Avoiding a “Heart Attack” on the surface of your eye…

To avoid giving your eyes a “heart attack,” we need to build up our blinks – not just more frequently, but also more forcefully (remember my January 2nd post on “blinking strong?”).

Because most dry eye disease is linked to clogging of the oil glands making the oil that normally protects against rapid evaporation (allowing as much as 20 seconds or more of staring to not be a problem), and because heat can help relieve this clogging (see earlier posts on this), I like to recommend heated “eyelid crunches.” For most, this is the use of a heat mask designed to deliver around 108-110 degrees Fahrenheit or 42-43 degrees Centigrade of moist heat for 3-5 minutes. During the first 3 minutes, relaxing the lids and letting the heat penetrate, and then for the next 1-2 minutes, forceful (as in conscious but not grimacing) 3-second squeezes of this lids together, followed by relaxing the lids for 3-seconds helps to do several things.

First, the action of a strong blink encourages the oil-producing (Meibomian) glands to deliver their oil – and if that waxy oil is hot, it is more likely to be more liquid and less like wax – so it can move along. This helps to unclog the glands and make room for better, newer oil to follow the old, stale, rancid oils that were “bottled up” behind those clogs.

Second, those eyelid “crunches” help to strengthen the muscles that help you to blink – so future, unconscious blinks are more likely to be stronger blinks. Strong muscles = strong blinks.

Third, this repetitive use of the blinking muscles can encourage “muscle memory” – that unconscious movement that helps tennis players return balls easily, pianists and other musicians play smoothly, and bicyclists keep up a rhythmic pedal stroke. The hope is to get you blinking better throughout your day.

One constant advice for those using digital devices is the 20/20/20 rule. For every 20 minutes of close work, take 20 seconds to look 20 feet or further away. This relaxes the internal, focusing muscles of the eyes that have been straining in a constant state of near focus (unless you’re lucky enough to have a natural near focus that matches the distance of your device, in which case you’re not likely to be straining for your focus because you are “nearsighted” or Myopic). But in those 20 seconds, you should also concentrate on several “good, strong blinks.” Adding regular strong blinks throughout your day (back to my January 2nd post) is another great help in avoiding an “ocular surface Heart Attack.”

Not every patient will benefit from heated eyelid crunches. Some have good oil volume, but may benefit from “better oil,” Others with more inflammation and less obstructive MGD may increase their inflammation (dilating blood vessels that deliver inflammation, which can increase inflammation getting to the eyes) with heat. Ocular Rosacea patients will commonly have both issues (“bad oil” and inflammation). As usual, ask your dry eye specialist if you would benefit from heated “eyelid crunches.”

By the way, Happy “National Sjogren’s Syndrome Day!” Sjogren’s is an autoimmune disease affecting water-producing glands for your tears, for your saliva, for your gut, and for women, for their female wetting. While oil glands have little to do with this problem, they still are a significant part of the dry eye problem. Anything that helps oil, helps dry eyes - and while other attention to the water-piece of a tear can help the Sjogren’s-piece (especially anti-inflammatory medications that fight the autoimmune features of Sjogren’s), it is still important to deal with any oil issues, too. More on Sjogren’s in future postings.