Optometrists active on TikTok may have heard of a trend called “mucous fishing syndrome,” where people pull long strands of mucus from their eyes. (See the sidebar, “A Damaging Trend.”) The videos are being posted under the #mucusfishing and #mucusfishingsyndrome hashtags as recently as this fall, with several thousand views.

In spite of the videos, mucus fishing doesn’t seem to have reached far beyond a niche community, based on the account of two TikTok-savvy ODs.

While the limited popularity of the videos may be some cause for relief, ODs can help patients by educating on the dangers of “fishing.” In addition to in-office education, ODs can use social media to address mucus fishing, as well as other potentially damaging behaviors that appear in online videos.

A DAMAGING TREND

Mucus fishing syndrome is characterized by an overproduction of mucus, usually as the result of a condition such as dry eye or conjunctivitis, or due to ocular trauma caused by scratching or rubbing the eye, explains Sarah Blackwelder, OD, owner of Vibe Optometry in Austin, Texas. The cells produce more mucus in response to the irritation, which is what causes some patients to pick at them. But this just irritates the eye further, causing even more mucus to be produced, and puts the eye at risk of infection from dirty fingers or corneal abrasion. “We typically see contact lens wearers stick their finger in their conjunctiva, which kicks the cycle off,” Dr. Blackwelder says.

AN ONLINE ECHO CHAMBER

When it comes to mucus fishing symptoms, “I don’t see it every day by any means,” says Brittani Carver-Schemper, OD, co-owner of Better Vision Optometric Center, in Fayetteville, N.C. (@BetterVision on TikTok). Occasionally she will get a patient who admits to mucus fishing after she examines their eyes and finds signs of it, but it’s not nearly as common as TikTok videos might indicate, she says.

Sarah Blackwelder, OD, owner of Vibe Optometry in Austin, Texas (@VibeOptometry on TikTok), chalks up the TikTok trend up to a small group who found an online “echo chamber” to inhabit.

Both Drs. Blackwelder and Carver-Schemper address mucus fishing and its consequences on educational videos they have posted to TikTok; both videos define the condition, and how pulling at the strands only causes more mucus to be produced. Dr. Blackwelder’s video also briefly discusses how N-acetylcysteine drops, an anti-mucolytic agent, can be used to curb mucus fishing.

EDUCATING ON TIKTOK

These videos often elicit viewer questions that provide additional opportunities for patient education. “I get contacted on social media all the time” with questions about whether a fad is healthy or not, says Dr. Carver-Schemper. Other fads the two ODs have seen people asking about online include placing eyeliner on the mucocutaneous junction and blow-drying eyelashes to make them appear longer.

Both ODs recommend keeping online advice general, as a formal diagnosis cannot be provided on social media.

“I typically give an honest but short answer on social media — either in the form of a comment but often it gives me the opportunity to make a follow-up video” explaining her thoughts on a course of action, says Dr. Blackwelder. These answers typically take the form of “we don’t usually recommend XYZ, but ask your eye doctor,” she says.

“I think education is where we fall short, and the more we educate, the less we’ll hopefully see some of these crazy trends,” says Dr. Carver-Schemper. OM