CAN MILIA HAPPEN ON THE WATERLINE?

Fast answer: NO. I get asked this a lot on social media. Even AI gets this wrong. MILIA cannot happen on the waterline simply because the skin cells are different. 

What Are MILIA?

MILIA are harmless, small, keratin-filled cysts. They form when dead skin cells become trapped beneath the surface. These benign bumps appear as pearly white dots. The photo below show very typical appearance and location of MILIA around the eye area. Notice it is on the facial area around the eyes. 

Okay, So if it's not Milia - WHAT IS IT?

The waterline is a completely unique area of the eyelid. It bridges the gap between the ocular surface and the outer skin. This transitional skin type is called the mucocutaneous junction where keratinized skin meets non-keratinized skin - usually marking entry or exit into an organ. The tissue is soft, pliable and moist. 

99.9% of the time my patients are looking at inspissated (aka clogged) or capped meibmobian glands. When the bumps are pearly white in color, clogged versus capped glands is usually the finding. Here the diagnosis is MGD, Meibomain Gland Dysfunction, not MILIA.

Are There Any Exceptions?

Theoretically you can get MILIA at the veryyyy edge of the eyelid exactly where the eyelashes are. In my 20+ years of practicing optometry, I've never seen it. Patients think MILIA, when in fact it's usually a clogged eyelash gland or eyelid papilloma. 

When to See Your Optometrist or Dermatologist

For MILIA, see your dermatologist to get them removed professionally to avoid scarring. For MGD, see a dry eye optometrist specialist for an eye care routine. 

• Read my blog posts on MILIA 
• Read my blog posts on MGD

• MILIA on waterline

• waterline bumps

• eyelid milia causes

• trapped keratin cysts

• eyelid hygiene tips

• milia removal waterline

• Dr. Tanya Gill milia advice

• We Love Eyes eyelid care

• prevent milia near eye