Is there a connection with PMR and Blepharitis?

[HelenDaisy]

Blepharitis: is it part of the PMR 'journey'? Or is it unrelated? As if PMR isn't enough....

[PMRpro Ambassador]

It isn't really part of PMR per se but a lot of people do develop it - partly because dry eye is common with many autoimmune disorders and that can contribute to it and also the pred probably doesn't help the body fight off the bacterial infection that can be involved

allaboutvision.com/conditio...

This

healthunlocked.com/pmrgcauk...

is a thread from last year about it with a lot more info and if you then look at the Related posts there you will find links to other past posts on the topic.

[HelenDaisy in reply to PMRpro]

Thank you. I’ll look into it. I just hope that this isn’t a lifelong condition. One of the few things that makes me feel good is my makeup.

[PMRpro Ambassador in reply to HelenDaisy]

If you do really scrupulous cleansing of your eyes - with mild soap and water rather than eyemake up removers - you will probably be able to get it under control. But you do need to be consistent about it. People in the past have said that using hot towels over their eyes or heated masks to soften the plugs of sebum have made a big difference.

[SheffieldJane in reply to PMRpro]

I now see from the linked thread that I have been deeply in denial about the duration of my eyelid infection. I had it a year ago! All I can do is make it look presentable by keeping it clean and lubricated. I paid £200 approximately, to see an Opthalmologist who ensured that my tear ducts were not blocked with a very gentle procedure. He was more interested in the exophthalmic signs he could see from Graves Disease from the 80’s. I think the proneness to infection is one of those on-going things that we have to manage ad infinitum. 😎😕

[PMRpro Ambassador in reply to SheffieldJane]

It's like PMR itself, not something to treat once and forget about - but ongoing good management makes a big difference.

[HeronNS]

If you use soap to wash your face (I know many don't) close your eyes and run the soap right over your eyelashes, then rinse off. I wouldn't be surprised if just a few days of this alleviate the problem. I don't bother with baby shampoo or other recommended allegedly milder products or eyelid wipes etc. Just Pears soap.

[SheffieldJane]

I have had a nasty eyelid infection for about 4 months. I think it’s persistence is to do with Prednisalone and Tocilizumab suppressing my immunity. I have GCA and Large Vessel Vasculitis. I was fine with PMR alone ( 4 years). It seems worse than Blepharitis with a thickened inflamed lid with a boil in the centre. Oral antibiotics gave me a couple of weeks relief, nothing else touches it. I keep my eyes scrupulously clean. ☹️

[HeronNS in reply to SheffieldJane]

Do you use hot compresses? I had a stye a few years ago (pred related I suspect as never had one before) and my doctor told me just plain water, not to use salt. Took ages to clear up. Next time it happened I added salt to the water and it was better in a couple of days. No issues since then, touch wood.

[SheffieldJane in reply to HeronNS]

Thank you for the tip. I will try this. You have to pause Tocilizumab for antibiotics. As soon as I started injecting again I felt the tell tale prickle in my eyes.

[HelenDaisy in reply to SheffieldJane]

I’m so sorry that sounds horrible for you. I’ve only had styes since prednisone.

[PuttyPenguin]

I've had blepharitis for most of my life but it has got worse since my diagnosis. There's remedies for it in Boots or you can use Johnsons' baby shampoo and rub that, with a cotton wool bud, along your eye. It's annoying, but in the scheme of things, it's not the worse thing that can happen.

[Marijo1951]

I've had dry eyes and intermittent blepharitis for a long time, particularly in my left eye. I've always assumed it was a side effect of pred rather than a result of PMR or GCA, but I'm not certain that that's correct. Whatever causes it, it's very unpleasant.

My present regime, as recommended by the optometrist at Specsavers Crouch End branch, is to wash morning and evening with Optase eye lid cleansing gel, use Hycosan Shield eye drops once a day and Hycosan Night gel at bedtime. I also have an Optase moist heat mask, but I'm a bit lazy about using it. I think the Hycosan Shield eye drops are the best I've tried for stabilising the tear film. Like all eye products they are expensive, but they definitely reduce the soreness a lot as well as preventing the redness.

[HelenDaisy in reply to Marijo1951]

Are you able to wear makeup? After everything else I’ve been through, I need makeup to cheer me up and restore some self esteem. I can’t face the world without it: my mask.

[SheffieldJane in reply to HelenDaisy]

I like the morale boost of make-up. Mascara used to be a big part of that, not now with the eyelid infection alas. I wear a little foundation on the lower half of my face and a little pearly highlighter, blusher, as well as a long lasting vivid lip . I have long eyelashes so I occasionally curl them. It is a different look but quite nice I think and very easy. I have recently sent for a clear mascara that promises to help with Blepharitis . I somehow doubt it though. We’ll see. Not the time to throw the towel in ladies, what with the wild hair. Have a happy Easter. Xx🌼🤗

[Marijo1951 in reply to HelenDaisy]

I wear a bit of foundation and lipstick but have never bothered much with eye make up, especially when I found that I was evidently allergic to mascara, even the supposedly hypoallergenic types. I'm certainly not tempted to start using eye make up now.

[borednow]

I use Garnier skin active Micellar cleansing water (Boots or any chemist). Fantastic stuff - recommended by optician. If you're in the UK, optician gave me a little leaflet issued by NHS about Blepharitis which I found very useful. Maybe Google it?

GP didn't know what was wrong with my eye!! Hey ho!!

[Marijo1951 in reply to borednow]

This is what I used before I was advised to use the Optase eye lid cleansing gel. I think the micellar water was quite effective for a long time, but when the condition flared up again it was less effective.

[PMRZ]

I have had it for years, unrelated to PMR. I use Blephasol every day and lubricating eye drops. But I don’t wear make-up anymore, it’s just not worth the pain!

[Pixix]

Just FYI, I was diagnosed with blepharitis two years before my PMR started, so in my case not connected! I have been shielding & haven’t worn makeup for 14 months now! No visitors to house except delivery people, & I’m learning to live without it...for how long, I’m not sure. Bought a mask, supposed to heat in microwave then out on eyes for ten minutes a day...lost the mask & don’t seem able to find a free period of ten minutes...ah, well, onwards!

[Telian in reply to Pixix]

I have a mask similar to yours and it does work

[Pixix in reply to Telian]

Thanks! Sadly, although I can find the soft case it arrived in, I seem to have lost the mask...will keep hunting! S x

[PMRpro Ambassador in reply to Pixix]

Give up, buy another, the "lost" one will turn up and you'll have a spare!!!!

[Pixix in reply to PMRpro]

Thought of this solution, but the other is brand new as I just can’t find the extra ten mins a day...already pandering to my other medical conditions with thirty mins physio, twenty mins on treadmill! Enuff is enuff! Would rather spend £4 on the 800 diet book I forgot to buy when it was on offer...but thanks to you for putting the 800 book in a post! S x

[PMRpro Ambassador in reply to Pixix]

I can drink a cup of tea with my eyes closed while listening to the news - wouldn't manage the treadmill blind I admit ...

[Pixix in reply to PMRpro]

I tried closing my eyes on the treadmill as thought it would be ace if I could combine the two...but became really dizzy & kind of disoriented within about 30 seconds...weird! But I can’t use the treadmill without holding the bars either, it’s trying to read at the same time, whoops!! I don’t drink tea, but can manage ribena & listening to David talking! S x

[PMRpro Ambassador in reply to Pixix]

Oh no - treadmills terrify me with all senses wide awake!!!

[Seekingasolution]

I’ve developed dry eye during the course of PMR which I’ve found irritating enough - not just the way it feels but red eyes don’t look so great either. In Boots there are a number of Hydrosan products - I’ve learnt that the red one is the strongest and the best for easing the problem. In the same section there are also some bleph wipes which are really nice to use. I always keep some with me on the move in case of need. I’ve upped the amount of plain water I drink too which seems to help - and yes make up back on !

[HelenDaisy in reply to Seekingasolution]

Good to hear! I feel so miserable with yet another problem

[Seekingasolution in reply to HelenDaisy]

I looked back to the PMRPro post and watched the Dr Hillary video. I think the good news is you can probably improve this symptom dramatically. I keep Hydrosan by the bed and a drop goes in as I wake up. It’s fine !

[Seekingasolution in reply to Seekingasolution]

Apologies - I should have said I can manage what I have to put up with like this . One thing this site gives you, apart from a lot of very useful information and support is a good sense of perspective. There’s so many people with the same condition or worse grappling with multiple conditions. Knowing you aren’t alone helps a lot. Knowing you might be able to improve gives you hope. I didn’t mean to imply that everyone is ‘fine’ with eye conditions which can of course vary dramatically.

[SheffieldJane]

It does add to the falling apart feeling. Courage!

[Sophiestree]

I have had dry eyes for years and blepharitis. Dry eye drops are a must to help lubricate your eyes and a gel at night, plus a hot eye compress really helps the blepharitis. You can get something called SpaceMasks which are quite good, which I have if I am going away for work with no access to a microwave. The prednisolone made my eyes far far worse for dry eyes and infection, and like SheffieldJane the TCZ has just added to the infection issue and I get an eye infection every month at least which I treat with chloramphenicol. DHC sell a mild soap and an olive oil soap which I can use on my face and gently around my eyes (my skin is very dry and sensitive) which might help, also OcuSoft do an eyelid wipe which might help. Make sure your mascara is not old if you want to wear make up as otherwise you are passing on the infection/issue each time.

[Telian in reply to Sophiestree]

Be careful around he eyes as they draw in whatever you put near them. I’ve had Blepharitis for many years before GCA/PMR, caused apparently by a bad bout of Acne Rosacea. Currently use prescribed Gel Tears. Am allergic to chloramphenicol.

I have chronic dry skin and can’t use any of the ‘soap free’ products. I’ve showered in Dermol 500 for nearly 30 years now and moisturise with Doublebase Gel, which I believe you can but otc now. I get mine on prescription.

The eye pads are good, optician sold them me. I mislaid it so bought another and promptly found the other!

It’s about what’s best for you. Such a massive market. The simplest daily routine I was given by the hospital eye dept was to cleanse your eyelids each morning with cooled boiled water using a cotton bud. It is soothing. I can’t be without my mascara.

When I had AR the whites of my eyes were blood red and first thing the nurse said at the eye clinic was ‘you’re wearing mascara’ and told me off! It was silly of me really. I was on antibiotics for 4 1/2 years!

[HeronNS]

Bemused by people wearing make up these days. I did wear a little, primarily so I didn't scare small children as I have those awful raccoon eyes, but now that I have to wear a mask whenever I leave my home it hardly seems worth it. No one can see me behind my mask and when outdoors very often my shades as well! Incognito, that be me. I guess when things finally return to normal I'll have to replace all my make up so as not to risk infection from old, opened products

[HelenDaisy in reply to HeronNS]

I teach exercise classes on Zoom and really prefer to look made up. It makes me feel like me. My eyes look red and piggy. I hate it and feel beat down by yet another PMR thing.

[HeronNS in reply to HelenDaisy]

True you don't have to wear a mask when on Zoom. I guess it all depends on how you feel because people looking at your small image on a screen aren't going to notice the things you are so aware of. I'm sure you look much better than you think!

[HelenDaisy in reply to HeronNS]

I’m the teacher so I full their whole screen! There’s no way I can be naked eyed!

[LCfan]

I had dry eyes and blepharitis years before PMR started in 2019. An eye consultant and an opticion both advised to dilute a tiny drop ofJohnsons baby shampoo in a little cool boiled water and use cotton buds to wipe all around the eye, going only in one direction with a new bud for the other eye. It usually worked after a few days for the itchy blepharitis. GP prescribed drops for dry eyes and an oily lubricant for nighttime. Haven't worn make up for ages, and frightened to use eye make which really made me look and feel much better.

[NanJean]

My Blepharitis diagnosis was much before GCA & PMR. It worsened on steroids. My Ophthalmologist did not want me to use any shampoo like baby shampoo reviewofoptometry.com/artic...

I also have been diagnosed with seborrheic dermatitis. Between the oily eyelids and oily facial skin, I found a discussion on a page which talked about using wipes of benzalkonium chloride up to 4 times a day! I had these wipes in the car at the time from a dollar store. And used them. Wow, they worked to stop the oily, crusty, itchy feeling. I use them once or twice a day. Now that many of these wipes have added alcohol, I have to be careful not to use them. I also don't want the Vit E nor perfumes, but finding brands without that is harder. Besides the Refresh Plus preservative free drops and warm compresses also go a long way in relieving the discomfort of Blepharitis .