Ever seen someone have their makeup done? If you’re a guy, probably not a regular
pastime… Many men probably don’t even know the difference between eyeliner and
Makeup application seems slow, tedious yet deliberate, and somehow, it comes together
like a work of art.
I grew up in a makeup-free home, with one younger brother and no sisters. My mother
rarely wore makeup apart from an occasional special event.
As an optometry student, I often noticed thick black powder on the lashes of some female
patients. On the slit lamp, the eye makeup looked like a black blizzard. I’d also see this
debris moving in the tear film. Sometimes, I’d get the name wrong of the product-causing-the-debris, and my patients would correct me that it was “mascara” not “eyeliner”. It took me a while for this to sink in.
It dawned on me, after regularly seeing how much debris collected in the tear film, that I
thought, ‘yeah, this must be why her eyes are watery at times’.
Fast forward to fifteen years later… A makeup artist came to my clinic for a routine eye
appointment. She explained to me that she uses three different brands of cosmetics, one
product was ‘hypoallergenic’.
I took a photo of her eyelid margin using my iPhone, via the slit lamp. The quality was good
enough to see the line of debris perching just on the edge of her Meibomian Gland orifices.
I showed her the photo and explained that makeup can easily clog her oil glands,
hypoallergenic or not. She said that she uses her ‘hypoallergenic’ makeup sometimes. Then I described how different cosmetics have preservatives and chemicals that can be toxic to her eyes, and hypoallergenic is just a marketing buzzword.
She glazed over.
Makeup was this patient’s skill and her life, and she wasn’t letting me convince her to try
any different products.
Besides, she was talking to a male doctor about makeup?! What could I know?!
So, what about you?
Are you keen on Dry Eye Management?
If you are, then you need to have a conversation with your female patients about makeup.
How do you start the conversation?
Whether you see a thick forest of mascara along the lashes, eyelid pencil along the lid
margins, lash extensions (with those hidden bacterial colonies inside the black tubes), or
foundation in the tear film and lid margin, start by taking a photo through the slit lamp
I usually find that it’s easiest to ask the patient to look down and take a photo of the upper
lid lashes. Then go to the photo and pinch the image to zoom in.
Talk to your female patients about how their makeup could be irritating their eyes now, and
potentially damaging their vision in the long term. Many female patients won’t know what brands they’re using (much less when they’re due to expire). Some will listen and change to a less toxic system. Others, like my makeup artist patient won’t. If your patients won’t listen, you could mention reducing their frequency of use to a couple of days per week.
As a male optometrist, I learned that female patient’s beauty routines are important. Image
is important, whether it’s in the workplace, or going out, or even seeing friends. It gives
women their dignity and confidence.
However, you must have the conversation with them about makeup, toxicity and the impact
on their eyes. Who knows, the next time they attend an appointment, they might even say
that they followed your advice and their eyes feel better. Many of mine have. Just have a
Take a closer look at eye care though my lens, visit my website:
D.E.Diva Guest Writer, Leigh Plowman, OD