BACKGROUND: Dry eye symptoms are commonly associated with blepharitis and resulting meibomian gland dysfunction (lid margin disease), which impairs the flow of oil from the meibomian glands onto the tear film, causing evaporative dry eye.
WHAT ARE LID SCRUBS? To prevent or treat blepharitis and MGD, patients are typically advised to pay close attention to eyelid hygiene and to keep their lid margins clean and free from debris. The basic practices of this eyelid hygiene are called "lid scrubs".
WHAT ARE THE GOALS OF LID SCRUBS?
- Remove debris.
- Deal with bacteria.
- Stimulate meibomian gland secretions. (This is why lid scrubs are often advised in conjunction with heat treatment - using heat, the oil in the meibomian glands is softened, then the "scrubs" can help get things moving.)
HOW DO YOU DO IT AND WHAT DO YOU USE?
- A popular method is cleansing with commercially prepared "lid scrub" products (SEE LIST BELOW). These can be pre-moistened pads, a foam used on bare fingers, or a fluid applied to a sterile pad.
- One of the most frequently prescribed methods, which is cheaper but not necessarily good for everyone, is baby shampoo lid scrubs, using a Q-tip dipped in a diluted solution of baby shampoo and water. This can be too harsh for some patients.
- Another alternative is simple lid scrubs, using Q-tips dipped in saline (such as Unisol) or boiled distilled water. This is a gentler alternative for those whose tear film is further destabilized by soapy agents on the lids.
SAFETY NOTE: Although "lid scrubs" is the common phrase used for lid cleansing, this does NOT mean that you are to vigorously scrub your lids - we're talking gentle wiping. Before you poke yourself in the eye with a Q-tip (it's not fun) consult your doctor and get some advice on safe care of your lids.
HOW LONG DO YOU HAVE TO DO THEM? Blepharitis and MGD are typically chronic, so lid scrubs typically need to be maintained long-term. You may have to do it more frequently in the beginning to get things under control and then less frequently as "maintenance".
DON'T CONFUSE THIS WITH... Some related conditions such as demodex mites may require further medical treatment if believed to be contributing to MGD. If so, further treatments may be prescribed, such as tea tree oil or antibiotic ointments.