Question

My 83-year-old mother's eyelids are pink. This started about a month ago and it comes and goes. We haven't been able to think of any foods she's eaten that might cause this. She has high blood pressure for which she takes medicine, and also has a leaking heart valve, but she refused a stress test. Should she see an eye doctor or her family doctor?

Answer

The eyelid skin is the thinnest in the body, and with age it becomes even thinner and the fat around the eyes begins to protrude forward giving a baggy appearance. Potential causes of pink eyelids might include: contact allergy; environmental allergy; thyroid disease (Grave's Disease); liver disease; an eyelid disorders (obstructed gland; inflammation); and fluid retention.

Allergens in the air can cause the eyelids to swell and become pink in color. Generally the eyes will be red and quite itchy and watery. Another possibility would be a new laundry or hand soap, eyelid cosmetics, hairsprays, a new pet, or is wearing a new clothing material outfit on a regular basis. These agents could be causing a local contact-type allergy, which again could be mild, but significant enough to cause the eyelids to intermittently become pink.

Some generalized diseases can also cause skin coloration changes. They include connective tissue disease (lupus); thyroid disorders, liver disease, and others. However, the skin color changes would not be so intermittent in nature if this were the case.

Eyelid problems can also be a cause. Blepharitis is inflammation of the eyelid margin that can be due to bacterial or viral infection. This is an easily diagnosed problem that responds well to gentle lid scrubs with diluted baby shampoo and a soft washcloth. Due to her age it is quite possible that she has eyelid laxity that could be causing some in-turning or out-turning of the lid margin that could be causing some discoloration (pink) changes. If her eyelid glands are obstructed or plugged then the lids can get swollen and discolored as well. Dry eyes are a common cause of red eyes, and if the eyes are rubbed whether intentionally or not the eyelids could be getting red and inflamed.

Your mother's heart valve problem might be causing some fluid retention that can at times manifest in the face and eyelid region. Any time fluid is retained the skin will often shift in color somewhat.

Any ophthalmologist should be able to provide a full eye exam that will exclude dangerous or other contributory medical problems or causes. A visit to her family doctor would be a good idea to be sure her blood pressure and heart are okay. Blood work might be useful to check kidney and liver function.