Treatment for Blepharitis, Chalazia, Styes and “Wet” Dry Eye

All of these conditions can be uncomfortable, unsightly and sometimes distressing. There are many differing options on how to deal with them, and advice should be sought from an eye care professional.

However, we believe that the following simple self help remedy can go a long way to relieving the symptoms, although there is no permanent cure.

We will start with “wet” dry eye which can be diagnosed with a few simple tests at an eye exam. The obvious question is always “How can I have too many tears and still have a dry eye problem?” Simple, the tears are on your cheeks – not in your eyes. The reality is that in this case, the viscosity (or oiliness) of the tears is too low, meaning that they do no remain on your eyes as well as they should and more crucially, they evaporate very quickly exposing the cornea, causing a reflex production of more tears. Of course, this further dilutes the tears causing them to run off the eye leading to more exposure of the cornea. This leads to further irritation, creating a vicious cycle.

Usually, dry eye problems arise not from insufficient tear quantity, but by poor tear quality; this is caused by not enough oil (called meibum) being produced.

Maibum is produced by small pore like glands in the eyelid margins, totalling about fifty in each eye. The problem is that they can get blocked.

Come and see us if you want the full reasons for this explained.

There are many and varied theories about how to get these little meibomium glands working, but here is ours, and what we believe to be the best method.

Applying heat to the eye

This first stage applies to blepharitis, chalazia and styes as well as “wet” dry eye.Click here for a printable version of these steps

  1. Fill a basin with hand hot water (approximately 46 degrees Celsius to 48 degrees Celsius). Water out the tap is ok.
  2. Place a clean face cloth in the water and wring it out.
  3. Place it on the eye (we recommend doing one eye at a time) for ten seconds – any longer and the temperature of the cloth drops too much to be effective.
  4. Repeat half a dozen times as quickly as possible, and then treat the second eye.
  5. Do this twice a day for seven days. Thereafter, once a week or fortnight should be sufficient to keep symptoms under control.

Most people will notice a significant improvement after three days.

If this all sounds like too much trouble (it isn’t), then we can supply eye bags which are a simple alternative. These are available in our practices.

For the control of blepharitis and more severe dry eye problems, after the heat application some authorities advocate the use of dilute baby shampoo applied with cotton wool buds or balls. We are not fans of this as this can further disrupt a compromised tear film. We prefer a very dilute solution of cooled boiled water and bicarbonate of soda (1/4 teaspoon in 1/2 cup is about right), even salt water (same proportions) is preferable. Lid wipes are an inexpensive and soothing alternative.

For styes and chalazia, slightly greater heat can be used. “Hot spoon bathing” is one of Granny’s stand bys, but actually works.

The simplest method is to place a wooden spoon in some boiling water and hold it a few inches from your eye. Do not touch the spoon to your eye (oviously!).

More severe or non-resolving eye problems are best dealt with by an eye care professional or GP. This may involve oral or topical antibiotics or even a short case of steroid eye drops.

At Burnside McPhee, all three optometrists are very willing to assist with these, or any other, eye problems.