Craig Blackwell, MD

Santa Cruz, CA
Diplomate: American Board of Ophthalmology
Fellow: American Academy of Ophthalmology

Welcome to the Website of Craig Blackwell, MD

An Ophthalmology Practice in Santa Cruz, CA

Eyelid Exam

Eyelid Exam

Particularly on the first exam the eyelids are checked for position, the presence of growths and for signs of infection and inflammation.
If the upper lid is lower on one side than the other that is called ptosis. It can happen because of either electrical or mechanical problems. The nerve signal may not be reaching the muscle or the muscle may be losing its attachment to the lid.
Frequently extra skin from the upper lid can sag over the lid margin partially blocking vision. If that interferes with vision then surgical removal, called blepharoplasty, is covered by your insurance. If it is only a cosmetic issue then surgery can be done, but is not covered by insurance.
The edge of the lower lid can be turned inward or outward. With a lid turned inward the lashes can rub directly on the cornea. With a lid turned outward the surface of the cornea can become exposed and dry. Both are repairable by surgery.


Once we have brought the microscope into place we return to the eyelid inspecting for signs of inflammation, called blepharitis. It can come from skin disease in the proximity of the lids or chronic low grade lid infection. We see redness of the lid margin and flakes trapped in the bases of the lashes. For most people daily lid scrubs will keep this under control. If that is not enough then antibiotics may be needed.

Lid Scrubs

Lid scrubs need to include warm water, soap and massage. The soap and water remove the oil and skin flakes and kill bacteria. The warmth and massage help get the oil moving from the glands.
One method is to put a drop of baby shampoo onto a warm damp wash cloth and hold that as a compress on the eyelids (closed eyes) for two to five minutes followed by mild scrubbing of the lids and rinse. Another method, for the shower, is to use your shampoo to wash the lids (closed eyes) concentrating on massaging action of the finger tips and rinse.

If you prefer, there are commercial lid scrub pads that have a gentle soap preparation.

If lid scrubs are not sufficient to keep blepharitis under control then we can also use antibiotic ointment, and in particularly resistant cases an oral antibiotic.