The Tragedy of Blepharitis and the Ocular Hygiene Bully

This weekend was my trip to the optometrist. I get new contacts every year, but it's been a long time since I got new glasses, so that's what I decided for this time around. So after the assistant's examination, the optometrist himself sees me.

The first thing he says after introductions and putting his magnifying lenses on, is "You know, you suffer from an incurable condition called blepharitis."

"Ugh. That sounds scary."

"It's just the result of consistently poor hygiene," the optometrist said in response. But wait, wait! Is this a scary condition or not? Am I going to go blind?

Turns out, no, this is not such a big deal. It's basically a heavier-than-usual buildup of crud from the tear ducts that accumulates on the eyelids and eyelashes. I've been brushing this stuff away for weeks without really thinking about it very much. And allergic reactions to airborne allergens may well play a part in it as well as not adhering to the elaborate rituals prescribed for resolving the condition.

Next question: "How long do you wear your contacts for?"

Me: "Oh, about three weeks, which I know is perhaps longer than I should."

Mean Optometrist: "Perhaps? Those lenses are designed for two weeks, period. You need to stop that. Stop it now. Look, they're your eyes but you won't lose your vision for lack of my advice."

Me: "Erm..."

MO: "If you want a contact-lens prescription, you ought to have the responsibility to wear the lenses the way they're supposed to be worn. Throw them away twice a month. The first and the fifteenth. No exceptions. Got it?"

Me: "Okay, doc. I got it."

MO: "Do you wear sunglasses?"

Me: "No, I keep sitting on them so I gave up on them last summer."

MO: "Bad idea, my friend, and I suggest you change your ways. Wear sunglasses when you're out and about."

Me: "Okay..."

MO: "Do I have to pull out the pictures of the kinds of things that fly into unprotected eyes? It's quite a horror show."

Me: "No! I believe you."

MO: "Right. Look in here and read the bottom line in the third set of lines."

Me: "20/30."

MO: "That's what I'm testing for. Read the bottom line of letters and numbers."

Me: "N - H - O - X - 2."

MO: "You got one wrong. The second to the last one."

Me: "Um... S?"

MO: "Good. Now, the good news is your blood pressure is fine, from what I can tell. What kind of solution do you use to store the lenses in at night?"

Me: "My wife and I were using the Bausch & Lomb ReNu, but after the fungus scare, we switched to generic versions of the same product."

MO: "So you're still using ReNu. Quit it."

Me: "I know it's a similar product, but--."

MO: "It's the same product. It's not the right product for your lenses and these things are very sensitive to small chemical imbalances. You get burning sensations in your eyes at night?"

Me: "Sometimes, yeah."

MO: "It's the ReNu product, chemically reacting with your lenses, irritating the tissues of your eye. I try and get all of my patients off that product, because it produces such terrible results."

Me: "I had no idea. Wow."

MO: "Here's a starter of a different product. Throw away all your generic ReNu when you get home. Got it? ReNu - bad! And here's how you wash your eyelids."

So after describing a ten-minute ritual involving more hot washcloths, baby shampoo, and eyelid massage than I'd ever heard suggested other than on Queer Eye For The Straight Guy, the mean optometrist gave me some contacts to wear temporarily that worked great. My distance vision was sharp, clear, and easy. I'm getting new glasses but the lenses will come soon enough. And every night I'm massaging my eyelids. No cucumber slices on the eyes (yet) but I've got to figure out a way to lie on my back with a hot, wet washcloth over my eyes that doesn't drip water all over my bed, or have me walking around with a damp blindfold.

I have to go back in two weeks to get my pupils dilated by this mean optometrist. I'm a little bit nervous.