Eyelids shouldn't have notches
January 18, 2021 10:07 AM   Subscribe

As of the day before yesterday, there's what appears to be a teeny-tiny notch, indentation, or divot in my left eye's low eyelid, on the waterline. Dr. Google tells me it's cancer (of course), meibomian gland dysfunction, or nothing/it'll clear up on its own. It's weirding me out and I'm not sure what to do.

It looks almost identical to this photo, roughly the same placement and size. I can't tell for sure if it's really an indentation or if the half of my eyelid closer to my tear ducts is slightly swollen.

The eyelid doesn't hurt or even feel weird, and neither does the eye itself. I'm glad it doesn't hurt, but whenever I look into the bathroom mirror I get kind of freaked out. Eyelids aren't supposed to look like that!

Likely irrelevant context:

In the last ~2 years I've had a horrible chalazion (on the other eyelid) that took a long time to heal; a minor stye on the outer part of my left lower eyelid that went away with treatment but left a small lump under my lower eyelid that has remained for a year; and a tiny white bump, possibly a milium, on my right upper eyelid. In the last couple of months I've occasionally noticed a faint blurriness in my right eye, only when using my very bright new laptop, but it's been hard to replicate and may have gone away with more eyedrop usage.

I have rosacea, seborrheic dermatitis, and eczema, all well controlled. I admittedly don't use the prescription rosacea gel as consistently as I should.

I use a CPAP at night and am on my computer constantly during the day, giving me a tendency toward dry eyes, so I use lubricant eye drops occasionally.

My mom, who is over 80, has both wet and dry macular degeneration.

Just before the coronavirus hit, I moved, and now live in a much colder area where I run the heater a lot and it's dry inside. I don't have a humidifier.

Where I lived before, I had seasonal allergies that necessitated anthihistamine eyedrops starting in February, but the growing season here starts a good 3 months after it did there.

I haven't used cosmetics in months.

I wear glasses, not contacts, and have hardly been wearing glasses at home anyway.

I don't have an eye doctor here, though I do have a GP. My area is experiencing a massive spike in COVID-19 and I don't feel safe going for medical care in person. But, y'know, eyes are important.

At-home treatments I'm trying (I don't expect immediate results, but they seem like good things to be doing):
warm compresses
starting Omega-3 capsules
using eyedrops more scrupulously
using metronidazole (rosacea gel) more scrupulously

And I will send an online message to my GP at some point soon.

Have you had an indentation in your lower eyelid like this? What did it turn out to be? How worried should I be, and should I be looking into more at-home treatments or risking going into a doctor's office?
posted by kutsushita nyanko to Health & Fitness (9 answers total)
I would go to your ophthalmologist - or if you don't have one go see your optometrist. Don't let covid stop you - they'll wear a mask and faceshield. The peace of mind if it's nothing will be huge and if it's something good to get started dealing with it.
posted by leslies at 10:56 AM on January 18, 2021 [1 favorite]

Can you make a telemedicine appointment with your GP? I suspect this is something that would be primarily evaluated visually, which can be done over an internet camera.
posted by heatherlogan at 12:43 PM on January 18, 2021

So as not to abuse the edit window: there's a tear duct opening at that location on the lower eyelid (I *think* it's one that drains tears out of your eye). So my first guess would be that the tear duct is involved somehow.
posted by heatherlogan at 12:47 PM on January 18, 2021

Best answer: A thing I have learned about my body that I think probably applies to most other bodies: what looks like a dent or indentation can actually be swelling. Everything else around the area got bigger so it looks like the area that did not swell is a dent and therefore the problem, which can distract from the actual problem.

It could be a blocked gland or duct, irritation due to dry eye or environmental irritants, or the beginnings of ocular rosacea (fairly common in those of us with facial rosacea!), or something else entirely that I don't know what because while I have a lot of eye and skin issues, I'm not an ophthalmologist or a dermatologist and my eyes and skin are not yours.

Definitely see what your GP says first, but if they refer you out, it is worth going to an ophthalmologist -- NOT an optometrist -- in person, even in the face of the 'rona. If it's nothing more than blocked glands, you'll get peace of mind and maybe some additional strategies to help treat it. If it's something else, even something relatively harmless, you'll find out, get treatment, and prevent it from becoming more of an issue. As someone with many eye issues that went untreated and misdiagnosed for a long time, trust me when I say you don't want to sleep on figuring out what's going on and getting it treated. As you said, eyes are important.

If you go to an ophthalmologist, know you'll be using your medical insurance, not your vision insurance. (This is US-specific, no idea how it works in countries with better healthcare systems.)

Have you ever been prescribed ivermectin (Soolantra / Rosiver) for your rosacea? If you have and you've got a tube of that lying around in your cosmetic cabinet somewhere, it could be a good idea to add that back to your routine (unless you stopped using it because of side effects or other health concerns, of course). It kills the mites that are thought to cause facial rosacea and the ocular version, so if that's what's going on with your eyes, it could help.
posted by rhiannonstone at 2:38 PM on January 18, 2021

Your friendly, virtual neighborhood ophthalmologist here to offer my standard:

Please see an eye doctor.

Please do not solicit medical advice over the internet.

The advice given here, while I'm sure well-intentioned, is neither good nor reliable.
posted by aquamvidam at 4:06 PM on January 18, 2021 [6 favorites]

I saw an ophthalmologist in early April right after the pandemic really kicked in. I was super nervous but the appointment went fine and all good precautions were used and I’m really glad I went! Also it was totally covered by my insurance to my surprise. Most ophthalmologists are not in hospitals so it won’t be as high risk. Eyes are really important, please get a trained professional to look at yours. Internet advice is not good.
posted by Mizu at 7:10 PM on January 18, 2021

Oh, also, basically I called the optometrist I go to for my glasses and they were closed but answering phones, gave me that ophthalmologist’s number, I cold called them, I described my problem (sudden eye pain when blinking and blurriness of vision) and she told me the doctor would call me back in half an hour. I got the call, I described my issue in way way more detail, she said she would like for me to come in, I did. My eye is fine, by the way! But yeah we had a whole detailed conversation on the phone that helped her evaluate if I should risk coming in. So you will probably be able to do something like that. Doctors understand the risks.
posted by Mizu at 7:20 PM on January 18, 2021 [1 favorite]

Response by poster: I have neither an optometrist nor an ophthalmologist here, and I've never tried ivermectin. But I did listen to everyone and have sent a message with a photo to my PCP. Thanks!
posted by kutsushita nyanko at 7:50 AM on January 19, 2021

Response by poster: For completeness' sake: The doctor I saw said, essentially, "shrug". If I develop other symptoms, I'm to let them know and they will refer me to an ophthalmologist.
posted by kutsushita nyanko at 2:10 PM on January 20, 2021

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