Symptoms on the eyelid

Swelling of the eyelid can have various causes and is harmless in most cases. Since the eyelid is anatomically predestined for swelling due to weak connective tissue and few muscle fibres, it can often swell as an accompanying symptom. An everyday example is an allergic reaction to pollen – the nose starts itching, the eyes become red and may also itch and the eyelids swell.

These symptoms disappear again as soon as you do something about the allergy. Another example is a child who has a cold, which is also known colloquially as a “red eye”. This is caused by a congestion and swelling in the nose and paranasal sinuses, and the tear fluid can no longer drain out of the eye via the lacrimal duct, so that the fluid accumulates in the eyelids.

If the child’s nose is kept free by decongestant nasal drops or spray, the eyelids also swell after a while. Further causes can be an allergic reaction to an insect bite, diseases of the atopic form (atopic dermatitis, bronchial asthma, allergic rhinitis), inflammatory skin diseases (eczema), inflammation of the edge of the eyelid (blepharitis) or the conjunctiva (conjunctivitis) or also the hormone status of the woman, whereby the eyelids can swell before menstruation. More rarely, abscesses or tumours can be responsible for the swelling.

As one measure, one can try to reduce the swelling of the eyelid with the help of cold black tea bags or cool packs. If the swelling lasts for an unusually long time, increases or pus develops, you should consult a doctor. Pain on the eyelid can have many causes.

If it is an inflammation, the following symptoms can be signs of inflammation: Calor (overheating), Rubor (redness), Dolor (pain), tumor (swelling) and Functio laesa (limited function). A possible cause is a barleycorn or hordeolum, which is an acute bacterial inflammation of an eyelid gland. A typical pathogen of a barley grain is the bacterium Staphylococcus aureus, more rarely streptococci.

A distinction is made between a hordeolum internum, in which a meibomian gland (sebaceous gland at the edge of the eyelid) is inflamed, and a hordeolum externum, in which a minor or zeis gland (secretion and sebaceous gland) is inflamed. A barleycorn manifests itself as a painful red spot or nodule in or on the eyelid with a possible central pus point, which can spontaneously open and flow out. Barley is treated with local antibiotics, heat and infrared radiation.

Blepharitis, the inflammation of the eyelid margin, can also be painful. Another cause can be the wearing of contact lenses that rub the inside of the eyelid. If the eyelid is reddened the upper eyelid is usually affected.

One cause can be an inflammation that makes the eyelid redden. The reason for this can be an inflammation of the eyelid margin or also a barley or hailstone. Further accompanying symptoms in these cases are adhesions and itching, swelling and a foreign body sensation on or in the eye.

An allergy to pollen, food or medication can also cause redness. The redness can be accompanied by watery eyes. Another cause can be contact dermatitis, caused by contact lens solutions, care products or cosmetics.

In addition to redness, the eyelid may also be swollen and itchy. Depending on the cause, it may be advisable to rinse the eye and treat with cold or heat, as is the case with barley. This topic might also be of interest to you:

Hailstones

Itching of the eyelid is often an accompanying symptom of an inflamed or irritated eyelid.

A dry or overstrained eye is often responsible for the itching. In this case it helps to close and open the eye several times to create a tear film as a lubricant or just close the eyes to relax. Special eye drops for dry eyes can also help against itching.

Another cause can be allergies that make the eye itch. In this case it is advisable not to rub the eye, as this could allow more allergens to enter the eye and increase the itching. Furthermore, cosmetics can irritate the eyelid and cause itching.

Another possible cause is inflammation of the eyelid margin or conjunctivitis. Also in this case rubbing should be avoided. A remedy against itching are cool wet cloths or cotton pads which can be put on the eyelids.

A drooping eyelid is also called ptosis and describes a low position of the upper eyelid. This drooping often leads to restricted vision. Possible causes are muscle weakness, nerve damage or weakness of the connective tissue.

A drooping of the eyelid can exist since birth. In this case it is a congenital disorder in which the eyelid lifting muscle or the nerve responsible for it has not been properly developed. A drooping eyelid can also occur with advancing age.

The reason for this is the connective tissue in the eyelid, which loses elasticity with increasing age and thus becomes flabbier. Furthermore, a drooping eyelid can be part of a chronic disease among other symptoms, as is the case with myasthenia gravis. If the drooping of one or both eyelids occurs suddenly, a doctor should be consulted immediately, as it could be a stroke or cerebral haemorrhage.

More rarely, poisoning, such as from snake venom or the botulinum toxin of the bacterium Clostridium botulinum, may be the cause of a drooping eyelid. More about this:

Causes of ptosis
Therapy of a ptosis

A knot on the eyelid is usually no cause for concern. Often the lump is a hailstone or barley grain, caused by a congestion of drainage from the Zeis, Moll or Meibom glands.

A hailstone usually comes as a nodular swelling on the edge of the eyelid, originates from the Zeis or Meibom glands, is not painful under pressure and is not contagious. On the other hand, a barleycorn is contagious due to the infestation with bacteria such as streptococci or staphylococci, can affect all three glands and can be painful. Both types of inflammation are accompanied by redness and swelling.

If the node is yellowish in colour and sharply defined, it may also be xanthelasma, a deposit of fat or cholesterol. More rarely, a malignant degeneration is behind a lump. The most common malignant growth on the eyelid is the basal cell carcinoma.

Much rarer are eyelid tumours which originate from the squamous epithelium, sebaceous glands or from the Merkel cells in the skin as well as melanoma. If you notice a proliferation on the eyelid, you should always consult a doctor for clarification. – Obstructed lacrimal duct

Basal cell carcinoma of the eye
Causes of xanthelasma

In general, white or greyish small scales are a sign of dry skin, with the sebaceous glands not producing enough sebum.

But also an overproduction of sebum can lead to dandruff which then looks rather yellowish and greasy. On the eyelid, dandruff can be a symptom of blepharitis, the inflammation of the eyelid margin. The inflammation originates from the sebaceous glands at the edge of the eyelid, which become clogged. White-grey greasy scales form at the edge of the eyelid, so that the disease is then also called Blepharitis squamosa. This topic might also be of interest to you:

Dandruff – the right treatment