My optometrist says I have “notched eyelids.” She thinks it may be because my meibomian glands are blocked. She says I have to use a “hot mask” (which she sold me, but I think a wet washcloth would work equally well) for 5 minutes several times a day followed by gentle eyelid massage.
Of course, I had no idea that meibomian glands (Meibomian Gland Dysfunction (MGD): Symptoms, Causes, & Treatment) were a real thing, and it all sounds uncomfortably similar to what causes a dog to start dragging its butt on the rug. But the hot mask feels amazing, whether or not it’s getting the meibum circulating again. So this here is a public service announcement.
I think I may have it too. About 6 weeks ago, I saw my optometrist and one complaint was about one eye that was sore, especially when I woke up in the morning. He didn’t use this word, but he did say something about blocked oil ducts and prescribed an oily cream. It is a real nuisance since the instructions say to put the cream in the eye but be careful not to touch the eye with the tip of the tube. This is all very hard because I cannot see what I am doing. He never said a word about hot compresses; maybe I will try them. One thing is my eyes (both of them) tear too much. Perhaps this is an overreaction to the lack of oil
Or an overreaction to the state of the world. For my ownself, I shed tears pretty much every day.
Carry on.
Can you put the cream on the tip of your gloved or alcohol-wiped finger and then smear it in your eye? (Technique developed after years of putting ointment in pets’ eyes.)
Scientists monitoring the ruins of the Chernobyl nuclear power plant in Ukraine have seen a surge in fission reactions in an inaccessible chamber within the complex. They are now investigating whether the problem will stabilise or require a dangerous and difficult intervention to prevent a runaway nuclear reaction.
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Now, researchers have seen a spike in neutron emissions from the room, with levels increasing around 40 per cent since the start of 2016. This points to a growing nuclear fission reaction, so researchers are trying to determine if this surge will fizzle out, as previous spikes in other parts of the ruins have done, or whether they will need to find a way to access the room and intervene.
Neil Hyatt at the University of Sheffield, UK, who studies nuclear waste disposal, likens the situation to “embers in a barbecue pit” and says “it’s a reminder to us that it’s not a problem solved, it’s a problem stabilised”.
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Given the obscurity of these things, I bet that you (and many others) actually do have dysfunctional glands. The cream sounds like a real PITA though. Maybe try the hot washcloth and lid massage treatment? Even if it doesn’t help with the blocked ducts, it feels pretty good on sore eyes.
This may be TMI, but before I had cataract surgery two years ago, I would often get tiny pimple-like cysts on the margins of my eyelids. (There is a kind of creepy picture of one in this paper: Lesson: A Modern Approach to Meibomian Gland Dysfunction) They were very painful and made my eyes tear a lot. Once I managed to pop them with a fingernail, the pain and tearing went away immediately. They weren’t serious enough to worry about, but I’m pretty sure they were blocked meibomian ducts. I haven’t noticed them since my surgery, but the lens implants corrected my extreme myopia, and if they were there I, like you, am no longer able to see them.
Anyhow, good luck. I’d be interested in knowing whether the cream or heat treatment alleviates the soreness and tearing.
TLDR: me too, causes blepharitis, told to use Blephasol.
Long version - never even been mentioned by an optometrist, but when I had to see an ophthalmologist I got torn off a strip for my shocking eyelid hygiene (!?) and told I had to use a proprietary wash or, if I preferred, a couple of drops of baby shampoo in a little water (can’t remember the exact proportions). Either way, it’s a dilute solution of a weak surfactant - wimpy soap, if you will, of the type that won’t sting your eyes like hell.
Blepharitis is a result of bacteria and inflammation from congested meibomian oil glands at the base of each eyelash. Routine washing of the eyelids helps subdue symptoms and prevent blepharitis. Washing each eyelid for 30 seconds, twice a day, with a single drop of hypoallergenic soap (e.g. baby shampoo) and ample water can help. The most effective treatment is over the counter lid scrubs used twice a day. Some doctors may recommend using a hypochlorous acid treatment depending on the severity.
I have that too. Quite painful at times. My doctor had me use a warm washcloth and do an eyelid scrub with baby shampoo afterwards. As long as I do the scrub every night it’s fine but if I skip a night or two I get very gritty feeling eyes again.
Conclusion: We observed a discrete improvement in the parameters of tear function. Scientific evidence is not strong enough to systematically recommend the use of omega‐3 and omega‐6 fatty acids as a standalone treatment of DES independently from its aetiology. However, they could be considered as an effective alternative to topical treatment in patients with DES secondary to certain pathologies.
ETA:
The best objective and subjective results were observed in a study performed in patients suffering Meibomian gland dysfunction
Update: I tried a compress and that was pleasant. Not sure it made much difference, but I will continue. Also I did use a clean finger with alcohol to insert the salve. It was certainly an improvement on trying to insert it from the tube. Only thing was a slight sting from the alcohol. Maybe I will try letting dry first. I don’t know what good a mirror would do if my eye is blocked by my hand with a tube in it.
Wash your hands carefully with soap and warm water.
You may want to hold the ointment tube in your hand for a few minutes to warm and soften the ointment.
Gently cleanse the affected eyelid with warm water and a soft cloth before applying the ointment.
In front of a mirror, with the affected eye looking upward, gently pull the lower eyelid downward with your index finger to form a pouch.
Squeeze a thin line (approximately ¼ - ½ inch) of the ointment along the pouch. IMPORTANT: Be very careful when applying this ointment. DO NOT allow the tip of the ointment tube to touch the eyelid, the eyeball, your finger, or any surface.
Close the eye gently and rotate the eyeball to distribute the ointment. You may blink several times to evenly spread the ointment.