“Eye swollen?”

You appear to have Meibomian Gland Dysfunction (MGD). MGD is a common eye condition, yet many people don't realize they have it. You get it when there's a problem with a few dozen tiny glands in your eyelids that help make the oil layer of your tears.

What Happens

These Meibomian glands, named after the German doctor who studied them, make an oil called meibum. There are approximately 31 Meibomian glands in your upper eyelid and about 26 glands in the lower eyelid. The glands in the upper eyelid are longer and produce more oil, or meibum, than the ones in the lower eyelid.

There are three layers to your tear film. The oily outermost layer, produced by special glands (Meibomian glands) within the eyelid, serves to prevent evaporation of the saltwater middle layer of the tears and perform barrier functions. The inner layer against the eyeball is made of mucus secreted from cells on the front surface of the eye and is important in helping the saltwater layer spread evenly across the surface of the eye. As you can see, any dysfunction in the layers of the tears can be problematic, and we especially see this with an increase in evaporation from MGD. Each gland contains little pockets called acini that act like an oil factory, producing the meibum. Meibum, water, and mucus form the three layers of tear film, the fluid that keeps your eyes moist. As previously mentioned, the oil helps prevent the water layer on the eye surface from evaporating or drying out too quickly. Changes to the amount or quality of the oil, or to the glands themselves, can lead to MGD. It's often the result of a combination of things. The most common type, obstructive MGD, happens when the gland openings get clogged, and less and less oil reaches the eye surface. Your eye doctor will tailor treatment based on the stage of your MGD as well as any underlying medical condition you have.

MGD may lead to dry eye syndrome. In fact, 86% of dry eye patients have MGD. You may have dry eyes or dry eye syndrome if you’re suffering from some of the following symptoms:

Dry-feeling eyes
A burning or stinging sensation in your eyes
Eye redness or a bloodshot appearance
A sandy or gritty feeling under your eyelids
Itchy eyes
Tired eyes
Increased sensitivity to the light
Blurred vision
Discomfort wearing contact lenses

If you’re experiencing some of these symptoms, I highly suggest scheduling an appointment with your eye doctor. Making sure that your moisture levels are normal and you have proper tear function is a vital part of keeping your body healthy and your immune system balanced.

Causes

In a healthy eye, pressure from a blink expresses a small amount of oil from the Meibomian glands which is then distributed over the ocular surface as the eye opens. The ocular surface is the foundation for ocular comfort and visual quality. Other causes of MGD are hormone fluctuations, especially androgen deficiency, as well as other conditions such as demodex eyelash mites, rosacea, and other seborrheic skin conditions.

Treatment of MGD

LipiFlow is an in-office treatment that we offer that combines warm compress therapy and pulsed pressure to reduce dry eye syndrome and correct the balance of oils in the tear film. LipiFlow applies controlled heat to the inner eyelid and applies mild, intermittent pressure. This pressure will open and clear the blocked glands in order to allow the body to produce its natural production of oils. This will cause your eyes to stop being dry and alleviate the symptoms associated with dry eye syndrome. The unique mechanism of action of the LipiFlow Thermal Pulsation System has been shown to improve gland function in patients with MGD.

By simultaneous application of heat and peristaltic motion to the eyelid, obstructed meibum is safely liquefied and pushed out of the gland orifices. Subsequent to Lipiflow treatment, application of a natural substance, called Avenova, has been shown to be beneficial and extend the beneficial effect to the treatment. This natural substance is produced by neutrophils in the body in response to bacterial invaders and inflammation. It works to fight off microorganisms on the skin and mucous membranes, ensuring that the affected area is clean, and it also lowers the melting point of the meibum lipid, much like salt on snow. It is well known that clean eyelids can help alleviate the signs and symptoms of dry eyes and meibomian gland dysfunction. The office of Dr. Edwin M. Schottenstein has available this lid and lash antimicrobial spray solution, Avenova, which is designed to remove bacteria and debris around the eyes. Avenova also kills the coronavirus that causes COVID-19 on hard surfaces.

Long-term effects of untreated MGD
If left untreated, obstructed glands will reduce oil production, atrophy, and eventually drop out. Once a gland has atrophied completely, function is lost permanently, which leads to chronic discomfort and potentially sight-threatening damage to the ocular surface.

Dr. Edwin M. Schottenstein

Get checked for style and chalazion.

That is called a pterygium. That is very common and usually gets worse when outside on a sunny day especially when not wearing UV sunglasses. It is not something that you need to be concerned about. You probably also have a conjunctival elevation (pinguecula) on your other eye as well (it just may not be as close to the cornea as this one is). It's not going to go away, but using artificial tears to keep your eyes lubricated and wearing UV sunglasses when outside is the best way to reduce the progression and irritation.

This looks like a Pterygium. They are caused by sun damage. But to be safe and make sure nothing else is going on with the eyes, you should be sure to schedule an eye examination with your optometrist.

Hi, without examining your eye with a microscope, it is difficult to know for sure, but it certainly appears to be a pterygium. It is an abnormal growth of the tissue that overlies the white of the eye(sclera). That tissue is called the conjunctival tissue, which normally just overlies the white of the eye. When it grows onto the cornea, the clear cap of the front of the eye, it is called a pterygium. Sun and wind promotes further growth. Use sunglasses outside. The swelling or elevation of the tissue can happen over time. This is not an infection, so I would stop the oral antibiotic. If there is mucus coming out of the eye, that would likely indicate a bacterial infection. The only way to get rid of it completely, is to surgically remove it, ie cut it off which I would not recommend at this point. If you are noticing soreness of the eye, watering of the eye from dryness, (Watering can also be a symptom of a viral infection) then a prescription for anti-inflammatory drops can be given, but no eye doctor will prescribe those without examining your eyes with the microscope and using different stains to make sure that is not the case. Giving steroid drops, without making sure it is not a viral infection, like the cold sore virus, is like throwing gas on a fire. I do not think you need to go in to be examined just yet, as you have no excess tearing, irritation or redness of the eye, which would indicate a viral infection. I also do not think you need the steroid drops now. The pterygium is elevated so it breaks up the tear layer on the eye and that can cause dryness. If that is the case then I would put some non-preserved lubricating ointment in your eye at bedtime. You can buy that OTC. All this assumes you have no pain/irritation of the eye, no redness or other signs of infection. If you have just noticed this on your eye, then I would just make sure you have sunglasses on outside. This typically takes years to grow, so there is no immediate effect. The sunglasses will not make what you have go away. It is to prevent worsening over time. Hope this is of some benefit to you.

https://www.aao.org/eye-health/diseases/pinguecula-pterygium
Frank Cao