Leaving makeup on at night triggered agonising incurable eye condition, it started as dry eye but it’s made my life hell

WHEN Sarah Koseki was first struck by a debilitating pain on holiday in Mexico, she could never have imagined a 20-year-old habit would be the cause of her nightmare. The 37-year-old, who had never suffered eye issues before, felt her eyelid become stuck to her eye “like Velcro” while out sightseeing with her family. Sarah Koseki first experienced issues when her eyelid got stuck to her eye, leaving her unable to see or sleep Credit: SWNS Sarah said she felt her eyelid become stuck to her eye ‘like Velcro’ Credit: SWNS Bewildered, she managed to peel her eyelid open but was struck by a sharp, intense pain that lasted for days. “I couldn’t find comfort with my eyes open or closed. I couldn’t sleep at all, I was beside myself”, the Field consultant, from Boise, Idaho in the US, says. Back in the US, she visited an emergency eye doctor who told her she had a corneal tear – a cut in the front surface of the eye – and gave her some eye drops to numb the pain. After two weeks, her eye had fully healed and she was told she must just have naturally dry eyes, caused by genetics or ageing. But three months later, a corneal tear struck again. And again, three months after that. Soon, she was left in debilitating pain from tiny tears every few months and decided enough was enough. Seeking professional help, doctors diagnosed Sarah, now 41, with meibomian gland dysfunction (MGD) – an incurable eye condition which causes the glands in your eyelids to get blocked. Yet it was what doctors told her had likely caused the condition, that shocked her most – regularly wearing eye make-up to bed. MGD is believed to affect up to 20 per cent of all Brits, with hormonal changes, ageing and medications often blamed as triggers. But, experts now say that consistently wearing eye makeup to bed is a little-known common trigger that has fallen under the radar for too long. Sarah had spent 20 years wearing make-up to bed. “I’m a millennial, so I used to do crazy eye make-up with cut creases, winged eyeliner and even eyeliner on the waterline, which is horrible,” she says. Sarah Koseki, 41, thought nothing of going to sleep with her eye makeup on for years Credit: SWNS For Sarah, every corneal tear leaves her unable to work or read to her kids for 48 hours Credit: SWNS “I went on a lot of nights out and from age 18, I would just go to bed. “I’m also a side sleeper, so I’d be rubbing one eye at a time into my pillow every night, and pushing my make-up into my eyes,” she adds. “Had I known it would lead to this, I would have implemented a night-time face wash routine.” Sarah, however, is far from alone. According to Purvi Thomson, head of optometry at OCL Vision, a private clinic in London, “sleeping in eye makeup is one of the most common triggers of MGD we see”. “Mascara, eyeliner and eyeshadow can physically clog the tiny openings of the meibomian glands along the lash line, and over months or years that repeated blockage stops the glands working as they should,” she tells Sun Health. “It’s a slow, cumulative process which is exactly why so many people don’t realise the connection. “Someone can do this for years without any visible reaction like breakouts or redness, because MGD doesn’t announce itself the way a skin flare-up does. “The damage is happening beneath the surface long before it becomes noticeable as dryness or discomfort.” In itself MGD isn’t sight-threatening, but it shouldn’t be dismissed as trivial, experts say. “Left unmanaged, it is the leading cause of evaporative dry eye disease and chronic dry eye can lead to corneal surface damage, recurring styes and blepharitis – a condition that causes swelling and irritation of the eyelids,” Purvi adds. “MGD becomes harder to reverse the longer it’s left because the glands can atrophy over time.” Dr Panayiotis Maghsoudlou, a clinical lecturer in ophthalmology at the University of Bristol, agrees. “Eyeliner and kohl go on that same strip of lid margin, and studies have found more gland loss in makeup users than non-users,” he tells Sun Health. “Age and contact lenses can also play a role.” He adds: “The advice is dull but it works. Take eye makeup off every night, soaking rather than scrubbing. Pictured, Sarah undergoing treatment for MGD Credit: SWNS Sarah, seen with a gel on the face and metal devices placed under the eyes to protect them, getting intense pulsed light therapy where pulses of light are applied to the eyelid and cheeks to help melt thickened oils blocking the meibomian gland Credit: SWNS “Keep eyeliner off the waterline, which sits directly over the gland openings. “If you are already diagnosed with MGD, a warm eye mask for eight to ten minutes and preservative-free lubricating drops four times a day are the place to begin, and an ophthalmologist can offer more if that isn’t enough.” For Sarah, every corneal tear leaves her unable to work or read to her kids for 48 hours, and all she can do is sit in a dark room and wait for the pain to pass. But, she has developed a daily routine – using eye drops six times a day, washing her eyes with tea tree oils and using a heat mask – to help prevent corneal tears. Sarah has also stopped wearing eye make-up. “There are so many pain receptors in the eye. I would rather go through childbirth again than have another corneal tear. “It’s so debilitating. You can’t drive, you can’t work, you can’t see. “I now never wear eye make-up as it’s too risky.” She tells Sun Health: “I miss mascara so much. It used to be the finishing touch that made me feel pretty. “However, I will say that now I’m in my 40’s less makeup is better anyway and I feel naturally pretty and not so done up. “As a field consultant, I go out to injured workers job sites to help the employer identify potential light duty work for the worker. “My MGD has made me miss days of work as I can’t drive when I’ve had a corneal tear. What is meibomian gland dysfunction (MGD)? According to experts, MGD is a common, persistent, and often under-recognised problem. Ms Reena Dave, a consultant ophthalmologist and clinical partner of Newmedica in Slough and Bracknell, tells Sun Health: “MGD, is one of the most common — and most under-recognised — causes of chronic dry, irritated eyes that I see in clinic. “The meibomian glands sit along the eyelid margins and release an oily layer that sits on top of our tears, stopping them evaporating too quickly. “When these glands become blocked or the oil they produce becomes too thick to flow properly, that protective layer breaks down. “The result is eyes that feel gritty, sore, tired or intermittently blurry, often worse by the end of the day.” She adds: “Left untreated, MGD itself isn’t sight-threatening for most people, but it is genuinely miserable to live with, and chronic inflammation can increase the risk of other issues such as blepharitis and recurrent styes. “In more severe or prolonged cases, can affect the ocular surface enough to cause corneal irritation. It’s also a leading contributor to dry eye disease more broadly. “If symptoms don’t settle with simple measures, it’s worth seeing an eye specialist rather than assuming it’s just tiredness or screen strain.” Sarah has now developed a daily routine, using eye drops six times a day, washing her eyes with tea tree oils and using a heat mask, to help prevent corneal tears Credit: SWNS “Certain employer job sites too, can irritate my eyes such as locations that have a lot of saw dust.” Alongside her daily routine, she also applies Hylo Night eye ointment to keep her eyes moisturised. “It’s just like brushing your teeth every day to prevent a cavity”, she said. “If I miss one day of my routine, my eyes get angry.” Her doctor also recommended using Johnson’s baby oil mixed with water on her eyes, but she has since learned that this can actually increase the risk of infection, as it is not a sterile treatment. “I think half the problem is that people aren’t getting good advice”, Sarah says. She has also tried Intense Pulsed Light (IPL) treatment, where pulses of light are applied to the eyelid and cheeks to help melt thickened oils blocking the meibomian glands. After the procedure, she didn’t have a corneal tear for 18 months. “I’ve tried out 85,000 things to find out what works for my eyes”, she said. “There’s no cure for it, which is the hardest thing, and anything that helps isn’t covered by [medical] insurance. “The money I’ve spent on this is insane. In time, I hope more treatments are approved on insurance. “I also hope that by spreading awareness of all the different causes of MGD, people can prevent it from happening to them.”