meibomian gland expression by doctor - what is your experience with this?

[Guest]

For those of you who have gotten a doctor to express your glands, i have a few questions, if you don't mind

1) By how much did it relieve your symptoms, if any? 50% improvement? 90%? etc.

2) If you experienced relief from the expression, how long did the relief last?

3) How often do you go to get your glands expressed?

4) How much better do you think the doctor's expression was than what you are able to do yourself at home? 10% better? 50% better? 100% better? etc.

And now about the experience itself:

5) does the doctor use numbing drops before the expression?

6) how long does it take the doctor to do the expression?

7) does the doctor do upper and lower lids?

8) how do your eyes look and feel immediately afterwards? how long before any irritation from the procedure goes away?

Sorry for all the questions... just trying to get a feel for what to expect if I get this done

Thanks all!

[regina]

wooh...okay I will go first..lol

Now this is before honey.....It relieved them 80 percent the day of expression...and then the next day back to normal. I got it done by the doc once a week and me twice a day. I do get relief...but it is very short lived.

He did use numbing drops...love that stuff, your eyes feel normal without the pain. Kept asking him if I can take home that eye drop! The doc was 50 percent better than I.

He looked at the tops but only did them once...said they werent blocked because he said the top lids are not so bad because of gravity...he would put a steroid drop afterward to help heal the pissyness of the eye lids and eye ball. I would leave there immediately feeling better ...with moisture in my eyes...It would last that day...but he next day pretty much back to normal. The whole process took 10 minutes.

so I did this for a year...driving downtown to this doc. But after the honey reduced my inflamation only after a few days, I was doing my normal expression and I saw the blockage actually come out! That was a first..I rarely got anything to come out of my eye lids even though I was doing them twice a day myself. I made an appt with the doc to see if they really were better after a week on honey and he said they blocked glands were not blocked anymore!...and havent had to go back to him to express my glands since! nor have I have to express my glands myself again. Now its just dry eye form sjorgrens ...

For those of you who have gotten a doctor to express your glands, i have a few questions, if you don't mind

1) By how much did it relieve your symptoms, if any? 50% improvement? 90%? etc.

2) If you experienced relief from the expression, how long did the relief last?

3) How often do you go to get your glands expressed?

4) How much better do you think the doctor's expression was than what you are able to do yourself at home? 10% better? 50% better? 100% better? etc.

And now about the experience itself:

5) does the doctor use numbing drops before the expression?

6) how long does it take the doctor to do the expression?

7) does the doctor do upper and lower lids?

8) how do your eyes look and feel immediately afterwards? how long before any irritation from the procedure goes away?

Sorry for all the questions... just trying to get a feel for what to expect if I get this done

Thanks all!

[Guest]

Thanks so much for the reply Regina! I appreciate your including all the details!

[tombuilder]

expression....

Just had mine done for the first time today, although the Dr. seemed less than enthusiastic about doing the uppers. He also suggested that for it to be really effective it must be done often, every two days or so.

His thoughts were more about dealing with the underlying inflammation, rather than enduring the constant trauma to the lids. He also showed me some fairly easy pinching techniques to do the lowers at home.

I suspect that since my case of MGD is probably more on the mild-ish side, I won't be going in as often, just starting up the pulse treatments of doxy.

[RobLIC]

You found someone, huh? Great. Every two days ... not crazy. But wish these guys made house calls.

[Guest]

Hmmm... well, if it only lasts a couple of days, then I don't think I'll get it done unless I'm desperate for relief.

The good news is that after a couple of days of getting a proper amount of sleep, plus mostly avoiding the computer, my eyes are back to where they were a week or two ago. Thank goodness! I am so incredibly relieved.

I was terrified that I would start some horrible backslide to where I was last summer. It's so easy to panic when you've been through such hell with this stuff.

So... back to what I've been doing... hopefully things will continue to move in the right direction... I actually was able to express clear oil from the majority of my MG's in my right eye now... sweet!... hopefully this continues... As for the left, it's still a work in progress haha. I think that since it produces less tears, things will take longer there... it gets dried out so much easier than my right... I'm assuming that also predisposes it to being more prone to inflammation which is no doubt bad news for the 'ol MG's...

[kitty]

1) By how much did it relieve your symptoms, if any? 50% improvement? 90%? etc.
NONE

2) If you experienced relief from the expression, how long did the relief last? N/A

3) How often do you go to get your glands expressed? JUST ONCE

4) How much better do you think the doctor's expression was than what you are able to do yourself at home? 10% better? 50% better? 100% better? etc.
PROBABLY 100% BECAUSE I HAD NEVER DONE IT MYSELF BEFORE, AND HAVE NOT SINCE.

And now about the experience itself:

5) does the doctor use numbing drops before the expression? NO

6) how long does it take the doctor to do the expression? A FEW MINUTES

7) does the doctor do upper and lower lids? YES

8) how do your eyes look and feel immediately afterwards? NO DIFFERENT how long before any irritation from the procedure goes away? N/A

[irish eyes]

1) By how much did it relieve your symptoms, if any? It's quite some time since any doctor did mine but I noticed improvement straightaway. To me, any improvement feels like 100%

2) If you experienced relief from the expression, how long did the relief last? A good number of days

3) How often do you go to get your glands expressed? N/A

4) How much better do you think the doctor's expression was than what you are able to do yourself at home? 100% better.

5) does the doctor use numbing drops before the expression? No he didn't

6) how long does it take the doctor to do the expression? Minutes

7) does the doctor do upper and lower lids? Yes he did

8) how do your eyes look and feel immediately afterwards? how long before any irritation from the procedure goes away? Felt great, couldn't see them

[RobLIC]

A note on this subject, which is near-and-dear: dysfunctional MGs are like sewers, holding stagnant, often infected, materials. If you don't get the stuff out, it festers and causes more inflammation.

The underpinning of a good MGD regiment has to involve expression and lid cleansing and massage. It's boring, monotonous stuff, and the AAO has been advising it for decades. Well, there's a reason for that.

Expression can be done by a doctor or at home. You'll get a much better expression from a doctor. If he/she tells you that expressing the uppers aren't necessary, because "gravity" will do the trick, you need to argue that point. Where ducts and ductules are already keratinized, gravity will not "do the trick."

Expression needs to be done repeatedly to show a lasting effect. Trust me, patience isn't my virtue, either. If you can get a doctor to do a warm expression, rather than a cold one, all the better.

At the end of the day, OTC eyedrops like Soothe don't help MGD (more than momentarily) and in many cases ultimately hurt.

[sherryberry]

Probing

The probing of the Meimbomian Glands is much more effective in my opinion. The study I saw with Dr. ****** in Tampa shows that even after 2 years many patients have not needed additional probing.

Just had mine done for the first time today, although the Dr. seemed less than enthusiastic about doing the uppers. He also suggested that for it to be really effective it must be done often, every two days or so.

His thoughts were more about dealing with the underlying inflammation, rather than enduring the constant trauma to the lids. He also showed me some fairly easy pinching techniques to do the lowers at home.

I suspect that since my case of MGD is probably more on the mild-ish side, I won't be going in as often, just starting up the pulse treatments of doxy.

[jenny2008]

i had probing done 3-4 times.. my doc finally stopped doing it for me because i got the same benefit from the expression. even with probing i still got clogged up within 3-4 weeks.... i usually go every 4-5 weeks to my eye doc and he expresses with the q tip method... like Rob said it is important to get done because not only does it give some short term relief but helps as a treatment in terms of inflammation and getting the eyes to 'calm down'... i always feel so good for at least 2.5 weeks..sometimes longer.

[RobLIC]

To clarify this post: When I said OTC eyedrops may ultimately hurt, I was referring to preserved eyedrops, which as we all know can cause problems if used many times a day. Newer preservatives (i.e. not BAK)=fewer potential problems.

At the end of the day, OTC eyedrops like Soothe don't help MGD (more than momentarily) and in many cases ultimately hurt.