The alarming reason why you should remove your mascara every single night

Warning: This story contains graphic images that may disturb some viewers.

No matter how tired you are at the end of a long day, you must clean off your mascara.

All of it.

That’s the message being shared by an Australian ophthalmic surgeon who treated a 50-year-old woman complaining of discomfort and irritation beneath her eyelids.

The patient admitted to Dr. Dana Robaei of Forest Eye Surgery in Sydney, Australia that she had been wearing “heavy mascara” on her eyelashes for more than 25 years, published in the American Academy of Ophthalmology Journal.

The woman told her doctor that she had failed to properly remove her mascara before going to sleep throughout those years.

When Dr. Robaei lifted the woman’s eyelids, she found numerous “darkly pigmented subconjunctival concretions” or tiny black bumps lodged under her lids. The bumps were the result of leftover particles from unwashed mascara that had accumulated and hardened under her eyelids over the years.

Dr. Ken Roberts, an ophthalmologist and member of the Canadian Ophthalmological Society, said makeup can infiltrate the tear film, which is the wet layer that sits on the front of the eye, and eventually move up under the eyelid when a person blinks.

“The [inside] eyelid surface has all these, I’ll call them pores, but they’re basically little openings, they produce tears, they produce oil, they’re sweat glands, and so these particles of makeup can get up inside the pores and over time they can certainly build up,” he explained during a telephone interview with on Thursday.

The pores will continue developing secretions despite the blockages, which can lead to the formation of little cysts filled with makeup debris that cause irritation and inflammation, Roberts said.

The patient, Theresa Lynch, recently told the Daily Mail newspaper that she was worried she would have permanent damage following Dr. Robaei’s discovery.

“I had fallen into a bad habit of wearing a lot of makeup and not washing it off. I should never have let it get this far,” she said. “You can’t miss a single day.”

The case study reports the concretions had caused some eroding on the inner surface of Lynch’s eyelids, which resulted in inflammation and swelling. She also suffered abrasions on the surface of her corneas, according to the study.

“Every time Theresa was blinking these bumps were rubbing on the surface of the eye and they pose a risk to her vision,” Dr. Robaei told the newspaper.

A biopsy revealed Lynch had developed pigmented macrophages, a type of white blood cell, that form at the site of an infection as part of the body’s immune response, the study said.

Lynch underwent a 90-minute surgery to remove all of the tiny, black concretions from her eyelids. Although Dr. Robaei was able to remove all of the bumps, Lynch was still left with some permanent scarring on her eyelids and corneas.

Dr. Robaei published the details of the case in order to raise awareness about the risks of failing to properly wash off eye makeup.

Roberts called this an “extreme case” and said that most people shouldn’t be too concerned about wearing eye makeup as long as they’re remembering to clean it off at the end of the day.

“I’ve seen lots of people that have had allergic reactions or irritation to possibly makeup or other things in their environment, but I haven’t seen anyone that’s developed permanent vision loss from using makeup.”

To avoid eye infections or long-term damage, on its website “lightly” applying eye makeup, such as eyeliner and mascara. The group also suggests buying fresh mascara every three months and applying it to the outer half of the lashes only.

Roberts also suggested investing in a magnified makeup mirror for areas where residual makeup can be difficult to see, such as the base of the eyelashes.