Figuring out Inflamation

[jlg_uk]

Some time ago I released that a major (and perhaps the most important) factor in my DES was inflammation of my inner eye lids. I've already posted some pics on this board if you want to see.

My eyes are white, my face is normal colour as are my outer eyelids (well maybe a little purple near margins) and my margins are pink. But my inner eye lids aren't and are seriously red in places and I don't think they should be.

I'd like to reduce the inflammation, especially as of course this can interfere with the meibomian glands being able to express oil - which in terms make things worse.

It's hard to know whether I should be doing cold compresses to calm the inflammation, or warm/hot compresses to aid massage + expression (my MGs have previously found to be blocked).

What causes the inflammation? Occular rosacea, demodex, hyperosmolarity, allergy? I think if I could answer this I'd be further forward.

[eva b]

same here

hiya,

your symptoms seem almost identical to mine. Bright red insides of eyelids, and no-one seems to know why. I've eliminated all perfumes/chemicals - as far as possible - and use nothing at all in my eyes except, very occasionally, pres. free saline drops..but even they can cause inflammation.

My (very helpful and knowledgeable) optometrist has called it "allergic conjunctivitis" and says the only known treatement is...yes, you guessed it, antihistimaine eye drops which he doesn't even bother suggesting to me.

All I know is that every time the inflammation increases, so does the likelihood of glands blocking, and there have been several episodes of him having to express blocked ducts. Not pleasant - but a lot better than the alternative which is a full blown meibomian cyst.

He has told me, and it is my experience, that the greater the inflammation the more I should concentrate on compresses...which I do. Somtimes 4 times a day for 15 or 20 minutes.

The crusting is sometimes has to remove, and makes the eyelid skin painful. I sometimes feel really in between a rock and a hard place, as I bet you do.

I'll be interested to hear further news/views from you. I wish we could figure out what causes the inflammation, but so far I am baffled.

best,
Eva

[Stanza]

I've had exactly the same 'enlightenment' around the same time. I realized very recently that I sometimes have put in drops where the pain is really my eye lid inflamation but I'm at a loss on what else to do. My rims look good but under my eye lids on the inside,the edges and beyond are red (not the whole inside lid though). The pain is only on the top lids not the lower ones though. The lowers are red but don't really bother me.

The crusting is sometimes has to remove, and makes the eyelid skin painful. I sometimes feel really in between a rock and a hard place, as I bet you do.

This made me curious - I do feel like sometimes a layer comes off the inside lid and then I'm raw for days, and stuffing in drops because anything 'will do' that might help.

I don't get cysts, but I've had sties in the past where I pushed wearing contact lenses - before I realised I had DES, I was determined to wear them more than I did -which was random - but ended up with a sty on the middle of my lid that took forever to go, if I only wear the contacts randomly for special events, I seem to be ok.

I've been dousing my eyes in Dwelle before sleeping the last week, and really putting it in when I'm flat on my back so that when I blink it goes right under my top lids too and this has helped a bit - but I say that and tomorrow I might be back to 'raw' status again! That and I'm trying to recognize better when my pain is from the lack of tears versus the redness. I think I'm getting there.

I went off make-up and made no difference to me (make-up though will irritate if it lodges in my eye but is otherwise, ok) I've had a basic allergy test before for something else and it came up with nothing.

[clairvoyant]

How often do you do scrubs and are you on anything like doxy/mino or azasite?

[acarol]

I have this problem too. Its under my lower lids that seem to burn and sting a bit. Warm compresses help a bit but they make the skin around my eyes really red and irriated. I am on Minocycline two weeks now (do i see any difference - NO..)

[eva b]

Stanza

my problem sounds very similar to yours - upper eyelids are the most sore, (often feels like there is something stuck under there when there isn't) lower lids can be red but don't really hurt.

I've had the same experience as you - when rubbing with a Q tip trying to remove crusts it seems like a fine layer of "skin" rubs off...then pain for days. Perhaps I'm rubbing too hard, it's so difficult to know.

Unfortunately I can't use any eyedrops, or any chemicals of any kind at all - allergic to everything, which doesn;t help at all!

I've recently started a course of of acupuncture in desperation to see if it will make any difference

[jlg_uk]

Lots of response However, I don't know who is talking to who - so I might be giving information that isn't wanted :P

It's a shame I feel an overpowering need to figure out the problems I have myself - as opposed to medical professionals doing that for me. Ho hum - not perfect world I guess etc. I think that if I understand what underpins my problems I have a better chance at helping myself or gaining assistance.

Firstly, my left eye is worse than my right. It's hard to know how much really, because when my left eye hurts I start blinking more and seeking assistance from drops etc - this means most of the time my right eye is protected before it suffers much (well maybe not in extreme environments like cinemas). I have patched my left eye before (which provides some relief) - and then found my right hurts after a while.

I mention this really because if the inflammation is caused by an allergy - wouldn't both eyes be affected the same? I'm not saying that's true - but just something I don't understand if so. For me, my left inner eyelids are redder which I take is a result or cause of the worse environment in my left eye. I am trying to rule out allergies - but of course that's very hard to do - I'm doing things like changing my face wash, changing to non-bio washing power etc. Maybe I should try anti-allergy drops again (the first time I didn't do it properly, wasn't tuned into my eyes etc). They all seem to have BAK though which puts me off.

I do not have any crusting on either on the margins or the anterior of my lids. My margins look fine to me. I do have what I think are blood vessels in the tissue under my lower inner lids - but only in my left eye. I don't know what that means.

I am doing scrubs + compresses but I've been a bit lax for the past week or so - must get back into the routine.

I'm using drops, ibruprofen and doxy (50mg for around 3 weeks now). Still suffering though unfortunately.

upper eyelids are the most sore, (often feels like there is something stuck under there when there isn't) lower lids can be red but don't really hurt.

Exactly the same for me here. Also I'm light sensitive which gets worse and if things go on for too long, even aches and then forehead tension/headache. Fortunately now I listen to my eyes more I've managed to get rid of the headache side of things at least.

Dr L seemed to feel my lids may show signs of allergy or ocular rosacea (based on pics: http://www.dryeyezone.com/talk/showthread.php?t=6767 ). There's a limit of course to what can be diagnosed over the Internet - hopefully my ophthalmology appointment later this month will help (NHS - not feeling hopeful especial after a colleague told me a story of the same hospital missing a sight threatening issue with his wife a few weeks ago, they told her it was all in her mind and to come back in 5 weeks - fortunately she went somewhere else a few days after and got it sorted).

[Stanza]

my problem sounds very similar to yours - upper eyelids are the most sore, (often feels like there is something stuck under there when there isn't) lower lids can be red but don't really hurt.

I've had the same experience as you - when rubbing with a Q tip trying to remove crusts it seems like a fine layer of "skin" rubs off...then pain for days. Perhaps I'm rubbing too hard, it's so difficult to know.

Yeah we sound very similar Eve, sorry you can't use drops though, that must be really frustrating!

I don't see crusts as such, except sometimes in the morning after using Dwelle and I sort of lightly masage over my eyes with q-tips and then specifically wipe each rim. I use water as hot as I can stand (so not boiling, not cold). If i'm not too rough it seems to be better. I need to find a way to have more patience with compresses too.

Jlg - I know where you are coming from on the not seeing professionals, we shouldn't need to feel that way but have also had no luck with them. I'm pretty sure though that seeing someone that can prescribe medication - to try options there is a good way to go - so I hope your NHS appt turns out ok.

I also have one eye worse, I think the lack of tears attribute to that eye being worse though - which in turn doesn't help the red thing, so I think it is normal that there's imbalance. Dr L says in his book that most people have one eye worse than the other.

[jlg_uk]

eva b: what antihistamine eye drops do you use? are they OTC? do they contain BAK?

Also - you say that you margins get crusted? And is the redness of your upper inner lids uniform or any particular area?

Sorry for all the questions

[eva b]

jlg - don't worry about the questions, I'm happy to answer

I don't - can't - use any antihistamine drops. In fact I can't use ANY eye drops at all, even pres. free ones...I seem to be allergic to everything sin ce the initial shingles misdiagnosis and mistreatment. It's as if my eyes got to a point where they just can't take any more of anything being put in. All I can occasionally use (and even that sometimes irritates) is pres. free saline!

Upper eyelids seems to be uniformaly red/inflamed, as far as I can see. I don't actually turn them inside out! When they're like that, they also feel sore, as if I've been crying for hours.

Crust are only on upper lid margins, in between the eyelashes and around the eyelash follicles. I actually wonder what this crusting is - whether it's meibomian fluid or coming out of the follicles themselves.
#
I'm seeing the doc for some more expressing today, so will ask him and come back to tell you.

Honestly, I sometimes think that between us on this board we know more than most of the medical profession!

[kkahthesea]

Eva,
I have the same problem...I am sensitive to anything and everything and cannot use drops of any kind in my eyes. I have a lot of inflammation, particularly in my left eye. I have red, swollen lid margins.... ocular rosacea. I also have a patch of red eyelid dermatitis (I got from loose foam rubbing against my eyelid). This all flares up with heat (washcloths, shower), But the MG glands feel plugged and this causes my eye to burn and feel uncomfortably dry. I've never had a Dr. express them.....how is that done?....does it hurt? Is it safe for tender, sensitive lids? I never know whether to use warm washcloths or not...they say no for ocular rosacea (more redness and inflammation), yet my glands seem to do better with some heat (but I'm afraid to press too hard, they're so tender)........yikes!!! What to do???
I didn't have any of these problems until I had a severe reaction to a antibiotic eyedrop in January......and I've been really suffering ever since.
I'm so frustrated because I can't seem to make progress.
Karen

[eva b]

Kath

I think experessing the meibomian glands is safe if done by a professional who knows what they're doing. As my optometrist does. It is literally squeezing with the fingers right against the lid margins by the eyelashes (As far as I know...of course I can't actually see what's going on)

It's sometimes a little bit painful - but nothing I cann't cope with, and I'm certainly not the bravest person when it comes to pain!

I experience what you do...when the glands are blocked, the lids burn and feel irritatated, so it's got tothe point when I know that it needs doing, and they certainly feel better once it has been done.

The other important thing is that it stops chalazions forming - in one case he actually made one go away by expressing the blockage!!!

I can certainly recommend it if you can find a doc who is knowledgeable enough to do it. I believe Dr Latkany's clinic offers it as a routine service