I'm writing to find out if there is a better way to treat blepharitis. My ophthalmologist says to soak the eyelids with warm water and then to rub away the crusts with a washcloth. This does not work well for me, partly because I can't see the crusts without the magnifying part of my glasses, and with them on it's very difficult to get to the crusts with my wet cloth. I tried cotton swabs, but they don't work well.

I'm wondering if there is something like an oil or medicine that would be OK to use on my eyelids that would either prevent or at least make removal of the crusts easier to do.

Lois Mears

Springfield, Oregon

Diluted Johnson's Baby Shampoo can help you safely remove crusts and control symptoms of blepharitis, a persistent inflammation of the eyelids and eyelash hair follicles.

Eyelid scrubs should be done two to three times a day when symptoms occur and every morning as maintenance therapy, according to Indiana University ophthalmologist Shailaja Valluri.

She advises her patients to place a warm washcloth over the closed eyelids for one minute. Then, gently scrub the lashes with Q-Tips dipped in a solution of three drops of Johnson's Baby Shampoo in one-half cup warm water for at least 60 seconds per eye.

Ready-to-use wipes are a convenient option. One such product, OcuSoft lid scrubs, is available at drugstores nationwide.

Eye doctors also recommend two drops of Visine Tears in each eye four times daily for blepharitis patients who have tearing eyes. It seems strange that when your eyes are tearing you need moistening drops, but you do.

"The reason you need moisture for eyes that already 'water' is that this watering is frequently due to irritation caused by dry eyes," explained Indianapolis ophthalmologist Dr. Eugene Helveston. "Simple eye-moistening drops reduce the irritation which causes watering in the first place. Why Visine Tears instead of regular Visine? The reason is that prolonged use of drops with a vessel-shrinking agent, usually epinephrine, causes a rebound vessel dilation much as what occurs with chronic use of certain nose drops. This does not occur with Visine Tears."

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