Struggling with blepharitis

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I've had sensitive eyes for around 30 years now and have always used eye drops like hypromellose to ease the discomfort.

I've now been diagnosed with blepharitis after being seen at an eye hospital. Tear production is normal, but I have mebomian gland dysfunction.

I was prescribed steroid and antibiotic combo ointment in November and a list of self care things, which I was doing anyway. Doctor has just prescribed another two weeks of steroid ointment and I have a follow up in March.

The problem has now returned after a few weeks respite my eyes feel gritty, itchy and like there's something in them. Left eye is worse. I have had filamentary keratitis towards end of last year and was prescribed acetylcysteine eye drops for that after filament removal.

I do:

Hot compresses - microwave mask and a heated pen thing which also vibrates. All kept clean and hygienic.

Eyelid cleansing with water and warm flannel - doctor said not to use any products just water. Flannel changed every other day.

Gel eye drops

Hyaluronic Acid 0.2% eye drops

Night time lubrication - ointment

I wash my face with water, no products used at all and no shampoo gets into my eyes or onto my face. No makeup used, nothing. No hair styling products used either.

I don't use a computer

We don't use central heating

I'm not exposed to chemicals, sprays, dusty or dirty environment etc.

I'm literally at my wits end. I don't know what else to do now. I don't know what's causing it or how to deal with it. I can't be on repeated courses of steroid ointment because it causes increased eye pressure and cataracts.

Does anybody have any suggestions as to what I can do? It's so painful and blurs my vision during a flare up. I've even been taking Fexofenadine in case it's due to an allergy. Eyes are worse in summer due to mild hayfever.

Please help.

I use dilute baby shampoo twice a day, rinsing thoroughly, and I wipe firmly with a clean flannel twice a week. You can cut your flannel into smaller pieces, and I use a separate one for each eye, so that any infection isn't transferred to the other eye. I was told that a flannel is preferable to cotton wool as the roughness removes any build up.
I was prescribed fexofenadine, as I do have a number of allergies, but I found piriton more effective.

Me too,I use the gel though and a clean wash cloth.

Can anyone recommend a heated eye mask? Nice to have found my tribe.

I'm on five different eye drops some once a day some twice a day the steroid four times a day. My eyes are very dry.

Yellox
Latanoprost
Brinzolamide
Pred forte
Brimonodine tartrate

The hospital gave me carbomer which does soothe them.

www.amazon.co.uk/Carbomer-Eye-tubes-Medicom-Healthcare/dp/B00WX6FMA2/ref=mp_s_a_1_1?crid=2JGPDO9LLF42L&keywords=carbomer+eye+gel+10g+x10+tubes&qid=1677626989&sprefix=carbomer+%2Caps%2C248&sr=8-1

I developed rosacea and associated blepharitis / meibomian cysts which in retrospect I think coincided with the start of peri menopause. Eyes are so much better since starting HRT. Ophthalmologist recommended fish oils / omega 3s too

Just coming on to say this. And you've bought it already.

I spent years with gritty eyes and blocked glands. I did the hot compress each night and eye drops up to 16 times a day!

What got it under control within a few weeks was using Bletherol with gauze pads which are gently slightly rough. I wet the gauze with the solution and close my lids down on the pad and wipe along. This gets to all the areas that are blocked.
Don't be tempted to use cotton wool.

It worked. After so many years of streaming drippy gritty eyes.

These are the pads I was recommended. Cotton wool can deposit fibres into the eye.

Artibetter 100pcs Non Woven Gauze Pads Disposable Gauze Sponges Wound Care Dressing Pads First Aid Surgical Ma sk Making Supplies amzn.eu/d/bNfhpU2

As a (formerly) fellow sufferer, you have my deepest sympathies. I tried pretty much everything - GP/Consultant prescribed, over-the-counter, 'natural' remedies. Nothing worked. Then one day whilst using one of these little wonders, I happened to wipe my eyelids (using each side for each eye) and noticed during the day that the itching had stopped. Tried a few more times and yes, success! No more itching, no swelling, no - well, just nothing. Magic. So I bought (at that time) a huge box of multipacks and kept them in the fridge, only opening 1 bag at a time and cutting the sheets in half, using one half per eyes. Lasted ages and coming straight out from the fridge was was both refreshing and woke me up in the morning :-) More importantly, it stopped my blepharitis in its tracks. After a few weeks I stopped using the wipes, and a few weeks after that the symptoms returned so I used the wipes again with same results. I now just use in the mornings and have no problems with my eyes. I just press very gently along the lash line, I don't 'rub'. You could perhaps buy a single pack from any pharmacy and see if it works for you - if it does, multipacks are the way to go and just cut them and put in a zip-lock back in the fridge.

I wouldn't be without and take some with me if I travel anywhere.

I hope they might provide some relief for you, OP.

The Optase tea-tree cleansing gel is brilliant too and I find it really keeps mine at bay.

Apologies if this is mentioned upthread - on the run this morning. I have horribly dry eyes (apparently my eyelids never quite close properly!) and use Xaalin eye lube at night. However, I really need something for day times, and none of the regular eye drops give enough lubrication. Can anyone recommend something for daytime use please, that won't give me panda eyes??!! (Waterproof mascara.)

I presume you've used Hycosan?

Well. What a bloody coincidence. Found this thread on waking up to a flat up. Over a year of this now. One case of blepharitis, led to a cyst, removed last year, eyes never felt the same since. Had 3 flare ups since. Use ointment as soon as symptoms start and they haven't been as bad as the first flare up.
I have a real fear of putting anything in my eyes so I've tried to stay away from drops but the optrex spray is just not cutting it.
After reading this, going to get some bletherol wash and will use guaze, rather than cotton, from now on.
I did use baby shampoo and sterile salt water in the past.

Tbh I can't remember: will try it. Thanks.

So pleased to see this thread. Thank you so much for aĺl the amazing advice here. Have started getting randomly swollen and or itchy eyelids over the last few months out of the blue, and it seems to be linked to rosacea and peri. I've found extra antihistamines, fish oil, and eyelid scrub are helping (thanks to a previous thread on rosacea here) but when your eyelid is swollen, is it best to do warm or cold compresses? What actually CAUSES the swelling? Hating the Mike Tyson vibe as a school run look.

What made the biggest difference to me was warm compressed and massage.

MN is so helpful with this type of stuff

Thanks so much for the Hycosan tip. Pharmacist recommended Hycosan Extra, which can be used as needed, and it's really helped.