Keep your eyes peeled
Lana Wong loved make-up. She took special delight in carefully creating her favourite eye make-up with eye shadow, heavy eyeliner and lashings of mascara. Enamoured with the fluttery, luscious lashes sported by female celebrities and models in glossy magazines, Wong (name changed for patient confidentiality reasons) even had fake individual lashes painstakingly glued to her real lashes to give her a permanently doe-eyed look.
But while Wong's efforts made her peepers look glamorous, she had trouble looking out of them. Her eyes were perpetually dry and uncomfortable, and were often irritated and red. Over two years, she consulted several ophthalmologists for help.
The eye doctors found that her tear secretion was low and diagnosed her with dry eyes. Using special fluorescein eye drops to temporarily stain the surface of her corneas, the doctors also found that there were dry spots on the surface of her corneas.
Wong was prescribed tear supplements or eye drops, and advised to take polyunsaturated fatty acids in the form of flax seed and fish oils to improve the quality of her tears. To help her eyes retain the lubricating tears longer, doctors even plugged two of the four holes (puncta) in her eyes that naturally drain away the tears.
Despite these treatments, Wong continued to suffer eye dryness and irritation. Desperate for relief, she hopped from one ophthalmologist to the next.
She finally found herself in the office of Dr Hui Siu-ping, a specialist in ophthalmology at Hong Kong Sanatorium and Hospital.
Taking a closer look at Wong's eyes, Hui discovered a low-grade infection of the lid margin called blepharitis.
Wong's meibomian glands - tiny pores that secrete meibum, an oily fluid that coats and lubricates the eye - on the edge of her eyelids were coated with skin and cosmetic debris. Meibum keeps tears from evaporating too quickly, and in Wong's case, the occlusion of the meibomian glands reduced the production of the oily substance.
Taken together with her low tear production, the combination proved a double whammy for Wong's dry eye problem.
Hui tried to remove the debris, but the delicate task was hampered by the stiff artificial lashes that were firmly glued to her natural ones. 'Imagine trying to clean between the teeth of a comb,' says Hui. 'It became very, very difficult to clean the rim of her eyelids.'
Hui advised Wong to remove the artificial lashes, but she was reluctant. Each set of artificial lashes had to be applied by a beautician and could last several weeks before they dropped off. Wong could not remove them on her own, and she would have to return to the beautician to get it done.
Unable to persuade Wong, Hui sent her home with antibiotic eye drops, anti-inflammatory medication, preservative-free tear supplements and instructions on how to properly clean her eyelids. Hui explains that while preservatives in tear supplements might not hurt the casual user, they could further destabilise the tear film on the eyes for a heavy user such as Wong.
This would only worsen the dry eye condition.
Hui also advised Wong to stop or reduce the amount of cosmetics that she uses on or near her eye. The natural oils of her skin will dislodge the products, which will then migrate into her eyes.
This, in turn, introduces more chemicals and contaminants into the sensitive organ.
Adding more products and debris to her eyelids could also worsen the occlusion of the meibomian glands and make the infection worse.
Still, Wong's decades-long love affair with eye make-up could not be undone in one doctor's visit. She tried reducing some of the eye products she used while faithfully following Hui's regimen of cleansing and medication.
After another visit or two to Hui, Wong noticed that her eyes were becoming less dry and irritated. She was finally convinced that Hui was right about the connection between her heavy use of cosmetics and her eye problems so she had her artificial lashes removed and found that her condition improved even further.
But it took one final blow to convince Wong to stop using heavy eye make-up. Dolling up for a banquet, she again caked on eye make-up and, several days later, was in Hui's office with a badly infected tear duct, from which Hui had to extract pus.
This time, Wong had to completely stop using cosmetic products near her eyes for a month while the infection was treated with antibiotics.
Hui advised her to throw away all the products that she had applied on her eyes to avoid reintroducing the bacteria into her healthy eyes.
After that harrowing experience, Wong now cherishes her health over beauty. She wears minimal eye make-up and continues to enjoy irritation-free vision.