Feeling a gritty sensation in your eyes? It might be conjunctival concretions.

Conjunctival concretions are small yellowish-white deposits that can form on the conjunctiva, the tissue lining the inside of the eyelids. They are common and are often asymptomatic, but when they become exposed, they can cause a foreign body sensation or sandy, gritty feeling in the eye.

Conjunctival concretions have been associated with meibomian gland dysfunction (MGD), chronic inflammation, dry eye disease, and aging. When larger or exposed, they can cause irritation, tearing, redness, light sensitivity, blurred vision, and in some cases, a corneal abrasion or scratch on the eye.

What Causes These Concretions?

Conjunctival concretions can be caused by:

• Meibomian gland disease and clogged oil glands
• Dry eye disease and low-grade inflammation
• Allergic or chronic conjunctival inflammation
• Aging

They can vary in appearance and consistency, including soft, hard, or silica-like material.

How Do We Know If You Have Them?

Conjunctival concretions can often be identified by everting the eyelids and examining the conjunctiva under a biomicroscope. Fluorescein staining can also help identify concretions that have eroded through the conjunctiva. Concretions can also be seen on meibomian gland imaging like with the Lipiscan.

Because they may not cause symptoms, they are sometimes found during an eye examination for another reason.

What Can Be Done?

Acute treatment:
If exposed concretions are causing symptoms, Dr. Pradhan can remove them in the office with topical anesthesia. Most asymptomatic concretions do not require treatment.

Preventative treatment:
To stop concretions from recurring, we can treat the underlying MGD and chronic inflammation.

This may include:

• Omega-3s — Omega-3s found in fish oil, algae oil, olive oil and nuts are the foundation of dry eye disease treatment, while also supporting the health of your heart and brain.
• Intense Pulse Light Treatment (IPL) with the Lumenis M22 — uses controlled pulses of broad-spectrum light on the skin below and around the eyes. It is FDA-approved for improving signs of dry eye disease caused by MGD for eligible adults. The treatment is designed to reduce inflammatory factors and support healthier meibomian gland function.
• OptiPlus (Radiofrequency treatment) — uses radiofrequency energy to deliver controlled heat through tissues around the eyes. This warmth can help soften thickened oils and improve meibomian gland function.
• Monitoring screen time — lack of blinking can contribute to clogged glands, making regular blinking and attention to screen time important for eye health.

IPL + OptiPlus: Different Approaches to MGD

IPL focuses on the inflammatory component of dry eye, while OptiPlus provides targeted heating to support oil flow and gland function.

For some patients, these treatments may be used together as part of a plan to address MGD and support healthier meibomian gland function.

Could MGD Be Behind Your Gritty Eyes?

If you experience a persistent foreign body sensation, sandy or gritty feeling, tearing, redness, or irritation, it may be worth looking beyond the symptom and evaluating the health of your meibomian glands.

Schedule a consultation with Dr. Pradhan to determine whether MGD or conjunctival concretions may be contributing to your symptoms, make sure you are taking the right supplements, and see if IPL and OptiPlus are appropriate treatments for you.

Call Eye Doctor MD, P.C. at (804) 270-3333 to schedule your consultation with Dr. Pradhan.

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