Eyelid Issues: Causes and Solutions for Double Eyelids

Q: Eyelid Issues: Causes and Solutions for Double Eyelids

Hello： A chalazion can potentially affect blinking, and if it becomes too large, it may also cause eyelid drooping or astigmatism. <br>Typically, warm compresses and topical medications may reduce its size, but they will not eliminate it completely. <br>For definitive treatment,

Eyelid issues

Hello, Doctor.
Recently, both of my eyelids have developed multiple layers (I originally had double eyelids).
The left eye has a smaller multilayer condition, and I feel normal when blinking; however, the right eye clearly shows multiple layers, and when I blink, it feels a bit stiff and not smooth (similar to a swollen eyelid, with a sensation of difficulty opening, but not completely unable to open, and there is no visible swelling).
Previously, I visited an ophthalmologist (the first one), who said that the issue with my right eye was a stye, but after using the prescribed medication for over two weeks, it has not resolved.
Last week, I went to another ophthalmologist (the second one), who said it was a very small chalazion.
They mentioned that if the medication does not help, it is unlikely to resolve on its own, and if it is not causing discomfort, it may not require treatment, as even if surgery is needed, it is too small to see well under anesthesia.

During the examination at the second ophthalmologist, they noted that my intraocular pressure was relatively high, and the visual field and optic nerve condition in my right eye were worse (both eyes have high myopia, but the right eye is deeper than the left).
They prescribed medication to lower the eye pressure, which I have been using for almost a week.
The retina, macula, and lens appeared to be normal.

If this is due to fatigue, I have significantly reduced my screen time after work and on weekends, and I have been applying warm compresses every night for almost a month.
Despite this, the sensation of difficulty blinking in my right eye persists.
What could be the cause of this? Is it related to the chalazion, or is fatigue not easily alleviated? If it is a chalazion, it should have been present for some time (I did not notice it before), and since I did not have any abnormal sensations when blinking previously, why am I only experiencing this recently?
Additionally, I have recently felt a tight and sore sensation in the eyelids below both eyebrows (on the side near the nose), but it does not feel like pressure in the eyeball.
I mentioned this to the ophthalmologist at the second clinic, and they suggested it might be due to fatigue.
However, as mentioned earlier, I have been trying to rest my eyes and apply warm compresses for a while, so is it still due to fatigue being hard to alleviate? Or could there be another underlying cause? Thank you for your assistance.

Nìngmíng, 20~29 year old female. Ask Date: 2021/04/08

Dr. Gao Pilin reply Ophthalmology

Hello: A chalazion can potentially affect blinking, and if it becomes too large, it may also cause eyelid drooping or astigmatism.
Typically, warm compresses and topical medications may reduce its size, but they will not eliminate it completely.
For definitive treatment, surgical excision is necessary.
Regarding chalazia, you can refer to: https://bit.ly/2CqNiYB.

You may sometimes feel a tight and sore sensation in the eyelids just below the eyebrows (on the side near the nose), which is often caused by fatigue.
You can use the 20-20-20 rule for eye care: every 20 minutes of computer use, look away from the screen for 20 seconds, focusing on an object 20 feet (6 meters) away.
Blinking 20 times during this break would be even better.
Try to avoid looking at your phone, and see if there is any improvement over the course of a week.

Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM; Wednesday from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; if necessary, you should visit a medical institution for treatment.
I hope to have the opportunity to serve you.
Gao Pi-Lin.

Reply Date: 2021/04/08

More Info

Hello! Thank you for reaching out with your concerns about your eyelid issues and the sensations you're experiencing. Based on your description, it seems you are dealing with a few interconnected problems, including the appearance of multiple eyelid folds, a sensation of heaviness or discomfort in the right eye, and possibly a chalazion (霰粒腫) or stye (針眼). Let's break down the potential causes and solutions.

Understanding Your Symptoms
1. Multiple Eyelid Folds: The appearance of additional eyelid folds can be due to several factors, including swelling, inflammation, or changes in the skin's elasticity. This can happen due to fatigue, allergies, or even the presence of a chalazion or stye. The fact that your left eye shows less of this change suggests that the right eye may be experiencing localized inflammation or irritation.

2. Discomfort When Blinking: The sensation of your eyelid feeling "stuck" or not moving smoothly can be attributed to swelling or irritation in the eyelid area. This could be related to the chalazion, which is a blocked oil gland that can cause localized swelling and discomfort. If the chalazion is small, it may not be visible externally, but it can still cause significant discomfort.

3. High Eye Pressure and Visual Field Concerns: You mentioned that your right eye has higher intraocular pressure and poorer visual field results. This is particularly concerning, especially given your history of high myopia (高度近視). Elevated eye pressure can lead to glaucoma, which requires careful monitoring and management. The eye drops prescribed to lower your eye pressure are essential in this regard.

4. Fatigue and Muscle Strain: The tight, sore feeling in the area below your eyebrows could be a result of muscle fatigue or strain, especially if you have been using your eyes more than usual. Even with reduced screen time and regular warm compresses, it may take time for your eye muscles to recover fully.

Potential Solutions
1. Continued Monitoring and Treatment: Since you have already consulted with two ophthalmologists, it is crucial to follow their recommendations. If the chalazion does not improve with topical treatments, you may need to consider a minor surgical procedure to drain it, especially if it continues to cause discomfort.

2. Eye Pressure Management: Keep up with the prescribed eye drops to manage your intraocular pressure. Regular follow-ups with your eye doctor are essential to monitor your eye health, especially given your high myopia.

3. Rest and Eye Care: Continue to give your eyes ample rest. Implement the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. This can help reduce eye strain. Additionally, ensure you are getting enough sleep, as fatigue can exacerbate eyelid and eye discomfort.

4. Warm Compresses: Continue using warm compresses on your eyelids. This can help with both the chalazion and any potential dryness or irritation you may be experiencing.

5. Consultation for Persistent Symptoms: If your symptoms persist despite these measures, consider seeking a third opinion or returning to one of your previous eye doctors for further evaluation. It may be beneficial to discuss the possibility of additional tests to rule out any underlying conditions that could be contributing to your symptoms.

Conclusion
Your symptoms could be multifactorial, involving both mechanical issues related to the eyelid and potential underlying conditions affecting your eye health. It is essential to remain vigilant about your eye care, especially with your history of high myopia and elevated eye pressure. Regular follow-ups with your eye care provider will help ensure that any changes in your condition are promptly addressed. Remember, your comfort and vision are paramount, so don't hesitate to seek further evaluation if your symptoms do not improve. Thank you for sharing your concerns, and I hope this information helps guide you toward a solution!

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