Eyelids cosmetics and cleansers are usually used on the eyelids or eyelashes. These can cause an irritant or allergic reaction in patients sensitive to such cosmetics and cleansers (Fig 1). Patients will complain of itching, burning and redness. Signs of contact dermatitis include blistering, redness and scaliness. If an allergy is suspected a patch test can be done to confirm an allergy and to ascertain the causative cosmetic or chemical responsible. Avoidance of the cosmetic will cure the condition.
Eye drops, contact lens and medicaments may also cause eyelid contact dermatitis. If you have eyelid dermatitis you should consult your doctor who will prescribe some creams and refer you to a dermatologist for allergy test if necessary.
Atopic Dermatitis is a genetic skin disorder. Patients with atopic dermatitis often have eyelid involvement· The skin may be red, scaly and sometimes oozing. Itch is common (Fig 2).
Sometimes the eye lining and eyelids are also affected in atopic dermatitis and a sore eye may result. There is watery eye discharge and patients may find their eyes sensitive to light. If the eyelid or eye itself is affected your doctor will prescribe some eyedrops and creams for you. Creams will help.
Many patients are also allergic to housedust. Housedust may aggravate their eye inflammation.
Like skin elsewhere, the eyelids can be infected by bacteria. The eye will show a thick, sticky yellow discharge and the eyelids may be red with yellow crusts (Fig 3). Impetigo is most commonly seen in children. Good hygiene and antibiotics are needed to clear bacterial infection.
These are flat to slightly raised yellowish plaques on the upper and lower eyelids (Fig 4). They are associated with high blood cholesterol or triglycerides level in about 20% of people with this condition. Sometimes there will be a family history of similar problem. The xanthelasma can be excised surgically or by laser or chemical treatment. Such lesions may recur. Patients with high cholesterol or triglyceride should have their lipid level controlled before surgery.
These are tiny skin coloured growths on the eyelids (Fig 5). Several family members may have the same lesions. These growths are harmless. They are enlarged, under developed sweat glands. Syringomas usually appear during adolescence and adulthood. Most people choose to leave these skin growths alone. These can be removed surgically by laser or excision for cosmetic reason.