EXTERNAL EYE DISEASES

Our external eye structures are exposed to many infections and injuries because they are exposed to the external environment. It is critical to maintain external eye health since it serves to protect the critical internal eye structures. Several external eye diseases even carry the risk of causing permanent vision damage if left untreated, so we take external eye health very seriously at the Garrett Eye Center.

• DRY EYES (Keratitis Sicca)
• BLEPHARITIS
• STYES, HORDOLUMS AND CHALAZIA

DRY EYES (Keratitis Sicca)

The tear film in the human eye is a very complex fluid. It is secreted by various glands around the eye. The tear film has mechanical, lubricating action and protects the eyes from harmful bacteria, allergens, and other infection substances. All of us develop less thick tears from age 40 on. This process is progressive and by the time we reach our 70s to 80s, the tear film is rather watery and not an effective barrier against scratching of the eyes or bacterial invasion. Ironically, one of the surprising symptoms of dry eye syndrome is excessive tearing.

As this is a very common problem, we feel that everyone should use artificial tears if they have chronic wet, scratchy, or irritated eyes. The first line of defense is using artificial tears at bedtime and the first thing in the morning. When artificial tear supplementation does not give sufficient relief, making better use of the body’s own tears is an effective treatment mode. This can be accomplished by blocking the drain of tears off the eyes with punctual plugs. After an evaluation is done with several tests to establish the quantity and character of the tear film, plugs can be placed in the ducts “puncta” that drain tears off the eyes and retention of a better tear film can be achieved. Dr Hartwig and Dr. Garrett feel that one of the biggest advantages of punctal plugs is that the pt retains his/her natural tears with its natural lubricating and bacteria fighting enzymes that cannot be duplicated in an "artificial tear"

In all dry eye patients, the use of artificial tears must become part of their lifestyle. Certainly, for the patient with any mild to moderate eye discomfort of a chronic nature, a trial for a short time with over-the-counter artificial tears is warranted. If the problem persists, further evaluation is warranted.

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BLEPHARITIS

Blepharitis is a common external eye disease related to persistent inflammation of the eyelids. This condition frequently occurs in people who have a tendency toward oily skin, dandruff, or dry eyes. Some people may develop an allergy to the bacteria that are present on the eyelids. Blepharitis can lead to a serious complication which is inflammations of the cornea.  It can predispose a person to styes.

Blepharitis can develop in childhood and continue throughout life as a chronic condition, or it can spontaneously develop later in life.

SYMPTOMS:

• Itching, burning, red eyes
• Gritty or “sandy” feeling
• Dandruff like flakes on the eyelids

TREATMENTS:

• At least twice a day, wet a washcloth with warm water, wring it out, and place it over the closed eyelids for a minute. Rewet as it cools, two or three times. This will soften and loosen scales and debris, and help melt secretions from plugging oil glands near the lashes.
• Wet a cotton swab with water and a small amount of baby shampoo. Gently scrub the base of the lashes on upper and lower eyelids and rinse eyelids with water.
• Your doctor may prescribe an antibiotic ointment to apply in the lower eyelids.

Medications alone are not sufficient. The application of warmth and detailed cleansing of the lashes are the keys to controlling blepharitis.

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STYES, HORDEOLUMS AND CHALAZIA

Definitions:

A stye is caused by a bacterial infection and appears a tender red lump on the eyelid. Most styes occur along the edge of the eyelid because the bacterial grow in the follicle of the eyelash.

An internal hordeolum is caused by an infection in one of the tiny oil glands inside the eyelid and appears as a small bump.

A chalazion is caused from a blockage of an oil gland in the eyelid. An internal hordeolum can turn into a chalazion if it doesn’t drain and heal properly.

Symptoms:

Stye- A stye starts as a red bump that looks like a pimple along the edge of the eyelid. As it grows, the eyelid becomes swollen and painful and may even water. Most styes swell for about 3 days before they break open and drain. Most styes heal in about one week.

Chalazion: A chalazion forms a hard lump or cyst under the skin of the eyelid. Chalazia grow more slowly than styes and may interfere with vision when they get large. Most Chalazia go away in a few months without treatment.

Treatments:

Most Styes and Chalazia can be treated by the following home therapies:

• Apply warm, wet compresses 3 to 6 times a day. This usually helps styes and Chalazia to heal faster. It may also help open a blocked pore so that it can drain and begin to heal.
• Use an over-the-counter ointment or medicated pad
• Don’t wear eye makeup or contact lenses until after the stye or chalazion heals
• Some styes require an antibiotic ointment, eye drops or pills if the infection has spread to the eyelid or eye
• Your doctor may need to pierce (lance) the stye or chalazion so it can drain and heal. Never try to lance it yourself, as it may cause more infection to develop

Prevention:

• Wash your hands before touching your eyes. Don’t rub them as this can irritate your eyes and invite bacteria
• Replace eye makeup, especially mascara, every 6 months. Used makeup can grow bacteria.
• Treat any eye inflammation promptly to avoid complications. Wash eyelids regularly with a mixture of baby shampoo and warm water.

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