Hygiene and Care of the Eyelids
The eyelids have several important functions in maintaining the health of the surface of the eye. Various disorders of the eyelids can lead to disorders of the ocular surface - and vice versa. Chronic disorders can lead to chronic eyelid inflammation (chronic blepharitis). This is often associated with excessive growth of normal bacteria on eyelid margin or with an infection.
On this page you will find:
The edge of the eyelid is particularly important for ocular health and It is endangered by irritant depositions that tend to accumulate there.
Changes to the eyelid margin are common - Hygiene of the eyelids by cleaning the deposits and crusts can thus prevent diseases
A Practical approach to regular Eyelid Hygiene is easy to perform in case of dry eyes and in other disease conditions. Suitable cleaning solutions should preferably be free of soaps in order not to dissolve the important lipid layer on the tear film
The edge of the eyelid (eyelid margin) extends from the outer border with the eyelashes over the free margin of the eyelid (... where the kajal pencil can be applied in cosmetics ;-) to the inner border that is in contacts with the eyeball.
The edge of the eyelid, the so-called eyelid margin, is of particular importance for the health and disease conditions of the eyelids and thus also for the surface of the eye.
The eyelid margin is the narrow, smooth strip of skin that leads from the dry oily skin with the eyelashes on the outside to the moist mucous membrane of the ocular surface at the inside.
The margins of both lower and upper eyelids constitute the limits of the palpebral aperture/ fissure. This is where the tear film lies when the eyelids are opened for viewing.
At the contact site of the posterior eyelid border with the eyeball the tear fluid forms a narrow strip of tear fluid, termed as the tear lake or tear meniscus. This is the reservoir from which the aqueous tear film is refreshed upon an eyelid blink.
=> Here is more information about the eyelid margin
The eyelid margin is perhaps best known for the fact that the cajal pencil can be applied here in cosmetics. This carries, of course, the risk of clogging the openings of the meibomian oil glands.
Deposits accumulate on the eyelid margin and favor inflammation
Lid Margin with depositions and incrustations on the free margin and at the base of the eyelashes. Depositions of sticky material often glue the eyelashes together in bundles. An animated figure explains how the depositions build up on the eyelid margin in disease states.
Many glands release their products onto the eyelid margin:
at the front side are, besides the eyelashes, small glands deliver oil and sweat via the hair follicle onto the surface (please see image)
the Meibomian glands, in contrast, release their oil at the back side towards the globe and have no contact with hairs
A lot of material thus accumulates on the eyelid margin, such as
residues of the gland products and from the tear film together with
skin scales, dust, environmental antigens such as pollen etc.
With disease the amount of depositions typically increases. Sticky material can glue eyelashes together in bundles and may glue the eyelids over night so that it becomes difficult in the morning to open the eyes. Some of this material remains liquid or foamy, while others become encrusted (see image) and is then difficult to remove.
A similar increase typically occurs in the numbers of bacteria and Demodex hair mites. Both are normal and basically harmless as long as they occur in low numbers. However, increased amounts of depositions on the eyelid margin as well as increased numbers of bacterial and demodex and their excrements have negative influences on ocular health by favoring inflammation.
Blockade of the Meibomian gland openings. Inspissated oil can occur inside the glands with whitish ´pointing´ of the orifices (white dots upper image) or it can protrude out of the openings onto the eyelid margin (lower image). A gland obstruction can, however, often be non-obvious without further investigations. ()termed as NOMGD)
The hygiene and care of the eyelids and especially of the eyelid margins usually only appears acute to the patient when disturbances have already lead to symptoms.
Most often this is a blockage of the Meibomian oil glands with corresponding complaints. This is the main reason for dry eyes.
Therapy options
In addition to hygiene and care of the eyelids for cleaning away irritant lid margin depositions
a physical eyelid therapy with warming and massage of the eyelids to remove gland blockages is a useful measure to prevent worsening of the condition.
=> here is more information on Meibomian Gland Dysfunction (MGD) with further options for therapy
Hygiene of the eyelids by cleaning the deposits and crusts
On the eyelid margin are the openings of several glands. In the front are the hair-associated glands (m, at the right side of the image) around the roots of the eyelashes and at the inner lid border open the Meibomian oil glands. In disease conditions the gland products accumulated on the lid margin together with dust and other debris and provides an nutritious environment for bacteria and demodex hair mites. Altogether this favours inflammation and worsening of the condition (please see an animated image how this develops). That´s why Lidcare is an important component of prevention and therapy for chronic dry eyes, Meibomian gland dysfunction (MGD) and blepharitis.
The so-called lid hygiene is carried out through a targeted cleaning of the eyelids with removal of inflammation-promoting deposits and crusts on the edge of the eyelid.
To this end, it is beneficial if moist heat is applied beforehand with a washcloth or cosmetic pad. Moisture softens deposits and incrustations and makes them easier to remove.
Bacteria as well as Demodex skin mites, that both appear to feed on the deposits and produce harmful products, are removed in the same course and/ or at least deprived of their nutrition.
Aim of the lid margin cleaning / hygiene:
By removing the deposits, their harmful irritant effects on the tissue and thus the inflammatory reaction is improved.
=> here is more information about Demodex infestation in blepharitis that is therapy-resistant with usual eyelid hygiene.
Hygiene and Lidcare for the eyelid margin can prevent disease
Regular daily cleansing of the eyelid margin is thus useful for the prevention and treatment of diseases of the ocular surface such as e.g. eyelid margin inflammation (blepharitis) and dry eye (sicca syndrome).
Also with allergic or inflammatory eye diseases and before surgical interventions on the eye, eyelid hygiene and care is a very useful addition.
Eyelid inflammation with increased lid margin depositions occurs e.g. in conjunctivitis, stye (hordeolum), hailstone (chalazion), or a hyper-sensitive eye area, as can occur in chronic skin disease such as neurodermatitis (atopic dermatitis), flushing of the face (rosacea), psoriasis, or seborrheic eczema.
Practical approach to Eyelid Hygiene
=> here is more general information about Lid margin cleaning/ Eyelid Hygiene
Baby shampoo - probably not
In the past, baby shampoo was often recommended to remove the mostly fatty deposits on the edge of the eyelid. This is certainly effective, but there is a risk that the necessary oil on the tear film will also be damaged. However, careful eyelid cleaning with baby shampoo is probably better than no eyelid hygiene at all.
Soap- free solutions are better
In the meantime, people have switched to doing without soap-like substances (detergents) that dissolve fat/ oil.
For example, lipid-containing cleaning solutions or aqueous cleaning solutions based on hyaluronic acid or other substances also used in tear substitutes can be applied.
Commercial systems are available for the hygiene and care of the eyelids
Commercial cleaning solutions are available to make eyelid hygiene easier. These products are often offered as pre-prepared soaked swabs or as a set together with other cleaning materials, such as cotton swabs etc., and can make regular eyelid hygiene easier.
In case of strong deposits of incrusted oils and debris on the eyelid margin with distinct signs of inflammation (redness, swelling), even without significant infestation with Demodex hair mites, it may be useful to make a therapy attempt with tea tree oil cleansing wipes, since tea tree oil and its active ingredients, according to studies, have many useful effects, e.g. antibacterial anti-fungal, anti-inflammatory.
Any treatment of the eyelids and eyes should be done very carefully and in consultation with an ophthalmologist. Please get advice there on how to perform treatment !
Regular eyelid care is beneficial
Regular cleaning and care of the eyelids can be a sensible strategy for the treatment and also for the prevention of lid disease, especially in the case of dry eyes due to clogging of the Meibomian oil glands. Commercial cleaning and care sets can make it easier to carry out regular eyelid hygiene.
Systems for cleaning / hygiene and care of the eyelids
If regular Cleaning and Care of the Eyelids does not improve the chronic eyelid inflammation sufficiently an excessive infestation with Demodex hairmits may be present. This can also be diagnosed by an eye doctor !
=> here is more Informationen about Demodex hair mites at the eyelashes and respective therapy options.