Inflammatory diseases as cause
Let us now turn to the numerous inflammatory diseases that can cause a swollen lower eyelid. Here it is important to keep in mind that inflammatory skin diseases can also spread to the area around the eyes, where they can lead to inflammation of the lower eyelid (to blepharitis). But not only bacteria, also viruses can lead to problems and inflamed lower eyelids.
Here, herpes simplex, herpes zoster, mollusca contagiosa and hailstones are the most common clinical pictures. However, an inflammatory swelling of the lower eyelid can not only be caused by skin diseases, but also by pathogens. Contact lens wearers are particularly often affected by inflammation in this area due to frequent contact with the eye and the eyelids, and must therefore be particularly careful and thorough in their eye hygiene.
For example, bacteria can cause erysipelas, eyelid abscesses, eyelid phlegmon and barley grain. The latter is probably the most widespread inflammation of the lower eyelid. This is actually an acute inflammation of one (or more) of the Meibom glands in the lower eyelid caused by bacteria.
In most cases, staphylococci are the pathogens. A barleycorn can occur on both the lower and upper eyelid. Not only does an inflammation of the lower eyelid occur, but also a very painful swelling and reddening of the skin, which can spread to the entire eyelid.
A grain of barley is not dangerous in itself, but first of all it hurts and obstructs vision due to the swelling. However, if barley grains occur more frequently, one should have the blood sugar values checked by the family doctor to exclude diabetes mellitus. Eczema is one of the most common skin diseases worldwide.
They come in many different forms and are not infectious. Eczema includes allergic contact dermatitis, neurodermatitis (sometimes also called atopic dermatitis or atopic eczema) and seborrhoeic dermatitis. The skin disease rosacea can also promote lower eyelid inflammation.
Acute eczema of the eyelid can be recognized by the typical symptoms: severe itching and reddened skin, small blisters or nodules, swelling and crust formation at the affected area. In the course of time the skin thickened there and became very dry and cracked. Especially in the area of the lower eyelids such eczema is very unpleasant and disturbing.
In order not to overlook another more serious disease, one should always clarify the cause of the eczema on the lower eyelid. They are not dangerous per se, but the torn and inflamed skin surface can cause parasites such as mites and lice to pray for a favorable environment, which is why careful eyelid care is so important. If then “only” a skin disease is really the cause for the inflamed lower eyelid, it is better to consult a dermatologist instead of an ophthalmologist.But be careful: both the barleycorn and the hailstone should always be examined by an eye specialist.
There are also several glands in the eyelids. The so-called meibomian glands, for example, produce sebum that keeps the edge of the eyelid and the eyelashes supple. From the edge of the eyelid, the oily secretion is also transported to the inner side of the eyelid, thus reducing friction between the eyelid and the eye surface.
In addition, there are also the zeis glands and the minor glands, which also produce sebum and sweat, and end between the lashes at the edge of the eyelid. If such a small gland becomes blocked and/or inflamed, the secretion produced in it accumulates and the gland swells and with it the eyelid at the site. The clinical picture is then also known as “barleycorn“.
The so-called hailstone is also an inflammation of the lower eyelid, but of a somewhat different kind. Here, the cause of the inflammation lies in a chronically blocked Meibom gland in the lower eyelid. The sebaceous secretion accumulates more and more and the tissue around it becomes inflamed.
A small hard nodule forms at the site of the gland. However, there are usually no bacteria or viruses involved here; it is merely a nodular cell cluster in the tissue that has formed as a result of the chronic inflammation (in this case, doctors also speak of a so-called granulomatous disease). The hailstone, unlike a barley grain, is not painful and is only disturbing due to its size and location.
Sometimes it is also slightly reddened, but this is not serious. The hailstones usually disappear on their own after a while, but in particularly persistent cases the doctor must give you medicine and prescribe anti-inflammatory ointments or tablets.
- Hailstones
- Ignition of a hailstone
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