At the end of my tether with under eye issues, not sure what else to use or can be done

I had something similar last year! Think I had developed an allergy to my best selling brand cheapie eye make up remover. I switched to Bioderma micellar water which seemed to solve the problem. But it was horrible while it lasted. I do wonder about the brands where the lid is not sealed or tamper proofed.

I have upper lid blepharitis and it is generally under control with cleaning twice daily using blephasol solution (I find the gels too fiddly) and a blepharitis eye foam from Boots that I use in the shower so the heat hopefully also helps the oil glands work a bit better.

This form of blepharitis is called interior blepharitis and causes depend on your age. There is no quick answers. Cleaning is a must and best done with natural soaps etc. I use olive oil soap. Firstly, go to amazon and get Optase Cleanse and protect. Amazon is artificially intelligent and can guide you. The Cleanse and protect lasts for a week. This will reduce bacteria in the eye lid area. Then soap your hands and wash face and closed eyelids twice a day. Heat can help but is fiddly. I you have a bath then you can droop a hot face flannel over the eyes daily. Use optase wipes afterwards. Use comfort eye drops four times a day and gradually it should get better xxx

Do you have any menopause specialist gps or centres in your area? Ask to see someone who is the hrt expert in the practice. We have one GP that specialises in it near me who is good.

I’ve got an eye mask from boots I heat in the microwave that the optician recommended. itchy skin can be due to declining levels of oestrogen affecting collagen - it’s been really noticeable for me. Think HRT patches would stabilised and top up the levels that’s what I meant.

i tend to think with skin you’ve got topical treatments and then the underlying cause - hormone imbalance etc. I have no medical qualifications whatsoever it’s only my experience of this. Of course the pmt swings etc of peri can also lead me to over consume sugar too.

You need to get on top of the skincare ingredients issue, above all.
(I flinched when you said you used that Rose Micellar Water to remove eye makeup, for example)
Every product you buy has the ingredients listed on it, and once you identify the main offenders re reactive skin, you’ll be an adept in no time.

The information is easily found online, in varying degrees of detail, but as a matter of urgency, strike out any product containing sodium laurel sulphate/SLS, perfume and essential oils, and urea. Loads of other things can set a person off but these are main offenders.
(Watch out too for alcohol: if the word appears alone, as merely ‘alcohol’, then it’ll be drying at the very least and is never used in the most beneficial skincare ranges. Alcohol will appear in other forms though, often as a neutral wax, and non-irritating. These will have a prefix such as ‘butyl alcohol’, and they are fine)
Parafin/mineral oil: it wasn’t til I abandoned this in skincare many decades ago that my skin really healed for good from hyper-reactivity. In itself, it’s harmless stuff but it also prevents any good bring transmitted or absorbed, as it just sits atop the skin.
Silicones: dimethicone is in many moisturisers and it too just sits there as a film, serving only to feel silky to the touch. I see it as a (harmless) total waste of space, and prefer ingredients which can actually do some good! These are plants. Botanical is best, in my experience.)

But here and now you want to halt irritation, introduce calming, and generally treat your skin extremely gently.
I’d try brilliant Balmond’s products (Boots has them), or the Trilogy Gentle range, and the HyloForte range of moisturising eyedrops is terrific.
You can buy eyelid wipes for blepharitis which will soothe a lot, or just swipe with original Optrex on cotton wool.

The important thing is to stop using stuff you haven't scrutinised for potential irritants, given this bad reactivity, and wait while things return to normal. (Wont be long) Skin likes calm and gentle, and repairs itself well. keep everything perfectly clean of course, and never use biological washing powder on your bedlinen, as its ferociously irritating. (Does sound like a bit of irritation was allowed to pick up a little infection via a mascara brush, or a pillowcase for example)

Steroid cream, the low dose OTC type, is useful but not near the eyes, and only ever very rarely. Soothing drops will help your eyes (and you can also use eyebright tincture on your tongue)

Yes sounds like blepharitis to me (but am not a dr). My eyes get sore, can’t tolerate contacts any more, eyelashes have thinned and can get styes more often. There are treatments that can improve this.

@Redruby2020 Had something similar, saw an eye specialist and had operations for dry eye to correct no effect. only thing that worked was taking a daily tablet of doxycycline and washing eyelids and lashes morning and evening with baby shampoo.

‘Ruby was a pretty girl, but Ruby is no more
For what she thought was H2O was H2SO4’

I think (hope) you meant hyaluronic acid……🙏🏻

It does sound like blepharitis. Look along the lash line for little white spots that show clogged follicles. With me it's my top lashes and I get a gritty sensation in my eyes, and then the skin around it gets sorted of crinkly and makes me look years older. Keeping you eye area clean is the best bet. No make up or product at all when you're flaring. Ive had good result from hydrochloric acid spray for eye irritation generally (hayfever symptoms as well as dry eyes etc ) . I've heard some recommendations for cleaning the lash line regularly with baby shampooo. Have you tried stopping with the eye cream altogether?

Do you have gel nails? It took me 8 months and 5 different doctors to figure out I had an allergy to BIAB which caused my eyes to flare.

Unfortunately, it didn’t clear up completely overnight once I had the polish removed, I was so fed up I paid to see a private dermatologist because the NHS pathway would take at least a year. They prescribed Protopic which is non-steroid, which has helped a lot but basically, once the allergy surfaces you can become sensitive to other things you may have previously had a tolerance to. It will cost ££££ to do a complete allergy panel so at the moment I’m slowly reintroducing products.

Also keep an eye out for products containing phenoxyethanol, it can make eczema worse and it’s in a lot of make up.

I feel for you, it is awful

Tbh I agree with OP - paramedics are not the right people to be dealing with a LOT of the issues taking people to a GP surgery.

The surgery-based physiotherapist made a referral to a orthopaedic consultant for my hip problems without me ever seeing a doctor for it in a year.

I'm not grateful, because it should have been done months before that because I was fobbed off with exercise for what turns out to be hip dysplasia, arthritis and trochanteric bursitis, none of which was suspected by the physio and the referral only submitted because I wanted to see a doctor.

Ooo yes nail varnish is another thing I react to 🙄 Have to use ones that are 5 free.

I’m sure I got the eye make up remover from Boots in the eye care section with the eye drops and eye washes but Amazon do it too. Optase is an eye product company they do drops and eye lid wipes so I trust them more than cosmetic companies.
I find while the eye creams aren’t I use aren’t anti aging I do find they help with dark circles and lines as they’re helping my eyelids and under eye stay hydrated and not irritated. I’ve got to the point now if I have to scroll to read ingredients I don’t buy. A lot of the anti aging creams have lots of ingredients so it’s hard to know what causing the reaction. Fragrance is another ingredient I avoid as that seems to irritate!

Do you have anything on your nails?

Acrylate allergies frequently show up on the eyes because of cross contamination after having nails done whether with gel polish or acrylics etc.

How old is all your make up? Might be time to chuck it all and start afresh. Including brushes.

Washing your hair over the bath could result in suds on your face for longer than in a shower.

The Cerave SA wash is deliberately made with lots of acids - that's extremely harsh to use on profoundly damaged skin. Switch to a less aggressive option for your face.

‘Paramedic of all people’ wow!! Just wow!! That’s how you speak about the health care professional that’s got you on the dermatology pathway.