Australian optometrist Leigh Plowman has interviewed two US optometrists, Dr Leslie O’Dell Hombach and Dr Bridgitte Shen Lee about the hidden chemicals in cosmetics, cosmetic removers and cleansers, and their impact on ocular surface health.
In a fascinating one hour interview, Dr O’Dell Hombach and Dr Shen Lee also spoke about their approach to detecting early signs of ocular surface diseases in practice and the way in which they educate make-up wearers (male and female) to maintain ocular health.
The two eye health professionals have recently developed and launched a new line of ‘clean’ eye make-up products, which do not include any harmful chemicals and have been developed with the eye, and especially the ocular surface, in mind.
Discussing the management of make-up wearers in practice, Dr O’Dell Hombach and Dr Shen Lee advised optometrists to ask patients what make-up they use routinely, how they remove it and whether they remove it every day. A surprising number of patients sleep with their eye make up on and do not remove it every day, in fact for some groups, this is a trend.
Five questions to ask:
- Do you wear make-up?
- Where do you apply your make-up?
- Do you wear eye liner?
- Where do you apply the eye liner? and
- Do you take off your make-up every night before you go to sleep?
A surprising number of patients sleep with their eye make up on and do not remove it every day, in fact for some groups, this is a trend
Taking a swab or using a photo to show how much make-up is still on a patient’s eyes is a powerful educator to demonstrate the (lack of) effectiveness of their cleansing regime and refocus habits.
Telling patients not to wear cosmetics won’t work, instead, offer tips to help minimise ocular complications:
- Avoid the area of the meibomian glands (‘the water line’) when applying eye make-up, especially on a daily basis,
- Do not have eye liner tattooed,
- Always go to bed with a clean face – carefully remove all makeup,
- Replace eye make-up monthly to avoid the risk of bacterial build up and/or expiry dates should be noted, and
- Avoid lash extensions or growing lashes with prostaglandin analogues,
without professional supervision – lashes are designed to divert the wind away from the eyes by extending their length, which is naturally one third the width of the eye, the lashes create a wind tunnel for air, dust and allergens.
Impact of Make-up
Describing some of the specific problems associated with eye make-up, Dr O’Dell Hombach and Dr Shen Lee said the glitter from glittery eye shadows travels into the tear film, while eye liner applied to the water line and eye liner tattoos block the meibomian glands. Out-of-date mascaras have potential bacterial build up and some, especially those that promote fuller eye lashes and growth in lashes, contain harmful chemicals such as prostaglandin analogues.
Speaking of eyelash extensions – they said dermatitis and blepharitis are very common, as is demodex manifestation. Many eye lash extensions contain formaldehyde glues and people who wear them long term typically require maintenance every three weeks. As a result they said, formaldehyde glues flow on to the ocular surface at these regular intervals. Some ‘falsie’ lash extensions are applied under the natural eye lashes. New false lashes with magnetised strips are applied to the lids with a thick eye liner containing powdered magnets.
When false lashes are worn long term, the lids and lashes are neglected as they don’t get a break from the product or a deep clean.
The full interview can be viewed at www.facebook.com/optomly/videos/232136228000910/