Comments hi everyone, I found this forum about a month ago and have been reading the posts. My eyelashes mysteriously fell out on my right eye (top lid)from very close to the outside edge toward my nose. I have felt like a freak because for over a year they did not grow. My eye doctor and regular physician told me to wait it out but I decided to take matters into my own hands. First I suggest seeing an oculoplastics specialist (they specialize in problems of the eyelids) to make sure it is not an allergy, trauma, madarosis, blepharitis etc...

I suggest the following links for more info: http://www.eyeweb.org/eyelids.htm http://www.mrcophth.com/eyelids123.htm

Topic: Blepharitis, Staphylococcal

Definition: Inflammation of the eyelid. More specifically it is the infection at the base of the eye lashes.

Alternative names: Blepharophlegmasia; palpebritis

Symptoms: Because of the corneal involvement, the patient may experience foreign body sensation, stinging, irritation, burning and pain. One may also notice tenderness in the upper and lower eyelids.

Signs: Crust or flakes are seen at the base of the eye lashes.Sometimes collarettes will form around the lashes and ulceration is noted when the crust is removed. Superficial punctate keratitis, SPK,may be seen (especially inferiorly) on the cornea. In addition, frequent \"bumps\" or hordeola may appear on the eyelids. Erthythema is usually noted on the eyelids.

Tests: This condition is really not too difficult for your eye care professional to diagnose. Using the biomicroscope and fluorescein dye,the doctor will be able to see the crusting on the base of the eyelashes and the SPK, respectively.

Treatment: Lid hygiene is very important. The eye lids should be soaked with a warm, wet, and clean washcloth. When the towel cools down this procedure can be repeated. This softens and loosens the crust at the base of the eye lashes. Next, lid scrubs can be performed using baby shampoo diluted with clean water. Again, a clean wash cloth or cotton balls are good to use for the scrub.

Antibiotic ointments (prescribed by your doctor) is used. When using ointments, remember they tend to blur vision. Thus, ointments are used best at night, right before you go to sleep. In more severe cases,oral antibiotics may be prescribed. If there is much eyelid redness,tenderness and pain, steroids may be also prescribed by your eye doctor.

Topic: Blepharitis, Seborrheic

Definition: Inflammation of the eyelid. It is associated with seborrheic dermatitis.

Alternative names: Blepharophlegmasia; palpebritis

Symptoms: Because of the corneal involvement, the patient may experience foreign body sensation, stinging, irritation, burning and pain. One may also notice tenderness in the upper and lower eyelids.

Signs: greasy crust or flakes are seen at the base of the eye lashes.In contrast to Staphylococcal Blepharitis, the lid margins for Seborrheic Blepharitis are less inflammed. Superficial punctate keratitis, SPK, may be seen on the cornea.

Tests: Same as above with Staphylococcal Blepharitis

Cause: Seborrheic blepharitis is associated with seborrheic dermatitis.

Treatment: also same as with Staphylococcal Blepharitis

I would in general suggest baby shampoo or eye scrub (http://www.eyescrub.com/), a gentle eyelid cleaner.They are basically pre-moistened sterile pads which are conveniently packaged in individual pouches. They are gentle and non-irritating as well as hypoallergenic and pH balanced for eye comfort.

for info on madarosis (eyelash loss): http://www.emedicine.com/oph/topic517.htm (the photographs are pretty gross though)

Background: Observation of the arachnid, Demodex folliculorum, has been reported since 1840. This hair follicle mite is the only metazoan organism commonly found in the pilosebaceous components of the eyelid of humans. Coston \"opened the eyes\" of ophthalmologists when he reported 22 patients with demodectic eyelid signs and symptoms.

Pathophysiology: D folliculorum (all stages) is found in small hair follicles and eyelash hair follicles. In all forms, immature and adult, it consumes epithelial cells, produces follicular distention and hyperplasia, and increases keratinization leading (in eyelashes) to cuffing, which consists of keratin and lipid moieties. Demodex brevis (all stages) is present in the eyelash sebaceous glands, small hair sebaceous glands, and in the lobules of the meibomian glands. Adults and immature forms consume the gland cells in all of these loci and, when infestations are heavy, can affect the formation of the superficial lipid layer of the tear film coacervate. Demodectic mites produce histologically observable tissue and inflammatory changes, epithelial hyperplasia, and follicular plugging.

Infestation of the eyelash hair follicle results in easier epilation and more brittle cilia. These mites also serve as vectors of infective elements and interrupt tissue integrity. They have been implicated in meibomian granulomas and are associated with certain dermatologic changes. All reported histologic sections of lid follicles infested with D folliculorum show distention and thickening. Coston claims that less than one half the specimens he observed showed perifollicular lymphocytic infiltration.

Follicular inflammation produces edema and results in easier epilation of the eyelashes. It also affects cilia construction, and lashes are observed to be more brittle in the presence of demodicosis. Madarosis (loss of lashes) is associated with abundant mites, the loss of eyelashes being the result of intercellular edema in the hair shaft, and loss of hair resiliency. Although epithelial hyperplasia associated with follicular plugging often is encountered, dermal changes seldom extend beyond the perifollicular epidermal area. This plugging once believed to be mite excreta, is now known to be epithelial hyperplasia with interspersed layers of lipid. The formation of a collar of tissue around the base of the lashes is observed clinically. This occurs significantly more often in follicles infected with D folliculorum. It is hypothesized that the epithelial hyperplasia is most likely a product of the abrasive action of the mite\'s claws.

Accumulation of waste material of the follicle mite may occur in affected follicles or sebaceous glands. Electron micrographs of the mite surface and feces show bacterial, viral, and rickettsial elements. Specific reports have revealed that both species pierce epithelial cells and consume cytoplasm. Only the D brevis has been observed with channels burrowed to the germinal epithelium in the sebaceous glands.

Demodex species-induced pathologic changes have been implicated in dry eye conditions. When follicular plugging involves the meibomian gland (D brevis) or gland of Zeiss (D folliculorum or D brevis), reduction of the superficial lipid layer of the tear film occurs. The effect of D brevis on meibomian structure has been implicated in chalazion formation. Chalazia are granulomatous inflammation of the meibomian glands, made of an organized core of epithelioid cells and histocytes surrounded by fibroblasts, lymphocytes, and plasma cells. These defense cells encircle particles too large for normal macrophages to engulf. D brevis has been observed in the center of these meibomian granulomas. Lid infestation by the Demodex species may or may not accompany dermatologic changes of the nose, cheek, or forehead.

D folliculorum has been suggested as a factor in pityriasis folliculorum. This dermal inflammation manifests itself as a diffuse erythema of the affected areas, scaly, dry skin and, in certain cases, with rosacealike lesions. The dry skin cycle described by Ayers is initiated when the demodectic mite plugs the follicle and reduces the sebaceous outflow, which leads to scaling, and rough and dry skin texture. Sebaceous outflow is reduced further when patients or their cosmetic consultant inadvertently decides to apply facial cream. The mite flourishes in this environment of oily additives leading to an increase in the population of the mites and the dry skin cycle continues.

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