Dry, Gritty Eyes do you have Blepharitis and uncomfortable red eye lids

Blepharitis, we can see you under our MECS scheme for this condition

Eye discomfort is often related to the health of your eye lids:

Sore, itchy gritty eye lids (Blepharitis) and dry eye grittiness are frequently linked. The edges of your eye lids contain tear glands which contribute to the tear film on your eyes. If the tear film is poor your eyes will feel dry and or gritty. The crusty deposits on your lids can fall into your eyes, causing grittiness blurred vision and discomfort. These deposits are often caused by small mites – Demodex and / or bacterial infections, sometimes a combination of the two. Styes are eye lid infections and can be related to eye mites. Blepharitis can last for a long time, sometimes for years. We provide experienced Optometric care and can advise you blepharitis can be treated and the symptoms can be greatly reduced within months. This service is provided and paid for under MECS, MECS is an enhanced Optometric service in Essex, provided by Primary eycare Ltd.

Demodex is one of the many parasites that live on our bodies, here is a link to a BBC podcast on Parasitism.

Dry eye is a long term condition that can affect not only your eye comfort and eye sight but also your quality of life. Advise for dry eye is coverd by MECS. See this recent study done at the University of Southampton.

Heat masks, (see further down), can be very helpful, but to do not help with blepharitis.

Inflamed or Crusty Eyes

Inflamed or crusty eye lids can be cleared up with good lid hygiene using a cotton bud and some warm water. Baby shampoo is sometimes suggested to clean the edges of the lids. This will clean the lids as far as the crusty deposits are concerned. However this removes the oily layer of your tear film too and thus contributes to dryer eyes and blurry vision again. Furthermore it does not address the reason for the crusty deposits.

The most frequent cause of crusty lids, especially in older patients is demodex mites, followed by a minor bacterial infection in the rims of the lids.

A solution of 2.5% Tea Tree oil will kill the eye mites that frequently live in both the roots of eyelashes and inside the oil secreting meibomian glands of your eyelids. Please don’t make this solution up yourself as Tea Tree oil is very irritant to the cornea of your eye, use Oust Demodex cleanser, available at out practices and on line. Blephaclean is another product available for blepharitis. We have tried this product, however it does not work as well as Oust which can be massaged into the roots of the lashes.

I occasionally have to remove the initial deposits from eye mites for clients with a soft cotton bud whilst shielding the eye with a soft disposable contact lens using eye numbing drops. Occasionally topical antibiotics in the form of an ointment are used for bacterial infected eyelid margins. The use of BlephEx is not recommended by us, it is basically a small power tool to remove the deposits, the power tool does not remove the cause of the eye mites. Make sure your eye lid problem is properly diagnosed, this is covered under MECS and paid for by the NHS. You may have a bacterial lid infection and no eye mites at all, which would need a different course of treatment.

How to greatly reduce Demodex eye mites which contribute to dry eye, lid infections and gritty eyes.

How to treat Demodex:

oust demodex blepharitis

We advise you to use Oust to reduce the deposits and increase the lubrication to your eyes: 

Wash your eye lids, then rub Oust into the roots of the eye lashes whilst your eyes are closed, morning and evening,do not rinse off.  You may notice minor skin irritation, in which case rinse the Oust off after each use. The longer you keep it on your lids, especially overnight, the better it will work.

 If you have persistent discomfort, stop using the Oust and consult me immediately. Continue this for two months, am and pm, leave on, after this period use the oust cleaner pm  only 2x a week long term. 

Pillow cases should be washed and dried at a high temperature as this kills the mites. Demodex is more prevalent in older people with poor immune systems. 

The average incidence of Demodex in patients with rosacea (skin condition that affects the face) was found by to be much higher, up to 100x, than in patients without rosacea. Some patients have noticed a significant reduction in rosacea by rubbing the affected skin with Oust.

 Oust Demodex cleanser, contains tea tree oil, the only substance that kills demodex mites and thus significantly reduces demodex  blepharitis. Oust can be bought from us in the practice or on-line, Amazon or a pharmacist web site.

Rosacea

This skin condition is frequently linked with Demodex, and we have had excellent results using Tea Tree oil in reducing the symptoms of rosacea on the face. You may want to try shampoo and or conditioner with Tea Tree oil for facial or scalp dermatitis, some clients have found this beneficial.

Tear Supplements

Some patients suffer from Sjogren’s syndrome, in this case there is not enough fluid on the eye and copious amounts of extra fluid is needed to prevent blurry vision and grittiness in the eyes. This is a rare condition.

Most patients with dry gritty eyes have deposits on the edge of the eye lids and possibly a reduced volume of tears as well. Using our eye microscope we can diagnose crusty lids and or poor tear coverage. Advise on tear suplements, both drops and gells is provided and paid for by MECS.

If you are lacking in tear fluid only you can use tear supplements such as Carbomer Eye Gel tear supplement or Hycosan Plus. A runny solution is used during the day and an eye gel tear supplement is used overnight. The problem with all the tear supplements is that they run out of your eyes, so some patients choose to have plugs for dry eye fitted. 

Punctum Plugs

For dry eyes, both lacking quality and quantity you can have punctum plugs fitted. These reduce or even block the flow of tears out of the eye. This causes the natural tears to stay on the front of your eye and help with maintaining lubrication.

The fitting of these is not painful. Semi permanent plugs last about three months and need to be replaced as needed.

Styes Hordeolums and Warm Eye masks

Your eye lids contain meibomian glands which contribute to the lubrication of your eyes. They may become blocked and infected over times, reducing the lubrication to your eyes. Infected meibomian glands are the main cause of bumps on your eye lids which are calles styes or hordeolums.

heat masks are unlikely to help with blepharitis, see Demodex above

Why you may benefit from a heat mask

An educational video explaining the conditions/symptoms of MGD, Blepharitis and Dry Eye

Warm Eye masks & essential lid massage after warming

Your eye lids contain meibomian glands which contribute to the lubrication of your eyes. They may become blocked over time, reducing the lubrication to your eyes. You can purchase eye masks online.

Further down this page is a video showing how to massage your eyelids after you have used an eye warming mask. Once your lids are warm the solidified wax in the gland openings has become liquid.

You could also use a warming mask like this which will stay warmer for longer, these are available on-line from Amazon or other providers.

After warming your eyelids you need to massage the edges of your eyelids to express the oily substance which is part of the tear lubrication. Without massage, after warming the lids, there is little benefit in using the warming mask, go to 4 mins into the video for direct viewing of how to massage your eyelids.

Symptoms
How We Diagnose Dry Eye

We use light blue and green dye to diagnose Dry Eye

Gritty dry Eye discomfort
Crusty Lids Diagnose

Using our eye microscope we can diagnose crusty lids and or poor tear coverage

eye lid with gritty demodex mite deposits blepharitis
Punctal Plugs

With punctal plugs, tears stay on the front of your eye and help with lubrication

location of punctum plugs used in the treatment of dry eye

When To See Simon Kleyn Optician - Optometrist

Make an appointment for an eye test / examination if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, call us straight away. 

Speak To Simon Kleyn Today

Speak to Simon Kleyn Optician – Optometrist to find out how we can help you find the best solution to your eye problems.

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