I thought sleeping with my make-up on was harmless. Now I’ve got a terrifying condition and doctors say it’s too late for me – I’m going to suffer this agony for life. Don’t make my mistake

It was on a family holiday to Mexico that Sarah Koseki’s eye issues first began. 

The field consultant, then 37, was out sightseeing with her family when she felt her eyelid become stuck to her eyeball ‘like velcro.’

Confused by what had happened, Sarah tried to peel her eyelid open – and was suddenly bowled over by a sharp, knife-like pain.

This lasted for days and was nearly unbearable. 

‘I couldn’t find comfort with my eyes open or closed; I couldn’t sleep at all; I was beside myself,’ Sarah said.

The holiday was ruined. Returning home to Boise, Idaho, Sarah visited an emergency doctor and was told she had suffered a corneal tear – a rip in the front surface of the eye that can cause extreme, sharp pain, redness and blurry vision.

Antibiotic drops and resting in a dark room helped ease her discomfort and within two weeks, Sarah’s eye felt fully healed.

But just three months later, Sarah again found herself in the same agonizing position. And the problem continued to strike with increasing regularity.

‘I would be in debilitating pain for 48 hours,’ she says. ‘Nothing helped. I would be on all fours in a dark room trying to get gravity to separate my eyelid from my eye. 

‘Sometimes I would just hold my eyelids away from my eyes with my fingers for hours to give me relief.’

By the fifth incident, which saw the corneas of both Sarah’s eyes tear, she decided to seek answers.

After a series of tests at a specialist clinic, Sarah was diagnosed with meibomian gland disorder (MGD) – a distressing condition which occurs when the oil-producing glands in the eyes stop working properly.

Affecting as many as 17 million Americans, it can cause severely dry eyes, irritation and damage to the cornea left untreated.

Aging, hormonal shifts – such as menopause – and underlying skin conditions can all contribute to the MGD.

But in Sarah’s case, doctors told her MGD was likely caused by a simple mistake made by nearly one in four women in the US: wearing her eye makeup to bed.

For nearly 20 years, Sarah had thought nothing of going to sleep with a full face of makeup.

‘I went on a lot of nights out, and after nights out, and from age 18, I would just go to bed,’ she explains.

Because her skin never broke out, Sarah always thought the habit was harmless. But she now wishes she had begun a night-time face washing routine decades ago.

‘There are so many pain receptors in the eye; I would rather go through childbirth 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 now never wear eye make-up as it’s too risky.’

Surveys show that around 40 per cent of women in the US confess to going to bed without removing their makeup when they feel too tired.

Separate studies have revealed that a further one in five Americans do not wash their face on a daily basis – with as many as two-thirds admitting to neglecting a proper nighttime skincare routine.

But experts warn that bad skincare habits can have lasting – and irreversible – effects on eye health.

MGD occurs when the small oil-producing glands along the eyelid margins become blocked or stop functioning properly, explains ophthalmic 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 surface of the eye comfortable,’ he says.

‘When the oil becomes too thick, or the gland openings become obstructed, 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 the circulation such as rosacea, contact lens wear, hormonal changes and certain medications can all contribute.’

MGD is the leading cause of dry eye disease, which affects tens of millions of Americans and can cause a gritty, sandy or burning feeling in the eye, 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 leave the surface significantly more prone to devastatingly painful scratches and tears, says Mr Hove.

Failing to remove eye makeup at night can be particularly risky, he adds.

‘The openings of the meibomian glands sit directly along the eyelid margin, so eyeliner applied to the waterline is effectively being placed over them,’ he says.

‘Makeup left on overnight can accumulate around those openings and contribute to obstruction and inflammation. Over many years may contribute to progressive gland dysfunction and, eventually, loss of gland tissue.

‘I would always recommend removing eye makeup thoroughly before bed and avoiding regularly applying eyeliner directly along the inner lid margin.

‘Once significant meibomian gland loss has occurred, those glands do not readily regenerate.’

For Sarah, the diagnosis came too late for the damage to her eyes to be repaired.

Now, she needs to carry out an elaborate daily routine to prevent further tearing – including using eye drops six times a day, washing her eyes morning and night with tea tree oils, and using a heat mask to soften the oils in her glands and help them to flow better.

Before bed, she also has to apply an eye ointment to keep her eyes moisturized.

‘It’s just like brushing your teeth every day to prevent a cavity,’ she says. ‘If I miss one day of my routine, my eyes get angry.’

She also has had to stop wearing eye makeup entirely – other than the occasional daub of under eye concealer.

Mr Hove says the best way to prevent further corneal tears is to treat the underlying MGD early rather than simply tolerating the symptoms, however.

‘One of the simplest things you can do to reduce your risk of developing or worsening the condition is blink properly,’ he says.

‘Every complete blink helps express oil from the meibomian glands, whereas prolonged screen use tends to reduce both the frequency and completeness of blinking.

‘Take regular breaks from screens, make a conscious effort to blink fully and maintain good eyelid hygiene. If you are prone to blocked glands, regular warm compresses can also help keep the oils within the glands fluid and able to flow normally.’

Likewise, he adds, keep an eye out for early symptoms.

‘Persistent gritty, burning, watery or intermittently blurred eyes should not simply be accepted as normal,’ says Mr Hove. ‘If symptoms continue for several weeks, it is worth having the eyelids, tear film and ocular surface properly assessed.’

In Sarah’s case, IPL treatment, where pulses of light are applied to the eyelid and cheeks to help melt thickened oils blocking the meibomian glands, has had some benefit.

Sarah’s corneas didn’t tear for more than 18 months after undergoing the procedure. But at around $550 per session – or as much as $3,200 for a full course of treatment – it can be prohibitively expensive for many.

‘I’ve tried out 85,000 things to find out what works for my eyes,’ she says. ‘There’s no cure for it, which is the hardest thing, and anything that helps isn’t covered by insurance.

‘The money I’ve spent on this is insane. Had I known it would lead to this, I would have implemented a night-time face wash routine decades ago.’