Eyelid crusts spreading onto eyelid margin...not another new finding!

[HYPERHEAD]

Just did lid hygiene with my trusty 10x mirror and noticed that the white crusts or scales have migrated nearly halfway across onto the top of the lid margin just in front of the holes where the oil comes out and it basically looks like a white bumpy line ?

I noticed since stopping 2x a day baby shampoo and switching to cleaning lids every other day in the shower with occusoft I noticed the crusts have come back with a vengeance , I stopped the baby shampoo as it was making my lids red and my eyes dryer

Have the crusts appeared quickly due to the bacteria become more agressive due to stopping baby shampoo , also if you stop baby shampoo or other lid products can the bacteria become more resistant to treatment due to suddenly stopping ?


I don't know what to do now as I'm worried how fast These waxy crusts can grow and are spreading onto the upper lid margin ..could these crusts spread right onto the gland oil holes?

I have just started using blephasol and blephagel and maybe this will remove the crusts quickly..I currently have these products in my arsenal so what do you think I should use :

Sterilid lid Cleaner
Occusoft original
Baby shampoo
Listerine

The problem is I can't do much heat to soften these crusts due to inflammation of eyelids so would just applying the lid cleaners to cold lids still work in removing the crusts also should I apply the lid cleaner to the lid margin where the gland oil holes are ?

[HYPERHEAD]

Anyone

Just want to clear a few things:

I'm currently using blephasol to remove the waxy crusts with the aid of heat as blephasol contains chemicals that Apparently dissolve the hard secretions ,so far there is a slight reduction in the hard crusts ! Over time do you think the blephasol will
remove all the crusts ?

Can someone explain how the crusts develop and spread so quick, and are the just surface crusts or can they sink deeper into the skin and cause damage?

I did find baby shampoo quicker at removing crusts but it made my eyes bad after while, strange thing is I didn't getting severe burning eyes when I was using the baby shampoo just irritation and since using blephasol although it leaves my eyes feeling very cool and fresh I start to get burning and greasy eyes in the evening, is the burning oily feeling a sign of dryness and should I use drops when I start to to notice a the burning as I usually know when it's going start as my eyes feel oily first

Thanks so much

[Tanner]

Sorry I can't help. I have not experienced this.

[littlemermaid]

Hypes, Is your skin getting more sebaceous or do you think this is more like eczema? Do you have much oily hair or dandruff?

Are you sure you're not poking about too much still? Is steam not enough?

What do you think your main eye problems are - can you describe your day? I'm also wondering whether you're maintaining a good tear film with wraparounds and bland eyedrops.

Have you seen lists of hypersensitive eyedrops and advice on cleaning options http://www.dry-eyes.co.uk/? I am thinking rather than talk to the sales lady and end up buying random expensive stuff, for advice first you would need the optometrist, JS (Specsavers, Banbury) or his wife, the pharmacist, if you can't get this local. I have still not forgotten how you reacted to the chloramphenicol and maybe sensitivity to eg bases is part of the problem.

Do you think your sebaceous glands are over-reacting to products, if you haven't got some obvious worsening dermatology? Eg with this hypersensitivity rosacea we are finding if we don't lightly moisturise (did you find a helpful oil?) to 'help the skin barrier' as well as clean, the sebaceous glands go mad, infect, and the immune system over-reacts eg into spots and redness same day. I know this ain't you, but maybe see the similarities.

[PotatoCakes]

Have you tried warm compresses, followed by lid cleaning (a former doctor preferred using Qtips and saline over chemical products) and then follow all that with cold, green tea compresses? I rarely do compresses anymore since they don't do a lot for me but I found the green tea bags really helped with inflammation, whether it was caused by heat or something else (like tearless crying).

[HYPERHEAD]

I do find green tea bags so helpful when the eyes get heated

But It looks like I'm having a problem with overproduction of sebum on the lower lids, it's getting so crusty and waxy looking there so quickly..but I'm getting such good relief for redness swelling and grittiness since using blephasol and my eyes don't feel as dry and feel almost normal..hoorayyyyyyy! ..its an awesome product and makes them feel so soothed and fresh.

Is there any point in seeing a derma? I did the steam and it made my lids very red and crinkly but did provide great ocular lubrication..so i cant do it all the time but it was great

Should I treat it with listerine ?

[HYPERHEAD]

Oh yeh I do have greasy skin and hair..and get a lot of yellow flaky skin in my ears and eyebrows!

[Andrew]

optimal blepharitis treatment

I am a dry eye specialist in Hampshire in England. I also import and distribute dry eye products from the states and elsewhere to the UK.

It is important to remember that we need to do hot compresses to open the meibomian glands, soften the wax blocking them and expand the waxy sectretions so they rise to the gland orifice. The problem with this treatment is that it also dilates the conjunctival blood vessels, causing the release of inflammatory mediators, which makes the eye red and inflammed. After lid cleaning it is important to do a 30-60 sec cold colpress with an Eyes-Pack or similar.

When there is an infective blepharitis element to the dry eye we tend to recommend Sterilid foam as the cleaner between the hot and cold compress. If not then Bleparosol works very well especially with sensitive eyes

We recommend an omega 3 supplement, Usually Theratear Nutrition as it has an optimised balance of small omega 3 from flax oil and long Omega3 from fish oil in Gilbard's optimised ratio. It also is hyper-refined to eliminate all the plant hormones(pyto-oestrogens) from the flax oil and heavy metals etc from the fisah oil unlike other omega 3 supplements

Most of our patients also use theratears eye drops as they optimise goblet cell health and hence mucous secretion, the "glue" that holds the watery part of the tears in place.





QUOTE=HYPERHEAD;70832]Just did lid hygiene with my trusty 10x mirror and noticed that the white crusts or scales have migrated nearly halfway across onto the top of the lid margin just in front of the holes where the oil comes out and it basically looks like a white bumpy line ?

I noticed since stopping 2x a day baby shampoo and switching to cleaning lids every other day in the shower with occusoft I noticed the crusts have come back with a vengeance , I stopped the baby shampoo as it was making my lids red and my eyes dryer

Have the crusts appeared quickly due to the bacteria become more agressive due to stopping baby shampoo , also if you stop baby shampoo or other lid products can the bacteria become more resistant to treatment due to suddenly stopping ?


I don't know what to do now as I'm worried how fast These waxy crusts can grow and are spreading onto the upper lid margin ..could these crusts spread right onto the gland oil holes?

I have just started using blephasol and blephagel and maybe this will remove the crusts quickly..I currently have these products in my arsenal so what do you think I should use :

Sterilid lid Cleaner
Occusoft original
Baby shampoo
Listerine

The problem is I can't do much heat to soften these crusts due to inflammation of eyelids so would just applying the lid cleaners to cold lids still work in removing the crusts also should I apply the lid cleaner to the lid margin where the gland oil holes are ?[/QUOTE]

[HYPERHEAD]

My typical day is slight grittiness in the corners of my eyes and a greasy oil feel to the eyes and white waxy crustations dominating the lower margins and now losing eyelashes on both lower and upper lids .

[littlemermaid]

Have you had a look on http://emedicine.medscape.com/dermatology/articles for eg seborrheic dermatitis with blepharitis. This would give you a basis for a useful chat with a dermatologist if you can get a GP referral to get diagnosis whether it's that or eczema or one of those differential diagnoses, stressing how awful it is dealing with the eyes alone. Like us, it sounds like it's important that the derms understand that you have hypersensitivities/allergies in the eyes (see the bits about compromised skin barrier) so they help you look for gentle solutions.

It's not so good to do this on the internet because you need a dermatologist, but if it is seb derm it sounds pretty untreated. Are you ok with anti-dandruff (ie anti-fungal) shampoos? and eg taking multivits + minerals? (It's really interesting how Malassezia, yeast normal on the skin but feasting on sebum, releases pro-inflammatory fatty acids. Also there are other glands and sebaceous follicles around the eyes to be affected apart from meibomian.). It's finding a shampoo for your hair that is sensitive enough to keep you good with no eye damage; we're using Head & Shoulders sensitive, also Avalon tea tree (demodex?) but only maybe 1/2xwk, other days it's a hypersensitive honey shampoo from http://www.naturesgiftuk.co.uk/ and this is where we get our moisturisers. One pharmacist told me anti-fungal shampoo used normally on the hair fixed eyelashes falling out in a child (interestingly, there were no other eye or skin symptoms, PubMed 'tinea eye'). The danger for us is making the eyes worse.

Tell the GP the eyes are bad and you need a derm for diagnosis.

Also I'm so sorry you can't get follow-up with the optometrist SW on the NHS - is there no way round this? can you talk to the GP about this? If you had glaucoma rather than anterior segment inflammation you would be monitored frequently in the NHS and this makes me furious.

We are supposed to re-present at A&E or emergency Eye Clinic in flareup, I understand. If you've had a consultation in an NHS eye department in the past and have medical records there (give them hospital number and name of consultant) you can see them again by phoning eg the triage nurse, or just phoning reception and asking what their system is.