Ophthalmology & Optometry/Persistent eyelid infection
Hello. I am a 53 year old male and have a history of blepheritis as well as a few styes/chalazions over the years, but had not had one in several years prior to this September. In mid-September I got a lower lid infection for which I was eventually prescribed Keflex, and which resolved into a painless (but still red) bump over the course of 2-3 weeks. That bump (chalazion I assume) is still there, but as best I cant tell it isn't bothering me on a day to day basis. Then a couple of weeks later, in late Oct./early Nov., I got an upper eyelid infection on the same eye. The upper lid seemed to start out much like the lower lid did, i.e., the entire lid got very red and swollen, etc. The optomotrist I had seen for the first infection put me back on Keflex, but after 5 days or so with no improvement I went to an ophthalmologist who put me on both Doxycycline and Bactrim. The very swollen lid slowly improved over the course of the next week, until it was about 75% better. However, this infection did not resolve into a localized bump like the first one. The doc called this one cellulitis, and it is more like layers of the skin are infected down inside the lid, with the infection seemingly focused on the middle lid margin. Despite the presence of a small white head there a couple of times, it never really drained much either. It did get quite a bit better than it was initially, leaving only a small portion of the center of the lid that is still somewhat red and swollen, and it remains mildly irritating to my eye function on a daily basis, but not really painful to the touch. Because it didn't completely go away, the doc put me back on the doxy/bactrim for another 2 weeks, and when that didn't work then tried a Medrol dosepak to treat it more like inflammation, but neither the additional antibiotics nor the medrol has had any real effect on it. Any ideas about why it seemed to resolve at first but now just won't heal completely? My doc is talking about having a CT done of my orbit just to check things out, but I don't have any other symptoms besides the upper lid itself and the irritation associated with it. Thanks for any thoughts you may have.
It seems for some technical reason you have not received my reply. sorry for the delay.
Those who get repeated chalazions (bumps on the eye lid) or other eye lid and lacrimal system problems need further systemic evaluation especially to rule out Diabetes or any other immune suppressing cause.
The treatment of these issues once they occur is usually the same- hot fomentation + antibiotics and sometimes need for anti inflammatory medication if moderate swelling of the lids.
When the cysts harden, they form a hard nodule or a localized bump which is felt by the finger tips and sometimes even seen. This usually happens if the drainage of the fluid has not taken place. Hence we advise all those who suffer from it to do repeated hot fomentation right at the beginning to keep the cyst soft in order to allow it to drain off.
In some cases when this cyst hardens over time, the only way to remove it is via a minor surgery by incising a small area in the underside of the eye and removing the hard cyst.
The main guidance I would like to give is to look beyond the eye and find the cause in the system. read more on http://www.shroffeye.org/extra-and-intraocular-inflammations-and-infections/
for understanding the details of what i mean.
I cannot comment on the need for CT Scan as this usually comes out of the eye examination findings.
Basically, this is a common condition, so do not panic. and do look into the article (link) where various causes are cited so that you may find a permanent solution by controlling those if found to have any.
Hope this helps,