From Geriatric Pharmacy Intern, Yesenia Martinez PharmD(c), Nova Southeastern University, College of Pharmacy
The eyelids of older adults can present with a multitude of conditions ranging from mild inflammation that resolves on its own to potentially fatal diseases. The following paragraphs discuss very briefly and in very general terms some of the more common eyelid concerns along with their possible causes and treatment options. Blepharoptosis, or drooping of the eyelid, can be the result of many things. It is fequently the result of the stretching of the skin due to aging but it could also be a sign of a more serious problem, such as neurological damage. Drooping caused by aging can be corrected with surgery if the problem is severe enough that it causes a significant loss of your visual field. Lid retraction, or the “stare”, often indicates a thyroid problem. In this case, the eyelids are pulled back tightly which may interfere with blinking and cause dry eyes as well as more serious complications. If bothersome, one treatment option for dry eyes is artificial tears or ointment. Blepharospasm, or involuntary eyelid twitching and blinking, can be the result of stress, too much caffeine, or fatigue. However, it may also be caused by a more serious psychological problem. If your primary care physician (PCP) or ophthalmologist determines the spasms to be harmless but the symptoms are too troublesome, they can be temporarily corrected with botulinum toxin injections (better known as Botox). When it comes to growths on the eyelids, it is helpful to keep several things in mind. Compared to malignant tumors, benign tumors are generally found in multiples, are better circumscribed, and are usually less inflamed. They also tend to grow more slowly, not bleed or ulcerate, and look “stuck on”. With regard to infection and inflammation, symptoms to look out for include redness, crusty eyelashes, itching, irritation, scaling, pain, and blurred vision. Another type of inflammation called seborrheic blepharitis may present with greasy or dry scales on the eyelids and eyelashes. Contact dermatitis is yet another form of inflammation and is caused by an allergen or irritant coming into contact with the very sensitive skin that makes up the eyelid. In most cases, these inflammatory conditions can be treated by your PCP with simple eye washes and/or antibiotics. A hordeolum, more commonly known as a stye, usually appears as a red, swollen lump that is tender and tends to be recurrent. These can be treated with hot compresses at home or, if necessary, your PCP may determine the need for antibiotics. Eyelids are made up of a complex set of tissues and they serve a very important purpose by lubricating and protecting the eye. In most cases your PCP can easily diagnose and treat your eyelids conditions, but in some cases referral to an ophthalmologist or more specialized physician may be required. In all cases it is wise to always discuss any concerns you may have or sudden changes that you notice with your PCP and allow him or her to perform a thorough examination.
Zucker, Jamie L. The eyelids: Some common disorders seen in everyday practice. Geriatrics. 2009 April; 64(4):14-19,28.