Lid Scrubs: Home-Cooked vs Commercial

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Extracted from http://www.agingeye.net/otheragingeye/blepharitis.php, published in 2003 in Eye Digest, U. of Illinois Eye and Ear Infirmary.

Lid Scrubs

There are several ways of performing lid scrubbing. You can choose whichever one you are most comfortable with. The scrubbing should be directed at the base of the eyelashes on the eyelid margin. Soaps (cleansing agent used) should not have excessive perfume or lotion content.

Neutrogena bar soap: This bar soap is used to form lather on the clean finger tips. Lather is then applied with fingertips on the eyelid margin and eyelash bases for up to 1 minute (with eyelids gently closed so that soap does not enter the eye). This is followed by a facial rinse.

's Baby Shampoo: The baby shampoo is first diluted one-to-one with water in a 'cup' in the palm of the hand. This is then mixed by rubbing with the clean fingertips and then applied in a gentle oval scrubbing motion to the margin and eyelash bases of the closed eyelid for 1 minute, followed by a fresh water facial rinse.

The soap solution (bar soap or baby shampoo) can alternatively be diluted in a container (e.g. plastic cup) and scrubbing performed using a washcloth wrapped around a finger (after dipping it in the diluted soap solution. A cotton tip applicator may be used alternatively.

Commercial Eye Scrubs

There are commercially available cleansing pads that are presoaked in a cleansing solution (OCuSOFT Lid Scrubs or Novartis Eye-Scrub). These cleansing pads are equally effective albeit more expensive method of lid scrubbing and are claimed to be less irritating to the eyelids. One study showed then to be preferred choice by patients as compared to other methods of lid scrubbing (CLAO Journal 1996;22:209-12).

Antibiotic treatment

The use of an ointment on the eyelid margin immediately after lid scrubbing may help to increase patient comfort. The choice here is usually Erythromycin eye ointment or Tobradex eye ointment (steroid-antibiotic combination). In addition, the antibiotics help to further reduce the bacterial load on the eyelids.

Oral tetracyclines (doxycycline or minocycline) for about 3 months can be used in recalcitrant Meibomian Gland Dysfunction (MGD) cases. Tetracycline antibiotics affect the meibomian gland secretions, inhibit bacterial lipases as well as reduce the eyelid bacterial load.

KJ