Bacterial MGD.

[Angela]

I haven't been referred yet (long story), and no one has mentioned a culture. The sinus infection/eye swelling actually got much worse the month I was taking lymecycline, though did clear rapidly with the amoxycillin. One eyelid is still slightly puffy in one corner, but nothing like before. However, my lashes are still falling out continuously, and seem to be getting smaller/thinner all the time. I have bald gaps on on the lower lid, and a couple of the ones that are left have become ingrowing. Is there a known link between bacterial MGD and lash loss? (wondering if ciclosporin may be accelerating this, apparently it can cause hair loss when used in dogs).

I once used fucithalmic when my eyes were horribly gritty years ago, at the time it was the only thing that made them comfortable at that time, which makes me wonder if there is a bacterial component to my problems as well. The lid wash is Sterilid - it does sting a bit but at least it does seem to help, unlike all the messing around with cotton buds/baby shampoo.

Forgot to add, the second time I used steroid drops, the glands all dried up and a number appeared to be infected (yellow blobby look, with redness/swelling around the area) and only unblocked with lots of compressing after immediately stopping steroids. This is the only time I've ever had anything like this, if they became infected I'm sure it was directly linked to the steroid drops.

It took me about 5 months before I eventually convinced an ENT to do a culture. He finally took me seriously when he got the results back because before that, a CT scan of sinuses showed nothing, although I was on methylprednisone at the time of the scan which I was told could have caused a negative result. Wait so your entire sinus/eye swelling problem got better with amoxycillin? My culture showed staph aeurus is resistant to anything in the penicillin family or I would try it. As far as your lashes falling out, this is the FIRST thing that I had as far as symptoms when this started. I had a significant amount of bald gaps on my upper lids, some have grown back and some have not. So yes I do believe there is a link between bacterial MGD and lash loss, especially because blepharitis and mgd are like brother and sister and a very common symptom of blepharitis is loss of lashes. Actually, when this first started I had no visible swelling but my eyelashes were misdirected so I think the inflammation was slowly surfacing and the lashes were the first to be affected or infected rather. I'm not sure about the cyclosporine causing or worsening the lash loss but I bet it's from the mgd.

I am going to look into the fucithalmic. I was using Vigamox for a week and while I didn't notice a decrease in swelling, I think my eyes felt a bit more comfortable. They're killing me at the moment. I will look for Sterilid.

My glands are blocked for the most part, I was told this by the doctor who treats me with IPL and my primary opthamologist. I also have the yellow and white stuff coming out of the corners.

How long were your eyes swollen and puffy before you got them under control? Does the skin look somewhat normal now? I can't believe how swollen I am. It actually spreads to my cheeks in the morning.

[Angela]

Just found this on rosacea support - some interesting thoughts on rosacea, staph. and tetracyclines:

Bacterial MGD/rosacea

GREAT find. I am actually considering seeing a guy who specializes in demodex.

[Angela]

Hi - I don't know for sure that I do still have a bacteria infection or yeast infections. What I do know is the chain of events and how it surely must all be related.
13 Feb - woke up with foreign body sensation in my right eye and lots of eye mucus from that eye. Thought it was just a foreign body at the time but looking back I am almost entirely sure that it was due to wiping my face with a towel that wasn't mine the previous night (I was away from home and staying in a church hall - anyone could have been using that towel) - some sort of infection
14 Feb pm - foreign body sensation went to my left eye too.
20 Feb - this is when I started getting the frontal headaches at night, after closing my eyes to try to go to sleep.
The past month, I've started getting the frontal headaches on and off throughout the day.
When reading about seborrheic blepharitis, I read that the greasiness of eyelids is due to an allergy to yeast on the skin. It's just my eyelids that are greasy - I don't have particularly oily skin, according to a recent skin care consultation. I have been using anti-fungal shampoos the past few months (Nizoral, Selsun), as well as my regular shampoo - letting the suds go over my eyebrows and eyelids too. Not sure what effect that has had.
Thanks for the info about the nasal spray, I'll see if it has the same effect when I'm using it. I hope the nasal spray and anti-histamines will work for me, but I just have the feeling that they won't because they aren't dealing with the underlying problems. I get the impression from my doctor that he thinks I have an everyday allergy (eg hayfever or dust), but I'm not sure it is - thinking about the chain of events.

Have the bacterial/yeast infections ever been confirmed by a doctor? I have suspected I have a yeast problem as I have gotten the girly type quite a bit (sorry if TMI), but I really have no idea how to figure out if the problem is more severe. I could not convince a GP to test me for this. I haven't tried an anti-fungal yet but that might be my next step.

Your story is interesting because I too think that this could have all started with a bacterial infection. I had shared makeup with many different girls, and I hadn't sanitized my makeup tools much. I overused an eyelash curler and even after I had the loss of lashes, which was the first symptom, I continued to wear makeup. I even wore fake eyelashes to mask the bald spots when attending a wedding. All of this went on for about a month before I got to an eye doctor because my original diagnosis was from a dermatologist who told me I had alopecia areata, a hair loss condition!!

Okay so the frontal headaches, I have them all day every day. They're never gone..only better or worst. I also have a very very heavy feeling in my upper eyelids, almost like someone is pushing them down, or there are weights on them.

The greasy lids, I had that a LOT a couple of months ago..for some reason that seems to have went away, despite all of the other symptoms worsening. And unlike you, I DO have very oily skin. So maybe my entire face is allergic to yeast? I truly believe my skin problems have been the result of something bigger all along, especially since I'm still having trouble while I'm well into my 20s. Maybe I'm allergic to staph?

I am going to get a prescription for Nizoral, I've been using Head 'N Shoulders and Neutrogena T-Gel with no noticeable difference in the scalp issues. I have bumps ALL over my scalp. My boyfriend says they look like bites. I believe it is staph-folliculitis.

I can relate with you about the doctor thinking you have an "everyday allergy". I've heard that is what they diagnose you with when your problem is too complex for them to diagnose. =/ It just shocks me that there are SOOO many people on this board with similar symptoms on top of the eye issues, yet doctors can't make the connection. I feel like maybe we have some new disease that hasn't been discovered yet. But maybe I'm crazy...

[littlemermaid]

Why aren't you asleep at this time, Angela?

Demodex: check out how Dr Tseng in Miami and the Ophth Dept in Tunisia are testing. They say if they don't flush 'em out with fluoroscein on the eye surface first they will not be clinging to the lash on extraction, then the lash goes straight onto oil on a slide. Everyone has demodex, it seems to be whether we react to the Bacillus Oleronius they pump out. Following Dr Powell with interest. http://rosacea-support.org/community....php?f=5&t=766

Yeasts: reports of chronic seb bleph caused by Malassezia furfur or various Tinea fungi, cleared up with Nizoral, maybe search PubMed. Following this, and vet research, with interest. http://www.ncbi.nlm.nih.gov/pubmed/16249768. Systemic or eyedrop antifungals are so horrible this is why we used normal anti-dandruff shampoo and it seems to me this helps keep the MGs clear. Main MG improvement was antibacterial eyedrops. NB she is acne rosacea aetiology, some eyelash base crusting, mixed rosacea, posterior, seb bleph MGD. We reduced flaxseed oil capsules because made eyes worse if too much, esp around menstruation. She is still reinfecting but we are controlling skin bacteria with mild antibacterial topicals which prevents this.

Candida: is there an antifungal without steroid?

Folliculitis: hope you can get testing to see if it's bacterial or fungal

Y-gwair: Brilliant link to wormgirl1 case study. Interesting that Azithromycin antibacterial eyedrop had systemic effect, like I've always said to derm/ophth vice versa on skin topicals but just been scorned... 'yeh but you're not applying it anywhere near the eye', how do they think a nicotine patch works.

[Pinky]

Angela,
Your symptoms are exactly like mine. My staph aureus has not reponded to doxycline, minocycline, or azithromycin. I had used most of these antibiotics off and on over the years to treat severe facial rosacea. Bactrim and vancomycin are the gold standards to treat resistant staph. For more info check out the MRSA forums.

[dijon84]

Have the bacterial/yeast infections ever been confirmed by a doctor? I have suspected I have a yeast problem as I have gotten the girly type quite a bit (sorry if TMI), but I really have no idea how to figure out if the problem is more severe. I could not convince a GP to test me for this. I haven't tried an anti-fungal yet but that might be my next step.

Your story is interesting because I too think that this could have all started with a bacterial infection. I had shared makeup with many different girls, and I hadn't sanitized my makeup tools much. I overused an eyelash curler and even after I had the loss of lashes, which was the first symptom, I continued to wear makeup. I even wore fake eyelashes to mask the bald spots when attending a wedding. All of this went on for about a month before I got to an eye doctor because my original diagnosis was from a dermatologist who told me I had alopecia areata, a hair loss condition!!

Okay so the frontal headaches, I have them all day every day. They're never gone..only better or worst. I also have a very very heavy feeling in my upper eyelids, almost like someone is pushing them down, or there are weights on them.

The greasy lids, I had that a LOT a couple of months ago..for some reason that seems to have went away, despite all of the other symptoms worsening. And unlike you, I DO have very oily skin. So maybe my entire face is allergic to yeast? I truly believe my skin problems have been the result of something bigger all along, especially since I'm still having trouble while I'm well into my 20s. Maybe I'm allergic to staph?

I am going to get a prescription for Nizoral, I've been using Head 'N Shoulders and Neutrogena T-Gel with no noticeable difference in the scalp issues. I have bumps ALL over my scalp. My boyfriend says they look like bites. I believe it is staph-folliculitis.

I can relate with you about the doctor thinking you have an "everyday allergy". I've heard that is what they diagnose you with when your problem is too complex for them to diagnose. =/ It just shocks me that there are SOOO many people on this board with similar symptoms on top of the eye issues, yet doctors can't make the connection. I feel like maybe we have some new disease that hasn't been discovered yet. But maybe I'm crazy...

No, I've not had any swabs to confirm presence of infection. The only thing that's relevant is that a few months ago I did research into the type of blepharitis I had and tried to link it with my symptoms. I concluded that I probably had seborrheic blepharitis, and after discussing everything with the doctor, he agreed.
My frontal headaches definitely don't sound as bad as yours. They probably are ever-present but it's just I don't notice it or don't even think about it sometimes. I get the heavy eyelid feeling too, but probably not as bad as you. When the frontal headaches are bad, it seems to be worst around my nose, it feels like my nose is being crushed.
I need to discuss with the doctor again (maybe a different doctor to get a fresh conversation) but I believe that the underlying problem now is with my sinuses and has been since 20 February. The eye infection I got initially probably resolved itself within a few weeks (it wouldn't last this long). I am thinking that until my sinus problems are resolved, neither will my eyes feel like they are back to normal. I think I've had sinusitis since 20 February and because I didn't do anything to treat it (until last week), it probably is chronic and may last much longer (reading up on it, my sinuses may now be permanently thickened). Someone I work with they started getting 'dry eyes' when their sinusitis began.
So I hope that resolving the sinus problems will lead to improvements in my eyes and eyelids, but I think it may be difficult to achieve this now that I think I have chronic sinusitis.

[RonnieD]

I am in a similar position with the eye irritation. My timeline is:

*Summer 1996 - took one cycle of Accutane
*Spring 1997 - caught a cold in Western Europe and immediately my eyes became permanently irritated, my nasal passage became congested and I became lactose intolerant.
*Spring 2001 - took Minocycline for six weeks. Was told I might see improvement after 5 weeks. Well, 20 minutes after taking the first pill all of my eye pain disappeared and my nasal passage congestion disappeared. I was perfect for 9 days until all irritation suddenly returned and has not left since.

I have seen all kinds of doctors from New York to Los Angeles to Vancouver to Miami. I actually just saw Dr. Tseng in Miami this past Monday in hopes that my irritation was demodex and could be treated with tea tree oil. Ten of my eye lashes were plucked and examined but I do not have demodex. My problem is MGD.

There are so many triggers that make my eyes worse, ranging from dry weather to cold weather to air conditioning to heat from furnaces to a litany of foods (ranging from raisins to mouth wash). I recently spent 3 months on an anti-candida (yeast overgrowth) controlled diet/supplement program, which did not help.

I keep persevering for a solution because I had TOTAL relief for the first nine days I took the Minocycline years ago. A solution is available; I just don't know if it is accessible. The common apparent link for all of us appears to be Accutane.

Has anyone had any success? Does anyone else have digestive issues or food triggers to irritate the eyes?

[Angela]

I am in a similar position with the eye irritation. My timeline is:

*Summer 1996 - took one cycle of Accutane
*Spring 1997 - caught a cold in Western Europe and immediately my eyes became permanently irritated, my nasal passage became congested and I became lactose intolerant.
*Spring 2001 - took Minocycline for six weeks. Was told I might see improvement after 5 weeks. Well, 20 minutes after taking the first pill all of my eye pain disappeared and my nasal passage congestion disappeared. I was perfect for 9 days until all irritation suddenly returned and has not left since.

I have seen all kinds of doctors from New York to Los Angeles to Vancouver to Miami. I actually just saw Dr. Tseng in Miami this past Monday in hopes that my irritation was demodex and could be treated with tea tree oil. Ten of my eye lashes were plucked and examined but I do not have demodex. My problem is MGD.

There are so many triggers that make my eyes worse, ranging from dry weather to cold weather to air conditioning to heat from furnaces to a litany of foods (ranging from raisins to mouth wash). I recently spent 3 months on an anti-candida (yeast overgrowth) controlled diet/supplement program, which did not help.

I keep persevering for a solution because I had TOTAL relief for the first nine days I took the Minocycline years ago. A solution is available; I just don't know if it is accessible. The common apparent link for all of us appears to be Accutane.

Has anyone had any success? Does anyone else have digestive issues or food triggers to irritate the eyes?

I'm sorry I didn't see this earlier. I took Accutane as well. You know what I actually think? I think that while yes Accutane does possibly cause MGD (shrinks glands), it also has an effect on the body in general. I think it has similar effects to immunosuppressants (steroids, etc.). I noticed that during and after my course, my resistance to colds was very low and antibiotics don't work well on me anymore. I also lost a significant amount of weight. Side effects from high amounts of vitamin a have been devastating as well and 'tane is just a synthetic form of it so basically this drug is just a nightmare.

Hmm. Congestion and lactose intolerance - I've heard that many lactose intolerant people develop congestion in the mucous membranes of the ears, sinuses, and throat...so those 2 symptoms happening at the same time was probably not a coincidence.

Your timeline is a little confusing. What were you prescribed the Minocycline for and what were they telling you to expect improvement of? Eye irritation?

As for demodex, I was also hoping that was my problem but my eyelashes were recently examined as well and the only findings were major flakes/dandruff. My main issue is Blepharitis/MGD. Dr. Latkany is my primary opthamologist and he tells me it is my Blepharitis that is likely the most bothersome as my dry is is only 2 out of 10 but my Blep is 9 out of 10.

Anti Candida diet - I have really been wanting to try this and when I get my weight a bit more under control (I'm much too thin) I will give it a go.

I'm still not sure that Accutane is my culprit but it is definitely questionable. The thing is, there are several people who have not taken Accutane, who have or have had similar skin conditions to me who still ended up with MGD/Blepharitis so I wonder if it's actually my skin problems that left me predisposed to this and if I would have developed it regardless of the medicine. Just like a lot of people who never had Lasik but still developed dry eye. Also, it seems that many sufferers say that it was some "event" that set off the initial onset of symptoms. Maybe Lasik was this event for the Lasik induced MGD patients? Who knows... In my case it could be one of many things. All I know is that I have a lot of other things going on (scalp issues, ringworm infection, gastritis, GERD, hair loss, VERY easy bruising, sinus problems, possible allergies) that all started at the same time as my eye problems, yet no doctor can help me make the connection. The basic answer I get is "allergies". Funny..I had no idea allergies caused pimples on your scalp....

As for digestive issues/triggers. I have the gastritis and GERD but I'm still really not sure of triggers because I pretty much get bloating after anything I eat and heartburn at random times even well after I've digested.

[Angela]

Angela,
Your symptoms are exactly like mine. My staph aureus has not reponded to doxycline, minocycline, or azithromycin. I had used most of these antibiotics off and on over the years to treat severe facial rosacea. Bactrim and vancomycin are the gold standards to treat resistant staph. For more info check out the MRSA forums.

Have you been on the bactrim or vancomycin? What were the results? I've been wanting to try Ivermictin after a very interesting article on a couple of mgd/rosacea patients who were almost magically cured by one course of it.

[Angela]

No, I've not had any swabs to confirm presence of infection. The only thing that's relevant is that a few months ago I did research into the type of blepharitis I had and tried to link it with my symptoms. I concluded that I probably had seborrheic blepharitis, and after discussing everything with the doctor, he agreed.
My frontal headaches definitely don't sound as bad as yours. They probably are ever-present but it's just I don't notice it or don't even think about it sometimes. I get the heavy eyelid feeling too, but probably not as bad as you. When the frontal headaches are bad, it seems to be worst around my nose, it feels like my nose is being crushed.
I need to discuss with the doctor again (maybe a different doctor to get a fresh conversation) but I believe that the underlying problem now is with my sinuses and has been since 20 February. The eye infection I got initially probably resolved itself within a few weeks (it wouldn't last this long). I am thinking that until my sinus problems are resolved, neither will my eyes feel like they are back to normal. I think I've had sinusitis since 20 February and because I didn't do anything to treat it (until last week), it probably is chronic and may last much longer (reading up on it, my sinuses may now be permanently thickened). Someone I work with they started getting 'dry eyes' when their sinusitis began.
So I hope that resolving the sinus problems will lead to improvements in my eyes and eyelids, but I think it may be difficult to achieve this now that I think I have chronic sinusitis.

It's unbelievable how similar our symptoms are. The crushing nose feeling you described..I could not have said it better myself. Also, sometimes my entire face is swollen in the morning, including my nose. Do you have anything like that?

I recently got another culture and it came back within the normal range...still have staph but a normal amount I guess. Symptoms are exactly the same. I also got my sinuses looked at by another doctor who diagnosed me with "allergic sinusitis". He showed me pictures of what allergic sinusitis looks like and told me my sinuses look just like them. I still have tons of white stuff coming out. It's been 6 months. I don't see it getting better.

[littlemermaid]

Sinusitis: are you definitely closing the tear ducts for at least 15 seconds after using drops? should not be able to taste them.

[Angela]

Sinusitis: are you definitely closing the tear ducts for at least 15 seconds after using drops? should not be able to taste them.

I do taste them. I try closing the tear ducts but maybe I'm not doing it correctly? I'm not on any drops right now. Have been using the vigamox for 10 days on then 2 weeks off.

[dijon84]

It's unbelievable how similar our symptoms are. The crushing nose feeling you described..I could not have said it better myself. Also, sometimes my entire face is swollen in the morning, including my nose. Do you have anything like that?

I recently got another culture and it came back within the normal range...still have staph but a normal amount I guess. Symptoms are exactly the same. I also got my sinuses looked at by another doctor who diagnosed me with "allergic sinusitis". He showed me pictures of what allergic sinusitis looks like and told me my sinuses look just like them. I still have tons of white stuff coming out. It's been 6 months. I don't see it getting better.

An update from me. No, I don't feel like my face is swollen in the morning. I've had an xray of my sinuses and they look normal. I've had a swab test done (swab was put deep inside my nose) and there was no trace of staph aureus or another bug (can't remember the name of it). The GP put me on Flixonase drops to put in my nose once a day for 4 weeks. I've done about 6 days so far. How I feel each day is really up and down but am currently having two good days. I'm beginning to suspect that I have a sensitivity/allergy to some dairy (I had a few days with very little dairy and felt better the day after). It needs to be investigated more but I remember that sometimes when I ate some cheese, it felt like my face was sweating (especially around my nose). So I'm currently trying to minimise the amount of dairy I eat and see how it goes. How are you Angela?

[Jenn1]

OP, how are you managing now and have your symptoms improved? I think alot of us can relate to your post and sinus/eye infection connection, but its so hard to link when other possibilities could be involved such as having taken certain meds.

[Gerri55455]

Angela, hi! I believe I've developed the same problem that you did to FML. Have you found resolution? If so, what helped. I'm desperate for a solution. Hope you read this. Thanks so much. ~Gerri