Eyelid Margin Cleaning

There is a wealth of research that supports the positive effect of keeping the eyelid margins clean. The best way to keep this very important area clean and free of debris is through lid margin debridement. The various techniques used to clean this area are very gentle and many patients notice an improvement in their dry eye symptoms immediately following these procedures.

Dr. James Rynerson likens the biological film (biofilm) that grows on our eyelid margins to plaque on our teeth. We all have been educated on the benefits of “fighting plaque buildup on our teeth”, but few of us know about the plaque that builds up on our eyelid margins. Dr. Rynerson suggests that because the eyelid margins are the only part of our bodies that do not get cleaned, this plaque build up starts at a young age and progresses throughout our lives.

Eyelid margin before and after cleaning.

Dr. Donald Korb in 2013 presented research showing that mechanical debridement of the lower lid margins provided statistically significant symptom relief and improved meibomian gland (the glands that open along the lid margin) function.

In 2015, Connor et al., used the BlephEx (Rysurg) device to debride the lids margins and found the same results.

The eyelid biofilm is made up of accumulated debris, dead skin cells, oils, and bacterial flora. This film negatively affects the sensitive tissue and glands along the edge of the eyelids. This leads to a disruption of the surface of the eye, leading to inflammation, dry eye symptoms, contact lens intolerance and worse.

When the lid margin is kept clean, the meibomian glands function better to protect our tear layer. Our tears will evaporate less and our eye will stay more moist. This fact has been proven by two recent studies. These studies showed that one month after eyelid debridement using a BlephEx device, tear breakup time was increased by between 60% and 66%. The authors predicted an even greater improvement with ongoing eyelid margin debridement.

With this recent knowledge and interest in eyelid margin health, there are new procedures and devices on the horizon. In fact there is already an at-home device called NuLids (NuSight Medical) available in the U.S. being promoted by american eye doctors.

Talk to your optometrist about your eyelid margins to help ensure comfortable, healthy eyes.