Unilateral Eye Irritation and Scaly Eyelid

[MSAK]

I am a 27 year old female and last fall, I suddenly developed
a chronic inflammation of my left eye and small bumps on my eyelids.
The doctors ruled it out as molluscum and told me to stop wearing
contact lenses (which I did).  I was given antibiotic drops to
help clear up my eye.  They did not work.  
  
Subsequently, I developed thick scaly skin on the eyelid.  The
bumps stopped multiplying and some of them resolved as a result of my squeezing out the hard white centers.  I was given a steroid cream and Elidol but those did not help either.  

I have been extremely frustrated by this persistant inflammation
of the eye and the scaly skin.  When I wake up every morning, my
left eye is inflammed, red and crusty.  I'm thankful that the
most of the bumps have resolved but my doctors are just as perplexed as I am.

I have also been given oral antibiotics and antihistamines.  

My left eye is always sensitive and the eyelid is now drooping.  My life has completely been changed by this eye problem and I've been so upset about it that I've even thought about ending my own life.  I live in New York City and I've seen about seven different (reputable) doctors.  

Does anyone know what might be going on?  Could this be a manifestation of lupus?

Thank you.  

[Alan Rockoff, MD]

There are several aspects of your presentation that leave me very perplexed:
1.  The fact that this problem is on one eyelid.  Most rashes (eczema, seborrhea) appear on both sides.  Is it possible that you might be aggravating this by rubbing the skin?  If so, you need to stop, or else no treatment will help.
2.  Molluscum refers to warts.  I'm not sure why these were even considered.
3.  Your statement that, 'I've even thought about ending my own life' is extremely alarming.  Over an eye rash?  Please get another dermatologic opinion, by all means--New York City has plenty of eminent doctors and prestigious medical centers.  But please also look into the psychological support you obviously need, and do this at once.

Dr. Rockoff

[soupsup]

Should you not be seeing a good opthalmologist about these problems - or is that what you meant about seeing "doctors" (you meant opthalmologist doctors)?

It sounds like you have severe conjunctivitus, probably coupled with blepharitis. These are both things you should look up on wikipedia.org to familiarise yourself with them.
I too have had my life severely impaired by the inability to wear contact lenses, because of contact lens intolerance, severe dry eye, conjunctivitus and blepharitis. I am overly conscious of wearing my glasses so I just have almost no social life whatsoever now - when before I used to do acting and had a very active social life - I now stay at home all the time - and I'm 20!

Anyways, it must be said that I think a dermatologist's feedback could be very useful - I need to get some feedback from a Dermatologist too (they might be able to give me feedback on blepharitis). I went on Roaccutane about 4 years ago and I completely blame that for all my problems - I have dry nasal passages, dry blemished skin, and dry eyes. I have been to numerous optometrists and opthalmologists and they have all been next to useless.
It was I who came across blepharitis and said "Hey, this is what I have!" - whereas all the opthalmologists only picked up conjunctivitis. So I had it diagnosed properly by another opthalmologist.

Anyways my point is you badly need to see a good opthalmologist, and as hard as it is you need to try find one that "specializes" in blepharitis or specializes in conjunctivitis - because apparently they do exist!

As you may be aware conjunctivitis is inflamation (inflammation) of the eyelids and can be caused by virus, chemicals/toxic/allergic, or bacteria. In your case the contact lenses rubbing against your eyelids probably inflames and aggravates it, plus any chemicals in your contact lens solution you may have been allergic to.
So it is absolutely essential that you do not wear contact lenses for a long time, at the very best case 6 months, but more likely over a year if not for a few - you may never be able to wear lenses again.
Next you should find out if you have blapharitis, because if the oil ducts in your eyelid margin become blocked this can mess up the tear stability of your eye resulting in dry eye - and of course it can cause a bacterial infection of the eye - and this can cause problems for the healing of your eye.

Whatever you use with your eye from now on must preferably be preservative-free (and once your conditions have stabilised you should consider using nothing at all) - and you must stop wearing makeup on your eyes, if you use makeup.

Finally, a good optometrist or opthalmologist might have recommended you do a "lid scrub" at least once a day - this is not so much like *scrubbing* but more like wiping. One method is to use baby shampoo with a bit of water on a cotton pad and gently wipe this on the eyelid - but please seek medical advice on this first. (There are pads you can buy for this purpose, and even just putting a comfortably hot wet towl and holding it on your eyes help unclog your oil ducts if you have blepharitis, and may be helpful in assisting healing of the conjunctivitis - but please seek medical advice on this).

I'd like to add that I sympathise, I think I can relate to your problem, good luck and I hope you come right! Hang in there!
Once your eyes heal and don't have any major problems you should look at corrective laser surgery, I would but my eyesight hasn't stabilised.

[soupsup]

Having already posted a long comment, I must say I'm not actually sure whether your problem is on the outside of your eyelid, or on the inside (posterior or anterior).
Indeed if it is on the outside of the eyelid then a dematologist sounds like the right person to ask - but if the whole eye is drooping like you say then you should definitely see an opthalmologist!

Good luck!

[MSAK]

Hi everyone,

Thank you for the comments.  I actually have seen multiple dermatologists and opthalmologists.  None of these doctors could offer much help.

I have this horrible fear that I have lupus...I saw some articles about unilateral eye irritation as the only evidence of systemic lupus.  I know about the dangers of self-diagnosis but I feel so frustrated by my doctors' lack of answers and help.

One last question:  I stopped wearing contact lenses a while ago and I am not sure how long it takes for the condition to stabilize?  I am assuming your eye does not go back to normal immediately...

I think my lid is drooping because the lid is thickened from all the dry skin, etc.  My eye is especially red after sleeping.

This has been so distressing that I've even considered taking my own life at times.

Thanks for your help again and I welcome any and all feedback,
MSAK

New York City

[Alan Rockoff, MD]

Lupus is not even an outside possibility.  Neither are preservatives (or else why would it affect just one eye?)

I repeat my recommendations, with emphasis.

Dr. Rockoff

[MSAK]

Hi,

I just wanted to touch base and let you know what happened.  

Only my left eye is stil irritated but the excessive dry skin on top of the lid has resolved a little due to the Blephamide cream.  (At the same visit, I was told my cornea has been irritated for the last two months.)  

I am beginning to lose lashes on my left eye however and am unsure as to what this is happening.

Basically, my condition is mysterious to my doctors and I wanted to post this in case anyone else has ever experienced similar issues.  I don't know what will happen but I hope it will get better.

Thanks,
MSAK
New York City

[MSAK]

I know it may seem crazy but I did find these studies relating lupus to a unilateral inflammation.  

Discoid Lupus Erythematosus Presenting as Unilateral Blepharitis.


discoid lupus erythematosus whose symptomatology included possible a symmetric posterior blepharitis.[17] Each had a long history of unilateral eyelid inflammation, pruritus, watery discharge, and loss of lashes. Asymmetric lash loss indicates potential sebaceous cell carcinoma.[18] Thus, the authors initiated a more intensive investigation, which revealed lupus.

[Rik47]

A related discussion, Eyelid irritation was started.