Dr Hagan: Possible Blepharitis

[PedroPrado]

Dr Hagan, 50 days ago i developed a small bump in my right superior eyelid. Painless and very firm. Almost 100% sure that its a chalazion.

3 weeks later, right next to this possible chalazion, my eyelid became red, itchy, with a little pain, like if i had something in my eye. Some light sensitivity and crusting. I also noticed that my eyelashes had something very similar to dandruff. Possible Anterior Blepharitis.

Today, the bump and the redness remains, unchanged. I dont have any type of pain but sometimes it itches. I have some crusting in the morning (only in that eye).

The thing is, that suffer from hair dandruff, and im begining to think that my eye came into contact with this dandruff because I use to touch my hair a lot and right BEFORE this symptoms started i remember to touch that particular eyelid (right eye) a LOT because i was testing the vision trough my left eye with some tests i found on the internet and to do that i have to touch my right eye with my hand to keep it closed, for several minutes. So, im suspecting that my eye came into contact with my hair dandruff trough my hand. Can that be the reason of unilateral blepharitis?

Im kind of worried because, as far as i have read in several sites, unilateral blepharitis is not that common and may indicate a tumor or cancer. Im worried about the chalazion too because is not showing any signs of getting smaller after 50 days.

Im attaching a 3 frame picture:
- The first frame is my right eye. You can clearly see the bump to the left (the possible chalazion that hasnt changed in the last 50 days), and the redness right next to it, at the center and border of the eyelid, which looks and feels like a small wound, with some red veins coming out of that region. You can also see that the eyelashes are growing separated in that particular spot.
- The second frame shows 2 kind of yellowish spots just at the eyelid margin. I have been tempted to pop them to see if that can reduce the redness in the eyelid, but i know is not a good idea.
- And the third frame shows my left eye, so you can see the difference between the two eyelids.

Your help is greatly appreciated. Thanks in advance.

[PedroPrado]

UPDATE FOR DR HAGAN:

About the chalazion:
No improvement at all. I have heard that steroid inyections are less invasive tahan cirugy and can have similar if not better results. What do you think according to your experience?

About the blepharitis:
I started to clean my eye with baby shampoo everyday while i shower. No improvement. In fact, i think my condition is starting to get worse because you see the red area in my eyelid just at the center, in the first picture that i posted? Well, that area is now a bump, more red, tender to the touch and painless. I dont know if this is a new chalazion (because i havent seen chalazions being red and tender, they all look skin colored and firm). The veins that converge to that spot are even MORE red, and my eyelashes are a complete mess, all of them pointing to a different location, so either the baby shampoo is not working for me or im doing something wrong.

So, i considered to change the treatment for my blepharitis, because im almost 100% convinced that this is a bacterial infection caused by staph. Why? Because this issue started RIGHT after i touched my eye several times a day (dont ask why, long story) and NOW i know that the fingers can have a lot of staph. Another clue is that at morning, after i wake up, there is yellow crusting in my eye. It itches like crazy too. Also, its completely unilateral (the other eye is healthy, at least for now...).

So, i ordered Ocusoft Lid Scrub Foaming Eyelid Cleanser to replace the baby shampoo (will arrive next week), and im thinking about Bacitracin in order to fight the staph infection. I know the ideal is to go to an ophtalmologist but where i live they charge a LOT and im currently unemployed. I dont know what you think about bacitracin and if its better than taking doxycycline.

Thanks again for your help.


(Now, there is something weird. First thing in the morning i see my eyelid and the veins are almost non existant, the red bump at the center is more pink/skin colored, and even my chalazion is a little less prominent. Then, 30 minutes pass, and its all back: the red veins and the red bump. I dont know if this can give you a clue but i though it was worth mentioning.)

[John C Hagan III, MD, FACS, FAAO]

You could start treatment and give yourself 30 days to see if the chalazion resolves. Given the shortage of physicians world-wide you might make an appointment to see and Eye MD in a month, if better cancel if not keep

yes the chalazion could cause a phosphine 180 degrees away from where located.  Its no different than creating a pressure phosphine with the time of your finger.

JCH MD

[PedroPrado]

Thanks for your help Dr Hagan. I want to know, is it too late to begin self treatment with hot compresses, to see if the chalazion can drain by itself? What is the max ammount of time that i can wait to see if the chalazion heals by itself? Im kind of worried that an insicion can cause cosmetic issues on the eyelid.

Also, im curious about someting. You see, since the chalazion appeared, i see a circle of light at the corner of my eye, everytime i move my eyes to the opposite direction of the chalazion. Im almost postive that this is a phosphene and that the pressure being made by the chalazion is creating it, because when i touch the chalazion i can recreate the effect. Is it possible that so little pressure can create a phosphene? Because i have searched a LOT about the relation of chalazion and phosphenes and i have found nothing.

Thanks again.

[John C Hagan III, MD, FACS, FAAO]

You understand that we cannot make a diagnosis over the internet nor do we attempt to do so. Having said that the most common things that could cause that you have focused on. The bump looks like a chalazion and you likely have blepharitis. Those two things on the edge of your eyelid appear to be blocked meibomian glands.

Use the search feature and archives and read about chalazia and treatment of blepharitis.  See an ophthalmologist as you likely would benefit from some prescription medication and may need the chalazion removed.  Ask your family MD to refer you to an Eye MD or go to www.geteyesmart.org and find one near you.

Read about using TheraTears Sterilid or Occusoft foam eyelid cleaners to clean the lid margins to help both blepharitis and chalazion

JCH MD