Eyelid problems

Eyelid problems are common and rarely serious, but see your GP if you’re worried or your eye is particularly uncomfortable.

The information below should give you an idea of what might be wrong, although it shouldn’t be used to self-diagnose your condition. It covers possible causes for the following eyelid problems, plus specific advice about what to do. You can find out about:

• Swollen eyelids or eyelid cysts
• Itchy, flaky or sticky eyelids
• Lumps on or around the eyelids
• Hooded or droopy upper eyelids
• Rolling outwards of the lower eyelids (ectropion)
• Rolling inwards of the eyelids (entropion)
• Yellow plaques on the eyelids
• Excessive blinking or uncontrollable closure of the eyelids

Swollen eyelid or eyelid cyst:-

swollen-eyelid

It’s quite common for the upper or lower eyelid to become swollen because of a meibomian cyst (also called a chalazion). This occurs when the glands in the eyelid become blocked. These cysts vary in size, from barely visible to the size of a grape. They usually take weeks to develop. They’re not usually painful, but can become red and painful if infected. The cysts can come and go by themselves, although they may take a few months to get better. You can help them heal by holding a clean flannel warmed in hot water to the closed eye for five minutes, and repeating this three to four times a day for up to four weeks. Another common cause of a swelling on the eyelid is a stye. A stye is a minor infection of the base of an eyelash that usually clears up on its own in a week or two. Holding a warm flannel to it regularly may help it heal faster.

Itchy, flaky or sticky eyelids:-

Itchy, flaky or sticky eyelids

Itchy and flaky eyelids are usually caused by an inflamed eyelid edge (blepharitis) or dry eye. Your eyelids may also stick together and be difficult to open, particularly when you wake up. These conditions can be irritating, but are rarely serious. You can reduce the irritation by keeping the eyelids clean and using artificial tears if your eyes are dry. Read about treating blepharitis and treating dry eyes. Contact dermatitis is another possible cause of itchy or flaky eyelids. This is a type of eczema triggered when the skin comes into contact with something you are irritated by or allergic to, such as make-up. The condition usually clears up after you stop using the substance your skin is reacting to.

Lumps on or around the eyelids:-

Lumps on or around the eyelids

Just like anywhere else on the skin, lumps can occur on or around the eyelids. Many lumps are simple cysts or styes (see above). However, occasionally a lump can be a sign of a more serious condition such as skin cancer and may need to be removed. Most skin cancers are basal cell carcinomas, which very rarely spread to other parts of the body. These often appear as a red or pink lump containing small blood vessels, although they can be pearly-white or “waxy” looking. Sometimes they may bleed. Less commonly, the lump may be a squamous cell carcinoma, which is more serious as there’s a small risk it could spread to other parts of the body. These usually look like an ulcer with a red base and a scaly and crusted surface. You may also lose eyelashes where the lump is growing. In rare cases, the lump could be a sign of a very serious type of skin cancer called melanoma that can spread to other parts of the body and can be very dangerous. A lump is more likely to be melanoma if it’s an irregular shape, dark or changing in colour, and getting a lot bigger over time.

Hooded or droopy upper eyelids:-

Hooded or droopy upper eyelids

As you get older, it’s quite common to have excess skin above the upper eyelids that can overhang and block your vision. This is called dermatochalasis. If it affects your vision, surgery may be considered to remove the excess skin (blepharoplasty). If the edge of your upper lid droops down over your eye, it’s called ptosis. This is usually age-related and develops slowly. Surgery may be needed if the edge of the lid droops so much your vision is affected. In rare cases, ptosis isn’t related to age and may be caused by serious conditions such as myasthenia gravis or a brain tumour. In these cases, it’s likely there would be other symptoms too.

Lower eyelid that rolls outwards (ectropion):-

Ectropion

As you get older, one or both lower eyelids can sometimes droop away from the eye and turn outwards. This is known as an ectropion. The drooping eyelid can disrupt the normal production of tears, which can cause your eye to become dry, red and irritated. Treatment may not be needed in mild cases, although drops or ointment may help make your eye more comfortable. Sometimes a minor operation is needed to correct the position of the eyelid. Read more about treating ectropion.

Eyelids that roll inwards (entropion):-

Entropion

Entropion is where the eyelid rolls inwards. It usually affects the lower lids, but it can also affect the upper lids. Like ectropion, this is often age-related. Entropion usually causes an uncomfortable watery eye because the lashes irritate the front of the eye (cornea). If this is mild, using eyedrops may be enough to protect the eye and keep you comfortable. Severe entropion can be painful and cause vision loss by damaging the cornea. Occasionally, a corneal ulcer can form and become infected. Surgery may be needed to correct entropion if it’s posing a risk to the health of your eye or is causing considerable discomfort. This is carried out under local anaesthetic.

Yellow plaques on the eyelids:-

Xanthelasma

Flat yellow patches (plaques) over the upper or lower eyelids are called xanthelasma.  Although these plaques are harmless, they indicate you have high cholesterol. See your general practitioner because you may be at risk of developing cardiovascular disease, such as heart attacks and strokes. Making changes to your diet and taking medication may be recommended to reduce your cholesterol level and reduce your risk of serious problems in the future, although these may not improve the plaques. If you’re bothered by the appearance of the plaques, it may be possible for them to be surgically removed or treated with a laser.

Excessive blinking or uncontrollable closure of the eyelids:-

Blepharospasm

It’s quite common and normal for the eyelid to flicker or twitch occasionally, particularly when you’re tired. It’s more unusual to have repeated spasms of excessive blinking and involuntary closure of one or both eyes. This is a type of dystonia (a movement disorder that causes muscle spasms and contractions) known as blepharospasm. Each spasm can last for a few seconds to a few minutes. The exact cause of blepharospasm is unknown. However, the blinking and closure can be triggered by bright light, stress or tiredness. Severe blepharospasm can be very disabling and embarrassing. However, an effective treatment is available. It involves having small injections of botulinum toxin (such as Botox) into the face to relax the muscles controlling the eyelids.