By the way, doctor: What can I do about Meibomian cysts?
Q. I have small white bumps on my eyelids, which are driving me crazy. They don't hurt, but they look awful. I've been told they're Meibomian cysts and that the only solution is surgery. What is your take on this?
A. From your description, you may have either of two common eyelid conditions: Meibomian cysts or milia.
A Meibomian cyst (also called a chalazion) is a small, fluid-filled sac that develops from a Meibomian gland, a specialized type of sebaceous gland. Like other sebaceous glands, Meibomian glands produce a thick liquid sebum — a mixture of oil and mucus — that helps keep skin (and hair, including eyelashes) from drying out. There are about 30 Meibomian glands in the upper eyelids and 20 in the lower lids. The glands discharge sebum through tiny openings (ducts) along the edge of the eyelid, just behind the eyelashes. There, sebum joins a layer of tears called tear film, which nourishes, lubricates, and cleans the outer surface of the eye and protects it from infection.