Dry, Gritty Eyes do you have Blepharitis ?

Causes:

Sore, itchy eye lids (Blepharitis) and dry eyes 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 discomfort. These deposits are often caused by small mites – Demodex and / or bacterial infections, sometimes a combination of the two.

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

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, however this removes the oily layer of your tear film too and thus contributes to dryer eyes again.

A solution of 2.5% Tea Tree oil will kill the 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.

I occasionally have to remove the initial deposits 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.

Make sure your eye lid problem is properly diagnosed, this is covered under MECS and paid for by the NHS. 

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.

 

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. 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.

If you are lacking in tear fluid only you can use tear supplements such as Gel tears or Hycosan Plus. A runny solution is used during the day and a gel tear 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 fitted.

 

Punctum Plugs:

For dry eyes, both lacking quality and quantity you can have plugs fitted which reduce or even block the flow of tears out of the eye, so the tears stay on the front of your eye and help with lubrication.

The fitting of these is not painful. Semi permanent plugs cost £7.50 each & last about three months.

 

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. see this video for home treatment:

Heat masks, do not help with blepharitis, see Demodex above.

 

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.

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

You now 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 the lid massage: