Bridgitte Shen Lee, O.D., FBCLA, lays out 5 eye health do’s + don’ts for patients passionate about beauty

As an optometrist focused on ocular surface disease (OSD), a woman doctor who wears makeup regularly, and a working mom who takes care of her physical health and appearance, I regularly discuss ocular cosmetics topics with patients.

Patients do not know what they do not know. Modern dry eye disease (DED) is a lifestyle disease.

In this Ocular Aesthetics column, I lay out the simple do’s and don’ts regarding makeup and other ocular cosmetics that you can recommend for your patients.

5 DO’S

1. Seek an OSD-Focused Optometrist for Your Ocular Cosmetics Needs.
2. Follow This Guide If You Are an Eyelash Extension or Falsies Devotee:
   Any OSD-focused eye doctor will recommend against regular eyelash extensions and falsies use, but many women—including doctors themselves—are devotees of this popular cosmetic trend.
   

   

   Find an OSD-focused eye doctor, obtain comprehensive ocular surface exam baseline data, then decide whether to continue based on the severity of test results/symptoms. See Table 1 (page 36) for what is considered a comprehensive ocular surface exam.
   

   

   For mild clinical signs and symptoms: Maintain daily lids/lashes foam wash, followed by preservative-free saline hygiene solution containing 0.01% pure hypochlorous acid (HOCl); use a preservative-free lipid-based tear supplement; and treat any underlying disease.
   

   

   For moderate to severe clinical signs and symptoms: Follow your OSD eye doctor’s recommended treatment plan.
3. Avoid Cosmetics That Have Harmful Ingredients.
   What are they? See Table 2 (page 36) for explanations.
4. Wear Facial (Physical) Sunscreen Daily.
   The secret to the best anti-aging facial cream is to wear a proper physical sunscreen (not chemical sunscreen) daily. Avoid vitamin A—retinyl palmitate or retinol—and oxybenzone (a synthetic estrogen). Instead, look for products with zinc oxide, 3% avobenzone, or mexoryl SX.
5. See a Facial Plastic Surgeon and Cosmetic Dermatologist for Your Anti-Aging Goals.
   It is important to see an experienced facial plastic surgeon and a cosmetic dermatologist for the latest noninvasive aesthetic procedures and injections of botulinum toxin and fillers.

5 DON’TS

1. Do Not Sleep With Makeup On.
2. Do Not Use Eyelash Extensions, Growth Serums, or False Lashes Without an OSD-Focused Optometrist’s Care.
3. Do Not Tightline Eyeliner Over Your Waterline on a Regular Basis.
   It blocks meibomian gland orifices and leads to meibomian gland dysfunction (MGD) and dry eye symptoms.
4. Do Not Use OTC Dry Eye and Redness Relief Drops Without Seeing an Eye Doctor First.
   Treat the underlying cause(s) of red eye and dry eye first. Many over-the-counter relief drops have harmful preservatives and ingredients.
5. Do Not Follow What’s Popular in Social Media!
   Do not do these things: iris and conjunctiva tattoo, eyelid tattoo, urine drops, Sharpies as eyeliners, eyeliners with magnetic dust for magnetic falsies.

Primary eyecare doctors play an essential role in educating patients on why they should follow ocular cosmetics advice: to help them look and feel their best and to protect their delicate ocular surface.

BRIDGITTE SHEN LEE, O.D., FBCLA, graduated from the University of Houston College of Optometry. She co-owns Vision Optique, a private practice in Texas. A lecturer on digital eye health, dry eye disease, anti-aging eye care, social media, and ocular aesthetics, Dr. Shen Lee is also a Tear Film & Ocular Surface (TFOS) Society Global Ambassador and spokesperson and medical adviser to The Vision Council.