Eye doctor checking mebium glands

[Matt0029]

I wanted to get my eye doctor to check my mebium glands next time I see him. What questions do I ask him so I know what kind of condition there in? I am on warm compress wear moisture chamber Googles alot. I'm on ikervis and doxy. I tried ayzter but didn't help. Is there anything else I can try? My glands work normally when on steroids. I really struggle in air conditioned environments, does that suggest my lipid layer is poor. Thanks for any advice.

[Alix]

You need to see an eye doctor who has a meibography, keratography or lipiview machine that will take images of your glands, both upper and lower.
This is not available on the NHS, only private doctors have this and few among them.

A standard slit lamp is no good.

I am sure you have seen images of glands before but they are supposed to be all there, and thick and straight.
Most of mine have either disappeared altogether or have truncated.

When I had meibography done, the doctor placed an image of my upper and lower glands next to images of "normal" eyelids, and then based on that, graded my MGD level from 0 to 4, 4 being the worst.

As your lipid layer is poor have you tried taking omega 3 supplements?

[Matt0029]

I think my eye doc who prescribes me ikervis and softacort. Doesnt have this machine. What can he tell on the slit lamp? The slit lamp is linked to a computer. I may have to go to another doctor after seeing my usual one. Who I see every 6months. Privately.

[Matt0029]

Yes I take omega 3.

[Alix]

A slit lamp is what any optometrist or eye doctor has - I am not sure they can get a real good look of the structure of the meibomian glands using this, but if the one your doctor has is linked to a computer it might be different. Ask him about both your upper and lower lids, alot of doctors are only interested in one or the other for various reasons (at least in my experience).

Understanding what your glands look like is key. If they are all there and thick and full length, but not producing enough oil then this is a very different situation to someone like me whose glands have disappeared/truncated, as glands don't regenerate no matter what.

[Matt0029]

Thanks for thats very informative. I think may glands are there but maybe aren't producing enough oil. Or are capped. But think I have tried everything bar lipiflow. Steroids cure it but can't use every day.

[Alix]

Good luck. I am interested to know what your doctor has to say. I have tried pretty much everything as well. I am now thinking about taking a vitamin deficiency blood test.

[Matt0029]

Can I ask what you have tired?

[Alix]

Yes I will send you a PM with the list as I'd rather not post it here