Sarah Koseki experienced excruciating pain during a family holiday in Mexico when her eyelid stuck to her eyeball, leading to a corneal tear. This initial incident, which caused sharp, knife-like pain and blurred vision, was initially treated with antibiotic drops and rest.
However, the painful episodes recurred with increasing frequency over the next three months, leaving Koseki in debilitating pain for up to 48 hours at a time. She described resorting to desperate measures, such as lying on the floor or holding her eyelids away from her eyes with her fingers for relief.
After the fifth incident, where both of her corneas tore, Koseki sought further medical evaluation. Tests at a specialist clinic revealed she had meibomian gland disorder (MGD), a condition affecting oil-producing glands in the eyes that can lead to severe dry eyes and corneal damage if left untreated. Doctors linked Koseki's MGD to her long-standing habit of sleeping with makeup on, a practice she had maintained for nearly 20 years since age 18.
MGD is prevalent, affecting an estimated one in five Britons. Contributing factors include aging, hormonal changes, and underlying skin conditions. However, in Koseki's case, the obstruction of meibomian glands was attributed to eye makeup.
Mr. Mfazo Hove, a consultant ophthalmic surgeon, explained that MGD occurs when the meibomian glands, located along the eyelid margins, become blocked or dysfunctional. These glands produce the oily layer of the tear film, which prevents rapid evaporation and keeps the eye surface comfortable. Blocked glands lead to an unstable tear film and dry eyes. He noted that makeup applied to the waterline can accumulate around gland openings, contributing to obstruction and inflammation over time, potentially leading to permanent gland dysfunction.
Koseki's diagnosis came too late for her eye damage to be fully repaired. She now manages her condition with a rigorous daily routine, including frequent eye drops, washing her eyes with tea tree oil, using a heat mask, and applying eye ointment. She has also stopped wearing eye makeup altogether due to the risk.
Hove emphasized that MGD is the leading cause of dry eye disease, which can manifest as a gritty or burning sensation, redness, and blurred vision. The compromised tear film makes the cornea more susceptible to painful tears and scratches. He advises thorough makeup removal before bed and avoiding eyeliner on the inner lid margin. Once significant meibomian gland loss occurs, these glands do not readily regenerate.
Preventative measures for MGD include conscious blinking, taking breaks from screens, and maintaining good eyelid hygiene. Warm compresses can also help keep the oils within the glands fluid. Experts urge individuals to seek assessment if experiencing persistent gritty, burning, watery, or intermittently blurred eyes for several weeks.
While treatments like Intense Pulsed Light (IPL) therapy have shown some benefit for Koseki, preventing corneal tears for over 18 months, the cost can be substantial, with full courses potentially reaching £1,600 and not typically covered by insurance. Koseki expressed regret over not adopting a nighttime face-washing routine earlier, highlighting the irreversible nature of the damage and the ongoing challenges of managing her condition.