Why Lid and Lash Hygiene Matters for Eye Health

Every day our eyelids and lashes are exposed to dirt, debris, and microorganisms which is why maintaining daily eyelid hygiene is essential in the prevention of many chronic eye conditions and infections. It also contributes significantly to overall ocular comfort as well as aids in the maintenance of a healthy tear film, which is critical for patients who suffer from dry eyes. 

Here are a few conditions to be aware of - that typically can be avoided by maintaining proper eyelid hygiene.

Blepharitis

Blepharitis is inflammation that affects the eyelid margins. Most often, this is caused by higher levels of bacteria (usually staphylococcus aureus) or eyelid mites (a parasite called Demodex) around the eyelids and eyelashes. The presence of low levels of staph bacteria in this area is normal, but without regular maintenance of lid hygiene measures, these levels can increase leading to inflammatory symptoms and chronic ocular discomfort. Regular cleaning of the eyelid and lash area can help remove excess oil, debris, and bacteria that contribute to this condition. If left untreated, blepharitis can lead to discomfort, redness, and also spread causing more complicated eye infections even affecting other areas of the eye (1). 

Eye infections

The eyes are vulnerable to infections like conjunctivitis (“pinkeye” which can be caused by bacteria, viruses, allergens or fungi) and hordeola, chalazia or styes (generally caused by bacteria). These conditions can result from the buildup of dirt, oil, and bacteria along the eyelash area. Regular cleaning routines and antimicrobial lid hygiene regimens can prevent the accumulation of these pathogens and reduce likelihood of developing eye infections (2). 

Dry eye  

Eyelid hygiene plays a crucial role in dry eye disease. The oil-producing meibomian glands which are primarily responsible for tear film stability are located in the eyelids. If the meibomian glands become blocked by accumulated debris on the eyelid (including bacteria, makeup, or other contaminants), it can worsen dry eye symptoms and further the insufficient lubrication of the ocular surface. Keeping the eyelids clean helps to promote proper meibomian gland function (3).

Maintaining clear, stable vision

As mentioned previously, excess buildup on the eyelid/eyelashes can interfere with the proper functioning of the meibomian glands. Not only does this worsen dry eye disease, but it also causes blurriness and instability in your vision. Regular eyelid cleansing helps maintain clearer, more stable vision and promotes overall eye comfort (3).

Irritation due to residual makeup, bacteria and debris

If you are a makeup-wearer, not removing all traces of makeup before bed can lead to clogged pores, clogged meibomian glands, irritation and even eye infections (3). For contact lens wearers, lid and lash hygiene is even more important since debris and bacteria around the eyes can easily become trapped underneath the lens, increasing risk of contact lens related infection and discomfort as well as decreasing overall contact lens tolerance. Cleaning the lids and lashes can also help reduce irritation in conditions like allergies (4). Removing allergens or irritants from the eye area minimizes the chance of an allergic reaction or flare-up.

How can I maintain eyelid and eyelash hygiene at home?

Using gentle cleansers for the eye area (and using them regularly) are helpful. Generally, cleansers with a shorter list of ingredients (reduces chance of allergy/sensitivity) and potentially with antimicrobial properties would be ideal. If you are unsure if the cleanser you are using is sufficient, asking your optometrist can also be helpful. They may also be able to guide you or suggest a cleanser that is more specific for bacterial or even parasitic buildup if you are more prone to that. There are many antimicrobial lid hygiene products available such as eyelid wipes, hypochlorous lid sprays, tea tree oil wipes, eyelid cleansing gels, among others.

In fact, Blinkjoy has recently launched two groundbreaking additions to the Blinkjoy family, designed to elevate your eye care routine and keep your eyes feeling healthy and happy.

The world's first hypochlorous 0.02% gel that also contains hydrating agents such as hyaluronic acid, castor oil, and evening primrose seed oil to soothe and restore skin barrier health. The formula is all-natural and without preservatives, dyes, or fragrances.

A gentle vibrating silicone brush that eliminates the need for finger scrubbing, ensuring a more hygienic and effective cleansing experience. The brush vibrations gently massage the lid margins and sensitive eyelid skin without causing irritation.

Are there in-office treatments available?

Yes. If you are suffering from chronic blepharitis or struggling to manage with at-home treatments, there are several in-office treatments available that can be much more effective at removing buildup on the eyelid area. These procedures usually involve an eye care professional utilizing more specialized equipment than what you’d be using at home to remove debris. A manual exfoliation is done by a doctor or trained healthcare worker applying a concentrated antimicrobial gel on the eyelid area and completing an exfoliating treatment. Other procedures like Blephex utilize handheld, specialized equipment to exfoliate the lid margins (5). Some eye care professionals will simply use povidone iodine, a surgical antiseptic agent, and apply that to the eyelids to kill and remove bacteria. Intense Pulsed Light (IPL) therapy could also be a good solution, especially if you also suffer from chronic dry eye, ocular rosacea and/or Demodex mites (6). Depending on your specific case, your optometrist will be able to recommend which one of these procedures would be best for you. 

Conclusion

By maintaining proper lid and lash hygiene either through at-home remedies or in-office hygiene treatments, you can minimize the risk of several eye conditions. Reduced risk of eye infections, ocular discomfort, worsening dry eyes as well as promoting better long-term eye health are all outcomes of good eyelid hygiene. Ask your optometrist if you could benefit from any of these methods.

Contributors:

Sarah Farrag, OD

Dr. Sarah Farrag is originally from Halifax, Nova Scotia, and is happy to be practicing optometry in her own hometown. She graduated with honors from the University of Waterloo Doctor of Optometry program in June 2015. In addition to routine optometric care, Dr. Farrag also fits specialized rigid and scleral contact lenses for corneal degenerative diseases including keratoconus and post-corneal transplant eyes.

References:

1. Putnam, C. M. (2016). Diagnosis and management of blepharitis: an optometrist’s perspective. Clinical optometry, 71-78. 

2. Yang, Shu, et al. "The microbiome of meibomian gland secretions from patients with internal hordeolum treated with hypochlorous acid eyelid wipes." Disease Markers 2022.1 (2022): 7550090.

3. Benitez-del-Castillo, Jose M. "How to promote and preserve eyelid health." Clinical Ophthalmology (2012): 1689-1698.

4. Dhallu, Sandeep. "Eyelid health: management of itchy, sticky and swollen lids: This article outlines the clinical presentation and management of itchy, sticky and swollen eyelids." Optometry Today 63.6 (2023): 48-52.

5. Noh, Ada, Srinivas Kondapalli, and Laura Periman. "Biofilm busting 101." (2023).

6. Tashbayev, Behzod, et al. "Intense pulsed light treatment in meibomian gland dysfunction: A concise review." The ocular surface 18.4 (2020): 583-594.