Inflammation of the eyelid


A swollen eyelid is annoying, unsightly and annoying in many ways. It can itch, flake, ooze or, due to its sheer size, obscure and restrict the field of vision.

There are many reasons behind such a swollen, thickened eyelid. The first and most important question that will help the doctor and of course the person affected in the search for the cause and diagnosis is the distinction between inflammatory eyelid swelling and non-inflammatory eyelid swelling.


Furthermore, one differentiates on the basis of the degree of severity and the area in which the lid is thick and swollen.

  • Does the problem occur only locally or is the whole eye affected or even the area around the eye itself?
  • How long has the problem existed?
  • Has it occurred suddenly and acutely or is it a dragging on and steadily worsening process?
  • Is only one or both eyes affected?
  • And, of course, where on the eyelid the swelling (see also: Eyelid swelling) occurs: on the lower or upper eyelid or on both lids, on the inside of the corner of the eyelid or on the outside of the edge of the eyelid?
  • What does the skin look like, is it reddened or wet, is it flaky or itchy?
  • And is it a soft or hard swelling, is it movable and does it hurt (when touched or all the time?)?

Depending on what the cause is, various other parts of the eye besides the lid can also be affected, for example the conjunctiva or the cornea. This can make the eye look red and feel dry and itchy, and sometimes patients also complain about new visual disturbances.

Of course, to say this in advance, there is also congenital swelling of the eyelid, which can usually be classified as harmless or which is treated by a doctor shortly after the birth. These include the blood sponges (the capillary hemangioma) or the so-called raised mole (also Nevus cell nevus called), which by the way does not necessarily have to be brown in color.

Of course, there is also eyelid swelling, which is very dangerous and requires immediate medical treatment. These include, for example, eyelid inflammation, which affects the whole eye or the eye socket. Or other acute pathological processes that can indicate other swellings or a state of shock in the patient. These include, for example, the so-called Angioedema or one Hives.

If the patient is again pregnant and complains of swollen eyelids, these can be a sign of a pregnancy-related illness (Gestosis), namely one pre-eclampsia.

The lid is rarely swollen due to tumorous processes in the area of ​​the eye. Far more often, however, it is a harmless hailstone, a very widespread form of chronic eyelid inflammation.

You may also be interested in the following article: Red eyelid - what's behind it?

What are the symptoms of an inflammation of the eyelid?

Diseased, inflamed eyelids are thickly swollen and reddened. As a rule, those affected wake up in the morning with their eyes sticky and on the edge of the eyelid, between the lashes and in the corners of the eyes there are yellowish, slightly greasy scales and crusts. The eyes usually burn and itch strongly and tend to produce more tears (also due to the constant sensation of foreign bodies in the eye). Those affected are more sensitive to light and the blink of an eye can be very painful.

As a further consequence of an infection of the already inflamed eyelids, ulcers can form, the eyelashes are damaged and can fall out or turn onto the inside of the eyelid and thus additionally rub the conjunctiva and the cornea.

Is that the eyelid inflammation that Blepharitis, not caused by any skin diseases, but triggered by pathogens, the following possible clinical pictures should be considered: erysipelas, eyelid abscess, eyelid phlegmon, phlegmon of the eye socket, a stye, a herpes simplex outbreak, herpes zoster, which manifests itself in the facial area, pelvic warts (also Mollusca contagiosa called), a hailstone, inflammation of the lacrimal gland, the tear sac or an occlusion of the tear duct.

Also read the article: The itchy eyelid.

Causes of inflammation on the eyelid

First, a brief overview of the possible causes of inflammatory eyelid swelling is given here. If the lid is due to an existing or a new skin disease, you should not only consult an ophthalmologist, but also or even primarily a dermatologist. An inflammatory skin disease is also referred to as eczema in the specialist literature.

Eczema as the cause

If it occurs in the area of ​​the eyes, eczema can also lead to inflammation of the eyelids (a so-called Blepharitis) to lead. Eczema is the most common skin disease of all, its manifestations are numerous and fortunately it is not contagious.

The most common eczema are allergic contact dermatitis, atopic dermatitis (sometimes also referred to as atopic eczema, but better known in this country as neurodermatitis) and seborrheic dermatitis (seborrheic dermatitis). Other skin diseases such as rosacea can also lead to inflammation of the eyelids and eyelids. The classic symptoms of acute eczema are itching and the usually severe reddening of the skin, the formation of blisters or small nodules, the swelling and the formation of crusts. In the process, the skin thickens on the surface, becoming dry and cracked.

Read more on this topic at: Contact dermatitis

If such eczema occurs on the eyelid, the edge of the eyelid or the corner of the eye (pain in the corner of the eye), it is usually particularly uncomfortable and sometimes painful. A doctor should therefore always be consulted - on the one hand, to get to the bottom of the cause of the problem and to be able to rule out serious illnesses. On the other hand, to alleviate the symptoms and prevent complications. After all, the inflamed lid skin is also a welcome place for parasites such as lice and mites, which find ideal living conditions here and can spread quickly.

Read more on the topic: Eczema on the eyelid

Stye or hailstone as the cause

Barley and hailstones can be the cause of inflammation of the eyelid.

As mentioned earlier, the most common inflammatory symptoms on eyelids are from either one Stye or caused by a hailstone. Both diseases are harmless happenings, those easy to deal with therapeutically is.

Now what is the difference between one and the other? In principle, in both cases it is a clogged sebum gland inside the eyelid, in one case there is only the swelling caused by the disturbed drainage, in the other case inflammation is added to the swelling.

The hailstone as the cause

A hailstone, too Chalazion called, occurs when one of the numerous small sebum glands inside the eyelid becomes blocked. With their sebum production, these glands normally ensure that both the eyelid and the eyelashes remain smooth and supple and that there is no unnecessary and annoying friction between them on the eye. The glandular bodies themselves are located inside the eyelid, their excretory ducts open both on the inside of the eyelid, i.e. directed towards the eye, and hidden on the edge of the eyelid between the lashes. Since they are very small, it can easily happen that one of these passages becomes blocked and the secretion produced can no longer drain away. It builds up in the gland, which swells and a tight knot forms in the lid. This is then visible as a small nodule near the edge of the eyelid or a little bit away from it.

The skin may be reddened or shimmering slightly pale purple, which is due to the fact that the swelling makes the skin tense and therefore thinner. Such a hailstone does not cause pain, nor do any other side effects usually occur (unless the hailstones swell so much that it is impaired in vision or its position and size prevents the eye from being completely open or closed can be). In exceptional cases, conjunctivitis can also be observed. Apart from that, such a hailstone is absolutely harmless and does not require any further medical treatment. The swelling will last a few days to weeks and then go away on its own.

Read more on the topic: Hailstone inflammation

Treatment of the hailstone

If this is not the case, i.e. if the hailstones persist for an unusually long time, or if pain or severe visual impairment does occur over the course of the day, an ophthalmologist should be consulted, who can then discuss further action with the patient.

For example, anti-inflammatory ointments or eye drops can be prescribed against the inflammation itself. Irradiation with a Red light lamp often helpful as the warmth helps keep the To solve secretion jam and the swelling will go away faster. If these attempts at treatment are also unsuccessful, the surgical route can be chosen.

A Hailstone surgery is a small routine intervention which is performed under local anesthesia. The doctor then makes a very small incision over the area of ​​the hailstone and can thus completely remove the inflamed and diseased tissue. Because the cut is so small, it doesn't even need to be sewn. Only an antibiotic ointment is used Infection prophylaxis is applied and the patient wears a plaster bandage over the eye for the rest of the day. The advantage of a surgical procedure is that the removed tissue can then be sent in for examination, thus confirming the diagnosis of hailstone and excluding other, more malignant diseases.

If a patient is plagued by hailstones frequently, it is recommended that the Reinforce eye hygiene. It is best to clean the eyes and eyelids daily and not leave out the eyelashes. This is done quickly with the help of a magnifying mirror and a cotton swab (moistened with warm water). In addition, should it appear necessary, you can have your doctor prescribe nourishing and antibiotic ointments, which are then applied to the edge of the eyelid. If there is still no improvement, antibiotic treatment in the form of tablets can be considered.

Contact lens wearers should be particularly careful with their eyelids, too regular ophthalmological checks go. Other diseases, such as diabetes mellitus, acne or rosacea, can also lead to hailstones being produced more frequently. The family doctor should be informed about this in order to be able to recommend preventive measures accordingly.


The barley grain is very similar to a hailstone. Again, it is a problematic sebum gland of the eyelid. A key difference to hailstones, however, is that barley grains do Secretion doesn't just build up and cause swelling, but that here the gland passes through a infection inflamed with bacteria (in most cases it is bacteria of the genus Staphylococcus aureus, a classic skin germ).

The symptoms of stye are very similar to those of hailstones: the affected gland swells and the skin is reddened. The swelling is due to the infection painful though and it forms pus, which is initially encapsulated in the tissue, this capsule (abscess) can later open spontaneously and the pus drains away. As soon as this has happened, the stye can usually heal without problems and without consequences. Hence it is also not necessary to treat the patient grandly here either Time and patience the best weapon.

Usually antibiotic ointments or eye drops will help.

Treatment of stye

To prevent the bacteria from spreading or a However, prevent the infection from getting worse, the doctor may prescribe drops or ointments containing antibiotics. It is important that the person concerned not with any foreign objects gets in the eye (fingers also count as foreign in this case). In general, children are more likely to be affected by stye than adults. This may be due to the fact that as a toddler you do not yet independently pay attention to minimum hygienic standards and the little ones often rub their dirty fingers in their eyes and thus transport the germs to where they have no business. It is therefore important to encourage the offspring to pay more attention to their own behavior. Once there is a stye, it is important for the child to have one Towel used strictly separate from the rest of the family owns in order to avoid that other family members can also be indirectly infected. Also increases an already anyway weakened immune system the riskthat a stye breaks out, for example in people with diabetes mellitus, this is the case and should be discussed with the family doctor. As always have to Contact lens wearers Pay attention to increased hygiene in the area of ​​the eyes, as the risk of introducing germs is much higher here.

General hygiene advice

Here are a few general tips and advice on eye hygiene:

It helps, relaxes and calms the eyes if you apply compresses moistened with warm water for a few minutes. The warmth contributes to the fact that the secretion produced in the glands is somewhat liquefied and can thus flow off better. This is how you can prevent a potential hailstone. A simple Massage the eyelids towards the eyelashes additionally supports the flow.

It is of course important to ensure good hygiene, both of the towel used and of the fingers.Small crusts, flakes or sleeping sand on the edges of the eyes and between the eyelashes can be easily treated with one as well warmly moistened cotton swab remove, a nourishing and slightly oily ointment can also be used here to keep the eyelashes supple and to protect the eyelid skin from drying out. Olive oil is also said to have mild anti-inflammatory effects. Of course, only use the swab on one side and then take a new one.

Harmful external influences such as Cigarette smoke, dry air or dust can also irritate the eyes and promote the development of inflammation. It is therefore important not to be too often in the vicinity of smokers (and to give up smoking yourself or at least to minimize it if possible), to let the air through the room regular ventilation to keep fencing sufficiently and not to allow too much dust to build up on the surfaces. If you suffer from permanently dry, irritated eyes and / or a foreign body sensation in the eye, an ophthalmologist should be consulted.

Anatomical basics

Here's a brief excursion into the anatomy of the eyelids so that you can more easily understand why an eyelid can swell in the first place. The structure of the eyelids tends to swell up more easily than other parts of the body. They are made of skin with relatively few layers, i.e. very thin, and the underlying tissue is loose and soft. There are hardly any fat deposits here, but there are more blood vessels and lymph vessels. This means that a lot of fluid is moved over the course of the day in a very small space. The space is also so narrow and limited because the lids have a connective tissue plate inside, which is firmly connected to the eye socket in the two corners of the eye and acts like a mechanical barrier. This explains why, as soon as the prevailing fluid pressure in the body rises even a little, this is immediately noticeable in the lids and edema forms (Build-up of fluid in the tissue). Since the excess fluid can easily move to the adjacent side, both eyelids are often affected by the edema.

Inside the eyelids there are also glands that use the sebum they produce to ensure that the eyelids and lashes remain supple. There are several types of glands in the eyelid that have their ducts on the edge of the eyelid as well as on the inside of the eyelid. If one of these small ducts becomes blocked, the secretion produced in the gland can no longer flow off properly, builds up and can become inflamed. The widespread stye is a typical consequence of such a clogged sebum gland in the eyelid.