos around lights at night now as well. Like you I think I have MGD causing unstable tear film, but I am just clueless as to why I am getting inflammation, I mean I am only 23 years old, why would my upper eyelids be inflammed like this?? Is it blepharitis?? I don't know cos I dont get the crusting like the photos on Google, and I dont get discharge or stringy stuff.

I think that's why my opthom said it was allergies - he just literally couldn't think of anything else it could be. Do you have any allergies jlg_uk, like dustmites, pollen or anything?? I know I am allergic to dustmites pretty heavily but dont get itching or anything so maybe its like an 'alternative' allergic response.

I am pretty fair skinned as well yeah, and prone to sunburn.. and have always had sensitive skin. Maybe you are on the right track with the skin problem? I might schedule a visit with a dermatologist although I don't want to embarrass myself by giving him a problem that isn't in his field. The only other thing I am thinking is that it is some kind of thyroid disorder, like hypothyroidism or something... causing this inflammation. I might get tested for that.

[jlg_uk]

Hi Arcaeon

It's hard to know what the cause of the inflammation is - and even knowing what causes what problem (inflammation > MGD > DES or MGD > DES > inflammation etc). At the current moment, I think it's possible I have rosacea that is causing a change to the meibum which is then going on to cause all the other problems from unstable tear film to inflammation to halos, light sensitivity etc. Ask me next month though and I might think something different.

Unlike some others here (especially those unfortunate enough to be LASIK victims), I'm still in the diagnosis phase like you, and really want to at least understand what specifically is going wrong. If the best treatment turns out to be lid hygiene/compresses etc that sucks but at least I know I'm not suffering whilst missing out on a better treatment.

In terms of rosacea, my face isn't hugely red, and I don't blush or flush particularly, but my skin is fair and is far from perfect. I'm a 32 year guy, so haven't paid huge attention previously (though I did have acne as a teenager) - but it's often a bit dry as is my scalp. It's on this basis that I'm thinking my skin maybe the root cause here. Lids = where dermatology and ophthalmology meet of course.

You probably don't have anterior blepharitis (I am not a Doctor) with crusting etc - nor do I. Posterior bleph is the other side of the lids though, and that's something I think I have (and perhaps you do).

Allergy is possible, and I've read on this board it doesn't have to involve itching. I don't think mine is allergy, although I can't rule that out for sure. I do get hayfever, so I know what itchy eyes are like and this isn't it! However, allergy is a complex business and I have tried doing things like avoiding dairy, changing washing power to non-bio, and freezing then washing pillows to kill dust mites etc. Not much success though.

I'd be interested to know anything you find or rule out if you're happy to share - I know acarol would be too. If you're taking more pictures anytime soon, it might also be good to take a pic of your closed lids (without makeup). I try and take pics sometimes both for others to see/compare but also so I can monitor over time any changes.

This whole thing sucks doesn't it. I remind myself that there are people out there with cancer, going blind, seriously ill children etc and compared to that I shouldn't complain, but there's no denying this is really driven down the quality of life I have and made me uncertain about my future employability in IT.

[Plat]

Mine are the same, even redder in the upper.

Has anyone tried any Anti-fungal drops? I am starting think it may be fungal rather than bacterial.

I had a past experience with a skin rash and 10 doctors kept giving me cortisteriods and anti-bacterials. After one year, the next doctor told me to get Canesten OTC cream. Went away in 3-5 days, after one year. Also, the symptoms did not exhibit your normal fungal infection. So could this be the same?

[sazy123]

Yep youve basically got the same upper eyelid margin inflammation as me. But ive got really bad lower (inner eyelid) inflammation with some swelling in the corner of one eye. Upper lids arent too bad. I was told it was allergies for ages, which i dont believe it is after 3 tests, and every allergy eyedrop- doing nothing. So the other explanation for me anyway was ocular rosacea which is causing prostier bleperitis (MGD). Your tear film doesn't look as bad as mine- is your lower lids inflammed? My lowers are really badly inflammed- i dont think much oil gets through there, expect when im ill and the inflammation goes away that is. Do you wear contacts?

Its really annoying coz there seems to be nothing that will treat this inner eyelid inflammation- im 90% sure thats what i need!

havent tried azasite yet, but expect i will get the smae result as everything else.

im also 23 and fair skinned.

[Stanza]

have same upper lid problem, lower lids look red but do not irritate in the same way but I also have itching and other DES symptoms but the eyelid thing is a major problem as it is difficult for me to tell when it's the lids and when it's the lack of tears that's causing me problems, adding artificial tears for the former is not going to help sort of thing...

I'm also fair skinned! Skin isn't perfect but not very bad either though.

[sazy123]

Seems to be a patern here. Fair skinned, inflammed inner eyelids (margins), MGD. Imo its ocular rosacea related.

Seems obvious to me that we need something that will treat inner eye lid inflammation- like restasis treats eye surface inflammation. As i believe that causes the MGD not the other way round. Ive tried everything for this inflammation- but nothing works. But researchers havent cottoned on to this, coz diagnosis is usually blamed on allergies! so frustrating.

Progesterone cream is on the right track but that doesnt treat inner eyelid inflammation, only outer and inflammation in the MG's them selves i think.

[Ineedatrashcan]

I seem to have the same issue. My upper and lower eyelids are red, sometimes completely red. No solutions yet....