Eyelid problems

Conditions that can lead to eyelid problems include:

• Blepharitis — a common inflammation of the rim of your eyelids that can cause itchy, crusty eyelids
• Chalazion — a small, firm fluid-filled cyst (lump) that may feel tender or heavy; it forms when tiny glands on your eyelid become blocked and inflamed
• Conjunctivitis — also known as pinkeye, it is usually caused by infection with bacteria or viruses, or an allergy; it often occurs during cold and flu season
• Drooping upper eyelids (ptosis) — when your upper eyelids droop or look hooded as the muscles that lift them have become weak; your eyes may also feel sore and gritty
• Lacrimal duct obstruction — blockage of the lacrimal duct, which sits at the inner corner of each of your eyes and drains tears into your nose; blockage can cause inflammation, swelling, infection and pus that leaks from your eyes
• Stye — a painful, pus-filled lump on your eyelid caused by infection of the base (follicle) of an eyelash

If you have Graves’ disease, an autoimmune condition that affects your thyroid gland, it can sometimes cause your eyelids to become inflamed — this is called Graves' eye disease or Graves' ophthalmopathy.

Allergies can also cause your eyelids to swell, as well as injuries eg if you are hit in your eye, blood may collect under your eyelid, causing swelling.

Often eyelid problems aren’t serious and will get better on their own. However, you should seek urgent medical attention if you suddenly lose your vision or your eyes hurt. 

You should also seek urgent medical help if you have eyelid problems and also feel unwell. Sometimes, swollen, painful eyelids can be a symptom of a severe allergic reaction or a serious infection such as cellulitis. 

Eyelid problems can cause a range of eyelid symptoms, including: 

• Flaky or crusty eyelids
• Itchy eyelids
• Lumps on your eyelids
• Painful eyelids
• Swollen eyelids

You may also develop dry, gritty or watery eyes and/or find it difficult to close or open your eyes.  

Swollen eyelid

A swollen eyelid isn't usually serious and in most cases, will get better on its own within two days. However, if your swelling goes on for more than two days or you also have blurry or lost vision, eye pain or the sensation that something is stuck in your eye, see a doctor urgently.

Itchy eyelids

Itchy eyelids can be caused by allergies or blepharitis. They can also be caused by an allergic reaction to creams or cosmetic products that you use on or around your eyelids — this is called contact dermatitis and will usually get better when you stop using the product.

Droopy eyelids

Ageing can cause the skin of your upper eyelids to become looser, causing your eyelids to droop. If this blocks your vision, it is called dermatochalasis.

Ageing can also cause the muscles that control your upper eyelid to weaken, causing your eyelids to droop. This is called ptosis and can be corrected with surgery if it reduces your vision.

Rolling eyelids

Ageing can cause the edges of your eyelids and eyelashes to roll inward — this is called entropion. It can cause discomfort and make your eyes water if your eyelashes irritate the front part of your eye (cornea).

Yellow patches

Flat yellow patches on your upper or lower eyelids is called xanthelasma and can be caused by high cholesterol. The patches aren't dangerous but it is important to have your cholesterol levels checked and if they are high, take steps to reduce it.

Blinking problems

Blepharospasm is an eyelid condition that causes your eyelids to spasm. You may also notice that you blink or close your eyelids excessively.

You may have an idea of what is causing your eyelid problems based on your symptoms. However, if you are concerned, it is important to see your GP for a diagnosis. If they think you have a serious eyelid problem, they may refer you to an ophthalmologist (a doctor who specialises in treating eye conditions). They may carry out a full examination to check your vision and eye health.

Eyelid problems, such as chalazions and styes, are often caused by common infections (ie bacteria and viruses) or inflammation due to exposure to irritants and can occur at any age.

Other things that increase your risk of developing eyelid problems are:

• A hit to your eye — blood can collect under your eyelid, causing swelling
• Ageing — drooping eyelids are most common in older people
• Bacteria and oily flakes collecting in your eyelashes
• Blocked oil glands
• Contact lenses — inserting and removing contact lenses over many years can increase the risk of drooping eyelids
• Skin conditions — people who have skin conditions such as acne, rosacea or seborrhoeic dermatitis are more likely to get blepharitis

Eyelid problems often clear up by themselves but sometimes you may need treatment. The specific treatment will depend on the underlying cause of your eyelid problem. You may need antibiotics, taken as eye drops, ointment, cream or tablets, to treat an infection. 

If you have blepharitis, a chalazion or a stye, your doctor may show you a twice-daily routine to help it clear up and prevent it returning. This may include:

• A warm compress
• Careful cleaning
• Gentle massage

Severe cases may also need antibiotic ointment or tablets.

Some people with drooping eyelids may benefit from surgery to improve their eye health and appearance. Your doctor can advise on whether this would be right for you.

Other eyelid problems may also need treatment with surgery or steroid medication.