We now have many choices of lid wipes and cleansers to offer patients with blepharitis and other eyelid conditions.

The treatment of conditions such as blepharitis, chronic dry eye, meibomian gland dysfunction, ocular rosacea and demodex has changed over the years. Previously, eyecare practitioners would recommend washing the eyes with baby, or no tears, shampoo. Today, we know that these conditions are microbial and inflammatory in nature, so a blanket treatment is no longer the proper course of action.

We must carefully assess these patients and prescribe a specific lid hygiene product just as we would prescribe treatment for conjunctivitis or glaucoma. These patients not only suffer from discomfort, irritation and cosmetic issues; their lid conditions can also adversely affect contact lens wear and ocular surgery outcomes.

Today, we have many options to offer our patients, including prescription and non-prescription wipes and cleansers. A specific recommendation to the patient is essential for proper treatment of these conditions.

Avenova with Neutrox from NovaBay is a prescription, non-detergent-based eyelid and eyelash hygiene product. It is indicated for cleansing the lids and removing foreign material and skin debris, and it is non-toxic, non-sensitizing and non-irritating to the skin and eyes.

Avenova contains pure 0.01% hypochlorous acid (HClO), which has a fast antimicrobial time-kill, anti-biofilm activity and anti-toxin activity. In the body, hypochlorous acid also neutralizes inflammatory toxins and inflammatory mediators and deactivates enzymes. The product is indicated for twice daily usage and can be started one week prior to intraocular surgery.

As a non-antibiotic agent, Avenova helps to address concerns about bacterial resistance and has been shown to eradicate 20 species of pathogens, including Gram-positive bacteria and methicillin-resistant Staphylococcus aureus (MRSA). As it is formulated without surfactants, detergents and soaps, Avenova is very gentle and non-irritating. Avenova is a great addition to any lid hygiene routine, including patients suffering from dry eye or blepharitis, contact lens wearers and patients having ocular surgery.

OCuSOFT offers a variety of lid scrub products for varying degrees of lid hygiene. OCuSOFT Lid Scrub Original Premoistened Pads effectively remove makeup, oil, debris and pollen from the eyelids. This is ideal for daily lid hygiene for mild-to-moderate conditions. This formula is also available as a foaming cleanser.

Additional products include:
OCuSOFT Lid Scrub Plus, also available as pre-moistened wipes and a foaming cleanser, which is formulated to clean and remove contaminants for moderate-to-severe eyelid conditions.
OCuSOFT Lid Scrub Plus Platinum, an extra strength, leave-on cleanser that has added anti-inflammatory properties.
Oust Demodex Cleanser, which incorporates tea tree oil.
OCuSOFT HypoChlor, available as a spray gel, which includes 0.02% hypochlorous acid to provide a mild, effective treatment for anterior blepharitis.

We Love Eyes, founded by Tanya Gil, OD, focuses on products that are non-toxic, vegan, and paraben- and cruelty-free. The Tea Tree Eyelid Foaming Cleanser includes tea tree oil and is safe to use with eyelash extensions. The company’s Tea Tree Eyelid & Eyelash Makeup Remover Oil also safely removes waterproof mascara.

The Eyelid Scrub Kit consists of a cleansing oil that has a higher concentration of tea tree oil and the foaming cleanser. Indications include itchy eyelids, such as from demodex, blepharitis and dry eye.

Blink Lid Wipes, from Abbott Medical Optics, are preservative-free, alcohol-free and hypoallergenic. This makes  them ideal for contact lens wearers, children and those with sensitive eyes. The addition of chamomile soothes the lid surface while cleaning and moisturizing. Individuals can use these wipes to remove makeup and treat lid disease. They are rinse-free and individually packaged.

Cliradex, from Bio-Tissue (a business unit of TissueTech Inc.),which was commercially available starting in 2012, is a natural, preservative-free cleanser for the eyelids and face.

Cliradex consists of 4-Terpineol, or T4O, the ingredient in tea tree oil that has been identified as a highly effective cleanser for eradicating demodex mites, which may be infesting the eyelids.

Cliradex is appropriate for patients who suffer from ocular irritation due to blepharitis, demodex infestations or ocular surface diseases such as dry eye and meibomian gland disease linked to microbial activity. Cliradex should be used once or twice daily, and the patient should experience relief within two weeks of regular use.

The company also offers Cliradex Light, a foaming cleanser for managing the symptoms of ocular irritation and mild blepharitis.

Alcon has added SYSTANE Lid Wipes to its line of dry eye products. These premium, pre-moistened eyelid cleaning wipes can be used as part of a daily hygiene regimen. They remove debris and eye makeup that can cause irritation, and they are hypoallergenic. Each wipe is individually wrapped.

Visi-Cleanse wipes, by Life Wipes, are super-soft, thick, pre-moistened lid wipes that require no rinsing after use. These wipes are made in the U.S.  and include ingredients such as aloe, cucumber, oat and chamomile.

One benefit is that these wipes are very gentle, and hypoallergenic, making them ideal for patients with sensitive skin or eyes. They are free of alcohol, phthalate, paraben, dye and fragrance.

Treatment of lid conditions, such as blepharitis, meibomian gland dysfunction, ocular rosacea and demodex, leads to overall better eye health, comfort, contact lens success, ocular surgery outcomes and patient retention.

By arming yourself with the knowledge of the prescription and non-prescription lid wipes and foamers available, you will be better able to prescribe the proper treatment to your patient. OO

Jennifer L. Stewart, OD, is a partner at Norwalk Eye Care, in Norwalk, CT. She is also the co-founder and chief optometric officer at Performance 20/20, a sports and performance vision clinic, in Stamford, CT.


800-890-0329 | Avenova.com

786-483-3054 | Cliradex.com

800) 233-5469 | OCuSOFT.com
We Love Eyes 



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