I have itchy, red eyes and small red bumps on the edges of my eyelid and inside. The optometrist diagnosed blepharitis and a chalazion and gave me antibiotic ointment. There are still some flakes. Could Manuka honey help?
Janet Nichols, via email.
Blepharitis is a common condition characterised by inflammation of the eyelid edges and irritated eyes.
Posterior blepharitis occurs when the oil-producing meibomian glands in the rims of the eyelids become blocked due to an increase in the cells lining the gland ducts. This is possibly triggered by bacteria, though we aren’t sure.
The oil is needed to maintain the tear film over the front of the eye, but when the ducts become blocked the oil becomes thicker.
‘I have itchy, red eyes and small red bumps on the edges of my eyelid and inside. Could Manuka honey help?’ Stock image
This also changes the make-up of the bacteria that live there, causing inflammation along the eyelids and eye dryness in the long term, as well as the ‘dandruff’ you describe (which is partly the result of the excess cells).
A chalazion — from the Greek word for a hailstone — occurs when the duct of a meibomian gland blocks completely. The secretions build up, forming a lump. As you have also been diagnosed with this, I suspect you have anterior blepharitis — which essentially means it’s a combination of both problems.
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Eyelid hygiene is the main treatment. This involves using warm compresses and regularly washing the eyelid with diluted baby shampoo on cotton wool, then rinsing with warm water. Massage the lid, using a cotton bud along the eyelid line.
The heat and massage turn the abnormal oily secretions back into liquid, which encourages drainage, while the gentle washing clears the accumulated debris.
If the dandruff is cylindrical in shape, this may be a sign of a microscopic parasite in the eyelash follicles. This is nothing to be particularly worried about. Using diluted tea-tree shampoo once a week might help. Apply it carefully with cotton wool and then rinse.
Taking omega-3 fatty acid supplements may improve the dry, gritty eyes, although study results have been mixed.
I’ve seen no published evidence suggesting Manuka honey can help, although Manuka drops may have a beneficial antiseptic effect, so there’s no reason not to try it.
I’ve had IBS and diverticulitis for years. I developed diastasis recti 15 years ago, which seems to have worsened, but doctors say it’s not a problem. Can you see any link, and should I just live with it? I am 79.
Alan J. Smith, Chelmsford, Essex.
Your life must be dominated by the bowel problems, but I don’t think there is a link between those and the diastasis rectus abdominis (also known as diastasis recti) — where the abdominal muscles are separated, causing a bulge in the abdomen.
The rectus abdominis muscles on both sides of the abdomen run in parallel from the ribs to the pelvis. If the gap is more than 2cm or so, it is considered abnormal. Some people are born with this, but in most it is a result of raised internal abdominal pressure. Pregnancy, obesity and abdominal surgery can all cause it.
‘I’ve had IBS and diverticulitis for years. Can you see any link, and should I just live with it? I am 79.’ Stock image
Diastasis rectus abdominis is obvious on examination — when lying flat there is no abnormality; but when you sit up, the increase in abdomen pressure results in a large bulge down the centre.
Weight loss and exercise can help by reducing fat, which may push abdominal contents forwards. It may also help tighten up the rectus muscles.
Where this doesn’t help, there is debate over surgery. One view, as you mention in your longer letter, is that the condition can be linked to lower back pain, which you’ve experienced. However, there are no studies to show surgery reduces this, so it’s essentially cosmetic.
I doubt whether the NHS can carry out this surgery due to workload, so continuation of your physiotherapy programme seems the best course of action.