Optimum Lid Hygiene
By
Shelley I. Cutler, OD, FAAO
The eyelids have several glands within them. It is important that they function properly in order for your tears to do their job…to wet your eye.
The majority of these glands are called the Meibomian glands. There are about 25 openings to the upper lid and about 20 to the lower lid. If you look carefully at your eyelid margins, you may see the little holes or openings.
If these glands drop out or get clogged or do not function properly, you may experience burning, stinging or even watering of your eyes.
The sebum (the fluid secreted from the Meibomian glands) should be the consistency of vegetable oil. If it hardens, it becomes more like margarine and cannot exit the glands properly and you may have some or all of the above complaints. The following is a very simple, but effective way to help your Meibomian glands function properly.
Warm Compresses and Lid Massage
By placing moist heat over the eyes, this will increase blood flow. It also may begin the process that will allow thickened gland material to begin to soften. (Just as if you were melting butter.)
A Bruder mask is excellent! https://www.bruder.com/moist-heat-eye-compress (Follow the product instructions)
An alternative (although not as effective) is to use warm compresses.
The ideal procedure to melt the Meibom is LipiFlow or IPL. (This will be recommended by your doctor, if needed).
Instructions for Warm Compresses:
Place a clean washcloth under the spigot and wet with warm water. The warmer, the better, but make sure it’s not too hot to be uncomfortable. Close your eyes and hold over the eyelids. Keep replacing under warm water to restore heat.
Hold against the eyelids for several minutes: (2-5 minutes) the longer, the better.
Open your eyes and gently press around the edges of the eyelids. If you press towards the Meibomian gland openings, some gland fluid could be pressed out. (This is a good thing. ) Try not to press too hard on the eyeball itself.
Lid Hygiene
After performing warm compresses and massage, take a damp Q-tip (initially wet it under the tap and lightly squeeze out the excess in between your fingers), place 1-2 “pumps” of the recommended eyelid cleansing product on it.
Recommended HypoChlorous Acid Eyelid product: (by your Eye Care Practitioner). Avenova… HypoCholor (by Ocusoft)….HyClear…etc
HypoCholorous Acid does not sting. Other product may.
Place the Q-tip on your lower lid margin where the eyelashes come out and stroke it back and forth gently (2-4 times) over the Meibomian gland openings. (Ladies, this is as if you are applying pencil eyeliner to above the eyelashes, not below). Repeat under the lash line as well.
On the upper lids, close the eye and rub above the lashes. If you attempt under the upper lashes to get the upper lid gland openings (which of course, is ideal), there is a good possibility that you may poke yourself in the eye. 
Be very careful if you attempt this!
DO IT GENTLY! (Think petting a dog or cat on their head). You do not want to rub the skin raw. You just want to introduce the cleansing product there to clean any of the excess sebum that may be remaining from the massage.
Then flush each eye with 2-3 non-preserved artificial tears drops.
Recommended tears: ___(Your eye doctor will recommend)_______
Add this simple, but effective, routine at the same time you floss and brush your teeth and you should start experiencing increased eye comfort and more comfortable lens wear.
Initially do twice a day, morning and evening with all make-up removed. As symptom disappear, it can be done in the evening only.
If you have very advanced Meibomian Gland Dysfuntion (or significant dropout), or severe dry eye disease, your doctor may recommend some of the more advanced options and treatments.
Optimum Lid Hygiene
