Your eyelids protect your eyes. They keep out foreign
objects such as dust and sand. The act of blinking also keeps your eyes moist. Occasional
fluttering of one eyelid is normal. Eyelid disorders can cause eyelid:
Eyelid disorders involving inflammation
Blepharitis is inflammation of the eyelids. Oil and bacteria
coat the edge of the eyelid, near the base of the eyelashes. It can cause:
Blepharitis can often lead to a stye or a chalazion. You can
treat blepharitis by applying warm compresses, cleaning your eyelids with a
moist washcloth and baby shampoo, and applying antibiotic ointment.
A stye, or hordeolum, is a red, sensitive bump that appears
on the edge of the eyelid. A bacterial infection of an oil gland, hair follicle,
or sweat gland causes it. Styes usually recede without treatment over time.
Applying warm, moist compresses several times per day can help it heal faster.
If you have a stye that doesn’t recede within one to two weeks, you may need to
A chalazion is a lump on the eyelid due to obstruction and
inflammation of an oil gland. Some chalazions heal without treatment, but applying
a hot compress will speed the healing process. You may need to take medication
for it or have surgery to remove it. If a chalazion regrows in the same place, you
should see your doctor. They can rule out a cancerous growth.
Meibomianitis, or posterior blepharitis, occurs when your
eye’s oil glands at the base of the eyelashes become clogged. The eyelid
thickens and may become crusty. Treatment for meibomianitis is the same as it
is for blepharitis.
The tiny hole at the inner corner of each eye leads to the
lacrimal duct, which drains tears from your eye into your nose. When the duct
becomes blocked, it can become inflamed or infected. The area will swell and
may discharge pus. Common symptoms include:
Many obstructions clear spontaneously. Hot compresses speed
the healing process. The area may also be massaged to help clear the blockage.
You can take topical and oral antibiotics to treat the infection. If other
treatments don’t work, surgery may be an option as a last resort.
Eyelid disorders involving lesions
Seborrheic keratosis is a condition that causes oily,
pigmented lesions that look like they’re stuck to the skin. They can occur
anywhere on the skin, including the eyelids. They’re common in older adults, and
your doctor can remove them surgically.
Actinic keratosis appears as a patch of skin that’s:
It can be a precursor to carcinoma.
A hidrocystoma is a clear cyst that appears near the edge of
your eyelid. The usual cause is a blockage of sweat glands. Your doctor can
remove it surgically if it interferes with vision or causes pain.
This condition causes small, waxy nodules. It’s due to a
viral infection. It occurs in people who have compromised immune systems. The
nodules can cause inflammation of hair follicles if they occur near an eyelash.
Your doctor can remove them by performing surgery or freezing them, but they
often clear up without treatment as the viral infection subsides.
Nevi are small lesions that people are born with. People
more commonly call them moles, birthmarks, or beauty marks. They can be flat or
elevated, and they may or may not be pigmented. They usually aren’t precancerous.
If one changes in appearance or size and becomes irregular in color or shape,
your doctor should evaluate it for melanoma.
A xanthelasma is a soft, yellowish patch that can appear
below the lower fold of the eyelid. Genetic factors or high cholesterol can
cause it to occur. Your doctor can remove it surgically or by using a carbon
disorders of the eyelid
A blepharospasm is an abnormal, involuntary spasm of the
eyelid muscle. It can appear as repetitive blinking, twitching, or fluttering. It’s
different than non-pathological eyelid fluttering, which doesn’t affect the
rest of your face. It can affect anyone, especially during times of sleep
deprivation or stress.
The types of blepharospasm include:
Benign essential blepharospasm (BEB)
occurs on both sides of the face. It’s a form of dystonia, which is a disorder
that causes involuntary muscle contractions due to malfunctioning of the basal
ganglia. BEB develops slowly, and some people have difficulty keeping their
eyes open or are sensitive to light. Symptoms usually occur during the day and
cease during sleep.
the condition worsens, the spasms grow more frequent and intense, often forcing
the eyes closed for periods. This can cause people with severe BEB to become
functionally blind, although they have nothing wrong with their eyes. BEB
occurs in men and women, but it most commonly occurs among older women.
can sometimes stop the muscle spasms, but this will cause permanent damage to
the eyelid. Some medications work, including injections of botulinum toxin to
relax or paralyze the muscles that have the spasms.
form of blepharospasm occurs on only one side of the face, and irritation of
nerves in the face is usually the cause. Sometimes, tumors can cause blepharospasms.
If you have facial spasms on one side of your face, you should get a brain MRI.
Blepharoptosis, or ptosis, occurs when the upper eyelid
droops. If the eyelid droops far enough, it can block your pupil, causing partial
blindness. Ptosis has a variety of possible causes, including:
problems of the levator, the muscle that lifts the upper eyelid, can cause congenital
ptosis. A baby can be born with this type of ptosis. The condition usually
affects one eye. If the eyelid droops low enough to obscure the field of vision,
your child’s doctor will need to perform surgery to correct the ptosis and
clear their vision. Otherwise, your child may develop lazy eye or permanent
that isn’t congenital is usually the result of aging. The long-term effects of
gravity or repetitive opening of the eyelids, such as when changing contact
lenses, stretch the connective tissues in the eye that attach to the levator.
Both eyelids are usually affected, although one will often droop lower than the
other. Treatment for this condition involves surgery.
can be one of the early symptoms of myasthenia gravis, which is a rare disease
that causes progressive muscle weakness in the face and elsewhere in the body.
You should seek immediate attention for this condition.
Other causes of ptosis
medical conditions that affect the nerves or muscles can cause ptosis,
damage from uncontrolled diabetes
infection of the eyelid
to the eyelid
A coloboma is missing piece of eye tissue. This appears at
birth and can affect one or both eyes. It’s the result of improper development
of the eye during gestation. While the eye is forming, a gap called the
choroidal fissure appears at the bottom of the stalks that will eventually form
into the eyes. These gaps usually close by the seventh week of gestation, but if
a gap doesn’t close, it will result in a coloboma. Colobomas that are visible
at birth can be a sign of an undiagnosed syndrome. Your child’s doctor will
need to perform a full workup if this occurs. Doctors can often correct
colobomas with surgery.
This condition occurs when excessive eyelid skin or fat hangs
over the edge of the eye and obstructs vision. Your doctor can remove it
Ectropion occurs when one of the eyelids, usually the lower
eyelid, turns outward. It exposes the inner eyelid and can cause irritation,
dryness, and redness. Eye drops can help keep the eye moistened, and steroid
ointment may also help. Taping the eyes shut when sleeping can also be a
preventive measure. Surgery is usually necessary to correct this condition.
Entropion occurs when one of the eyelids, usually the lower
eyelid, turns inward. This causes the eyelashes to rub against the cornea and
surrounding soft tissues, irritating them and causing redness and a discharge
of mucus. Your doctor can treat it with eye drops and steroid cream until they
can perform surgery to correct it. Entropion is most common in older adults.
Palsies affecting the face, such as Bell’s palsy, can affect
the eyelid. This results in an inability to close the upper eyelid, or a loss
of muscle tension in the lower eyelid. Protecting the eyes by using eye drops
and taping the eyes shut can help prevent conditions such as corneal abrasions
Trichiasis occurs when your eyelashes grow incorrectly and
rub against the cornea. This can cause:
- tear production
Removing the eyelashes corrects the problem. If the lashes
persist in regrowing incorrectly, your doctor can surgically remove them. They
can also permanently remove the hair follicle using electrolysis or
Types of cancer that can occur on the eyelid
Basal cell carcinoma is the most common type of cancer to
occur on the eyelid. It usually appears on the lower eyelid or near the inner
fold of the eye as a firm, pearly nodule. If the carcinoma appears on the edge
of the eyelid, eyelashes may be missing around the tumor.
Basal cell carcinomas usually don’t metastasize, but they
can spread to other areas near the original tumor. If they grow large enough,
they can interfere with vision or eye movement.
If the tumor is small, your doctor can remove it with
limited reconstruction. If it’s large, you’ll need surgery and complex
reconstruction of the surrounding eye tissue. When surgery isn’t possible,
radiation is another option. However, it has higher rates of complications,
such as vision loss, and the cancer is more likely to return.
Squamous cell carcinoma spreads more aggressively than basal
cell carcinoma. Lesions usually form on the upper eyelid and often begin as
actinic keratosis. The lesion might be:
Treatment is similar to basal cell carcinoma, but more
aggressive surgery often is necessary to cure it.
Sebaceous carcinoma occurs in older adults. It can look like
a chalazion or blepharitis and can metastasize aggressively to other organs of
the body. Large tumors might require removal of the eye to remove all of the
Melanoma is a rare form of eyelid tumor. These tumors are
pigmented and are highly likely to metastasize, even if they’re small.
Treatment involves aggressive surgery and potentially radiation.
Preventing eyelid disorders
Follow these tips to prevent the development of eyelid
- Wash your eyelids regularly with warm water and
baby shampoo to help prevent infections and inflammation.
- Avoid touching or rubbing your eyes with your
- Wash your hands regularly.
- Blepharitis is associated with dandruff, which is
caused by bacteria. Use antidandruff or medicated shampoos to control the
bacteria, but consult your doctor before using any of these shampoos.
- Avoid allergens if you experience eye redness or
swelling after being exposed to them. Stay indoors when pollen counts are high.
- Use hypoallergenic makeup if regular makeup
- Wear wide-brimmed hats and sunglasses that block
ultraviolet rays to reduce your chances of developing cataracts and eye
What is the outlook for people with eyelid disorders?
Some eyelid disorders will go away with time or once an
infection clears, but many can lead to serious chronic disorders if you don’t
get treatment for them. These disorders include dry eye, astigmatism, or even
vision loss. Contact an optometrist or ophthalmologist if you have a problem
with your eyelids.