What's going on?

There is a problem with your lids, usually caused by a collection of
dandruff-like skin flakes and fatty crusts around the base of your
eyelashes. This is often associated with some inflammation and low-grade
infection with bacteria. This inflammation results in irritation of the
surface of the eye with consequent dryness, burning and gritty. The
bugs can even release toxins which can damage your cornea directly.

There are about 20 fat glands that line the upper and lower
lid. These release fat for the tear film to prevent the tears
evaporating too quickly. If they are blocked then the lids become
inflamed and the eye dries up.

What will my ophthalmologist see?

The lid margins will be red, with some flaky material around the
bases of the lashes. We can also see the heads of the fat glands all
blocked up with fat.

What will my ophthalmologist do for me?

The mainstay of therapy is lubricant drops to minimise ocular irritation and lid hygiene (see below).

What can I do?

The lid margins should be cleaned daily. First the lids should be
warmed with a hot flannel to loosen any flakes and liquefy the fatty
material in the fat glands. An eggcup of water should be boiled and
allowed to cool, and a drop of baby ("no-more tears") shampoo (to avoid
stinging) should be added. The upper and lower lid margins at the lash
bases should be cleaned with a cotton bud moistened with the water once
or twice a day.

What do I need to know?

This is likely to be a chronic condition. Topical lubricant drops
will alleviate symptoms to some degree, but the underlying pathology
will only be resolved by long-term adherence to regular lid hygiene.