15+ Yrs. of red swollen eyelids

I’m 25 yrs. old and have been diagnosed with blepharitis since I was about 9 or 10. I eat healthy, exercise, and am not allergic to anything I am aware of. I do get dandruff sometimes but it’s controlled with a dandruff shampoo. My eyelids are constantly red and puffy. There is no itching but my eyes do seem to become dry very easily. I’ve been told by every opth. I’ve visited that I need to cleanse my lid margins with baby shampoo or a store bought lid cleanser (I’ve been using OcuSoft pads). The last one also told me to do warm compresses and lid massages in addition to the lid scrubs.



I was prescribed some ointment (tobradex) and some drops (can’t remember the name). At first the lid massages seemed to work, coupled with the drops. But after discontinuing the drops, everything went back to red. I also started to get severe eye aches/headaches from what I believe was the lid massages.



As of now I have stopped the warm compresses and lid massages and only use the OcuSoft pads at night before bed. I’m still puffy and somewhat red but this seems to be the best I can do.



I’ve read numerous forums on people experiencing the same or similar issues with their eyes/eyelids. Everyone seems to get diagnosed with the same thing, advised to do the same thing, and no one sees any real results.



I deal with people on a regular basis and this issue is a huge burden on my confidence. The entire time I’m talking to someone I feel like they are judging me because of my problem. I also work at a computer for the majority of my day (8-10) hours and wear prescription glasses for up close activities. My eyes get very tired and strained from this and it seems to enhance the lid redness.



I don’t want to see another doctor that’s going to tell me the same thing as the last 3-4 did. There has to be another solution. Is there surgery I can get to take care of this one and for all, or another method of maintenance that will give me some real results and make my eyelids normal?

[Ray T Oyakawa, MD]

Some cases of blepharitis are very difficult to treat.  You mentioned dandruff, so this may be a seborrheic  blepharitis.

This is a chronic condition that sometime is very difficult to treat.

Warm compresses before lid hygiene with pads ( most patients do do it correctly-our staff frequently has to teach the patient a few times), oral doxycycline or Oracea (slow release type of doxy).  Azasite rubbed into the lashes twice a day for two weeks after lid hygiene, a mild topical steroids, etc.  

You need to find an ophthalmologist who will listen to you and spend the time to get it
fixed.  I see many patients like this.

Dr. O.

[tlee3]

Is there surgery available to fix the problem? I've read some information about blephroplasty but that seems to remove excess eyelid skin. I don't think I have enough excess skin to remove....

Do you have any recommendations for opths in the Phoenix, AZ area?

[tlee3]

I also meant to ask how you recommend performing the lid massages. One of my problems is that the massages seem to give me an eye ache. Maybe I am pressing too hard.

[Ray T Oyakawa, MD]

Surgery will not help blepharitis.   You need to have some one from the doctor's office show you how to clean your lids.

Dr. O.

[tlee3]

Can you explain the correct procedure and technique so I can compare it with what I have been told to do?

Also, what about the fact that I am at a computer most of the day and tend to get really dry eyes? Is that because of the blepharitis or from the long hours at the pc? It seems to make my eyelids even more red though.

[Ray T Oyakawa, MD]

We have our patients fold a paper towel, moist it and heat it in a microwave.  Apply to lid and make sure it is not too hot.  You may have to do this a few time to soften the hardened oils and to open up your pores.  The scub the lashes with Ocusof.

Yes, dry eye from the lack of blinking while working on a computer can aggravate the problems.

Dr. O.

[tlee3]

Thanks Dr. Oyakawa,

I understand the pieces involved in the process, but you mentioned that I should go to my opth and have them show me HOW to properly clean my lids. Can you explain the proper way to do this? Otherwise I will not know if what they are telling me is accurate.

[tlee3]

Can you help here?

[Suehelp]

I have eyelid problem on and off for couple of months now.  Part of the upper eyelid get puffy after a night's sleep.  It is red and somewhat itchy and somewhat hard to open the eye(s).  When the swollen got down, the skin in the area would become flaky.  I do not have allergy and have not been using any eye makeup for a while.  I appreciate any advice or suggestion on remedies.  Thanks