It was on a family vacation Mexico that Sarah Koseki’s eye problems first started.
The The field consultant, then 37, was touring with her family when she felt her eyelid sticking to her eyeball “like Velcro.”
Confused by what had happened, Sarah tried to open her eyelid – and was suddenly knocked over by a sharp, knife-like pain.
This lasted for days and was almost unbearable.
“I could find no comfort with my eyes open or closed; I couldn’t sleep at all; I was beside myself,” Sarah said.
The holiday was ruined. Back home in Boise, IdahoSarah visited an emergency doctor and was told she had suffered a corneal tear – a tear in the front of the eye that can cause extreme, sharp pain, redness and blurred vision.
Antibiotic drops and resting in a dark room helped ease her discomfort and within two weeks Sarah’s eye felt completely healed.
But just three months later, Sarah found herself in the same painful position again. And the problem continued to occur with increasing regularity.
“I would be in debilitating pain for 48 hours,” she says. ‘Nothing helped. I was on my hands and knees in a dark room trying to let gravity separate my eyelid from my eye.
“Sometimes I would hold my eyelids away from my eyes with my fingers for hours to bring relief.”
It was during a family vacation to Mexico that Sarah Koreski first experienced a painful corneal tear
In the fifth incident, which ruptured the corneas of Sarah’s eyes, she decided to look for answers.
After a series of tests at a specialist clinic, Sarah was diagnosed with Meibomian Gland Dysfunction (MGD), a painful condition that occurs when the oil-producing glands in the eyes stop working properly.
It affects as many as one in five Britons and can cause severe dry eyes, irritation and corneal damage if left untreated.
Aging, hormonal shifts – such as menopause – and underlying skin conditions can all contribute to MGD.
But in Sarah’s case, doctors told her that MGD was likely caused by a simple mistake that almost 40 percent of women in Britain made: wearing eye makeup to bed.
For almost twenty years, Sarah hadn’t thought about going to sleep with a full face of makeup.
“I went on a lot of nights out, and after a night out, I just went to bed from the age of 18,” she explains.
Because her skin never broke out, Sarah always thought the habit was harmless. But she now wishes she had started a nightly facial cleansing routine decades ago.
‘There are so many pain receptors in the eye; “I would rather give birth again than have another corneal tear,” she says.
“It’s so debilitating; You can’t drive, you can’t work, you can’t see. I never wear eye make-up now, it’s too risky.’
For almost twenty years, Sarah hadn’t even thought about going to sleep with a full face of makeup
Sarah experienced tears in the surface of her eyeball almost every three months, causing her eyes to become red, watery and unbearably painful
Research shows that around two in five British women admit to going to bed without removing their make-up when they feel too tired.
Separate surveys have found that a further one in five Brits don’t wash their face daily – with as many as two-thirds admitting to neglecting a good night-time skincare routine.
But experts warn that poor skincare habits can have lasting – and irreversible – consequences for eye health.
MGD occurs when the small oil-producing glands along the eyelid margins become clogged or stop functioning properly, explains eye surgeon and founder of Blue Fin Vision, Mr Mfazo Hove.
“These glands produce the oily outer layer of the tear film, which slows evaporation and keeps the eye surface comfortable,” he says.
‘If the oil becomes too thick or the gland openings become clogged, the tear film becomes unstable and the eyes dry out more quickly.
‘Age is an important factor, but prolonged screen use and reduced blinking, infections such as blepharitis, conditions that affect circulation such as rosacea, wearing contact lenses, hormonal changes and certain medications can all contribute.’
MGD is the leading cause of dry eye disease, which affects millions of Britons and can cause a gritty, gritty or burning sensation in the eyes, as well as redness, blurred vision and watery eyes.
And because the tear film is the first protective layer over the cornea, this gradual erosion can also make the surface significantly more susceptible to devastatingly painful scratches and tears, says Mr Hove.
It can be particularly risky not to remove eye makeup at night, he adds.
“The meibomian gland openings are located right along the eyelid margin, so eyeliner applied to the waterline is effectively placed over it,” he says.
‘Makeup left on overnight can build up around those gaps and contribute to obstruction and inflammation. May contribute to progressive glandular dysfunction and eventual loss of glandular tissue over many years.
‘I would always recommend removing eye make-up thoroughly before going to bed and avoiding regularly applying eyeliner directly along the inner edge of the eyelid.
In Sarah’s case, the IPL treatment, which involves applying pulses of light to the eyelid and cheeks to help melt thickened oils blocking the meibomian glands, has had some benefit.
“Once significant loss of meibomian glands has occurred, those glands do not regenerate easily.”
For Sarah, the diagnosis came too late to repair the damage to her eyes.
Now she must perform an extensive daily routine to prevent further tearing – including using eye drops six times a day, washing her eyes morning and evening with tea tree oil, and using a heat mask to soften the oils in her glands and help them flow better.
Before going to bed, she should also apply an eye ointment to keep her eyes moisturized.
“It’s like brushing your teeth every day to prevent cavities,” she says. “If I miss a day of my routine, my eyes get angry.”
She’s also had to stop wearing eye makeup altogether, aside from the occasional dab of concealer under the eyes.
However, Mr Hove says the best way to prevent further corneal tears is to treat the underlying MGD early rather than simply tolerating the symptoms.
“One of the simplest things you can do to reduce the risk of developing or worsening the condition is to blink properly,” he says.
‘Each full blink releases oil from the meibomian glands, while prolonged screen use can reduce both the frequency and completeness of blinks.
‘Take frequent breaks from screens, make a conscious effort to blink fully and maintain good eyelid hygiene. If you are prone to clogged glands, regular warm compresses can also help keep the oils in the glands fluid and flowing normally.”
Likewise, he adds, pay attention to early symptoms.
‘Persistent gritty, burning, watery or occasionally blurry eyes should not simply be accepted as normal,’ says Mr Hove. ‘If the complaints persist for several weeks, it is worthwhile to have the eyelids, tear film and ocular surface properly assessed.’
In Sarah’s case, the IPL treatment, which involves applying pulses of light to the eyelid and cheeks to help melt thickened oils blocking the meibomian glands, has had some benefit.
Sarah’s corneas ruptured no more than 18 months after she had the procedure. But at around €300 per session – or as much as €1,600 for a full course of treatment – it can be unaffordable for many.
“I’ve tried 85,000 things to find what works for my eyes,” she says. “There is no cure for it, which is the hardest part, and anything that helps is not covered by insurance.
‘The money I spent on this is insane. If I had known this would lead to this, I would have implemented a nightly face wash routine decades ago.”
