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Lid hygiene: Drops, compresses and shampoo, oh my!

By Dr. Roxanna Potter, FLTN Columnist- Do you shampoo your hair? Do you wash your face (including eyebrows and facial hair/beard) and all the rest of your body and hair? How about your eyes? Our eyelids and eyelashes are some of the most neglected areas on our body when it comes to personal hygiene, and many problems can stem from the build up of oils, dirt, bacteria and other debris in or around the eyes. Basic eyelid hygiene can prove beneficial and often therapeutic in many patients, particularly those that suffer from dry eye or blepharitis (chronic inflammation of the eyelids).

Oil glands near the edge of the lid line (behind the lashes) continuously pump oil onto our tears to help lubricate and preserve a tear film over our eyes, but they can often become plugged or dysfunctional. Bacteria and other microorganisms normally colonize our eyelids, lashes and glands but can sometimes grow out of control and cause problems.  Also, dirt and debris from the environment can collect in our eyes, lashes and under our lids. Symptoms of redness, flaking or crusting of the eyelids, irritation, grittiness, dryness, itching and recurrent styes or bumps on the lids may indicate the need for better lid hygiene. Consult your eye doctor to rule out more serious conditions such as infection, severe dry eye, eyelid cancers or other issues before beginning a regimen of lid hygiene.

Proper lid hygiene begins with a warm soak of the eyelids. With a warm, wet washcloth, heat your lids with gentle pressure allowing time for all the oils and glands in the lids to soften/melt. This usually takes approximately two to three minutes with a relatively hot (don’t burn yourself!) compress or up to 10 minutes in more severe/neglected cases. Washcloths may not stay warm long enough for this, but you can also use a rice pack, potato, or commercially made eye mask if needed.

Next, wash your face with a gentle soap, with special attention shown to the eye area (do not get soap in your eyes directly). Diluted baby shampoo can be used close to the eyes with less chance of irritation, or commercial eye cleansing products such as Ocusoft or CliraDex may be recommended by your doctor in moderate to severe cases. Then, mechanical massage and scrubbing of the lids should be performed with a clean finger or cotton swab to remove any crusting or debris. Make-up should be thoroughly removed.

This regimen done regularly (once or twice a day) will ensure cleanliness and good, even flow of moisture and oils to your tears and eyes. This will improve your eyes’ comfort significantly, and can be healing in cases of ongoing lid irritation and inflammation. Only a few minutes of effort each day can lead to dramatic results, often without the need for prescription medication or other expensive treatments.