posterior blepharitis and MGD

[Praveen]

I understand posterior blepharitis is inflammation eyelid condition and MGD happens when meibomain glands do not work properly. If I am not wrong MGD and posterior blepharitis are 2 different things

But I am not able to understand who causes whom.
Does posterior blepharitis causes MGD or vice versa?

In posterior blepharitis because of the inflammation of inner eyelid, meibomain glads gets blocked and they can't induce enough oil into tear film. But it does not mean that
meibomain glands internally has stopped producing oil. I mean if inflammation goes down, glands should start working properly (after initial warm compression and expression to remove initial blockage).

Second when you have inflammation, why doctors suggest warm compression in case of posterior blepharitis? To me it seems contradictory.

I am totally confused so thought to ask this questions to experts here




.

[Lacey1]

I've been struggling with the same questions. I've been dealing with this for about 7 months (I think it's been years), but it's been 7 months where it's been really bad and I finally got a diagnosis. I'm hoping if my inflammation goes down the gland will start pumping out the oil again. It's my only hope and I keep trying different things. I don't really think I have a "blockage" of oil, I think mine is more the inflammation is causing the blockage, that or I've just stopped producing oils :-(. I pray its the first of the options. Hopefully scientists will find the answer. You are not alone in the confusion :-)

[jenny2008]

i thought any type-posterior or anterior were both considered 'blepharitis".. ??? i have both but the posterior most severely.. have had it over 4 and 1/2 years w/ sjogrens... good luck

[Praveen]

here is what i found on another thread

http://www.dryeyezone.com/talk/showt...d-inflammation

as per doc Latkany "The inflammation causes the MGD".

so to me in sounds, if I work on my inflammation, everything should be ok. Now big question, how to bring inflammation under control?

What are the causes of inflammation? is ocular rosacea?

[jimi51]

Hi,
I suffer from all that and more but I would ask your Doctor to look in Azasite. There are some new studies that show it's effectiveness with inflammation. I have been using it at night once a day for a week and half, I am not sure but I think there is some relief but the jury is still out but I think worth taking a look at. Good luck!

Brad

[Pearl25]

Hi Praveen I wanted to ask you if among your signs of blepharitis you also had a thickening of the eyelids?

[sazy123]

Praveen, your post really makes sense.

So i have severe inner eyelid inflammation (which i think is caused by either ocular rosacea or allergies- probably the former). What you say is true- get the inflammation under control and the glands will produce oil again. I know this to be true in my case- due to the fact that when ever i have another health problem occuring in my body (can last for months i.e. bad throat) the awful redness and inflammation of my inner eyelids goes away, and my eyes feel GREAT. How ever i would add that if i press on my lids thick oil still comes out- so there seems to be some dysfunction despite the inflammation ( but its not enough that it makes my eyes dry).

Of course as soon as the other health problem gets better, inflammed eyelids return and so does the dry eye.

So how do you control this inner eyelid inflammation??????? thats the million dollar question id love to know. Ive been on extreme diets in the past, karens fish oil regeme for 1 month and it just has no impact on this inflammation. Even steriods did nothing. Hot compresses dont do anything because of course they dont get rid of the inflammation.

Theres two types of MGD the plugged type with some inflammation caused by that. And the non plugged type that is caused by inflammation. Dr Toyos said before starting IPL- my glands were 90% open, I was like err ok well they dont feel like it!!

[abbygirl]

I am confused too. What is the difference in anterior vs posterior Blepharitis?? Do oral antibiotics help with this?? I have very puffy & red upper lids in the AM which I get under control with cold compresses. I cannot see the "gunk" in my lashes but my doctor can. I also have MGD and use warm compresses in the PM. I can get some clear oil out of my bottom lid glands but very little from the top. How do you guys get oil out of the top lid glands without a huge amount of pressure on your eyeball??

[sazy123]

Anterior is where the outer side of the eyelid on lash line is infected. Prosterior is basically MGD in addition to inflammed eyelid margins (inner side but can be both), with blepth.

Some people have MGD without bleph, but i suspect most have a bit of bleph because its brought on by the MGD.

I look down and press on the top eyelid, move around too express. If your eyes are puffy in the AM have you thought about allergies? do you have visible inflammation, if so that will be causing MGD- so best to try anti inflammatory measures.

[Hopeful2]

Hi abbygirl,

I believe 'anterior blepharitis' refers to the lid area and can involve a bacterial infection. Posterior blepharitis refers to the area behind the lashes and lids. When you pull your lower lid away from your eye, on the posterior, or back of your lid, you will see some vertical channels. These are your meibomian glands. Oral antibiotics, such as doxycycline, are considered helpful in both forms of blepharitis, in the ophthalmic community.

When I press on my upper lids, I have my eye open wide and I press gently just above the lashes. I can't see the oil coming out, but I can feel the moisture on my eye from the expression.

I can see and feel the 'gunk' or crusty deposits on my lashes in the morning. . . It is not there right away, but after about five or ten minutes of having my eyes open, I can feel the deposits on my lashes, more so in my right eye than my left.

Here's to a healthy eye year in 2012!

[abbygirl]

Thank-you both for your quick replies. I have thought about allergies and have practically redone my bed ie. I now have allergy covers on all of my bedding. No improvement.
From your descriptions, I have both kinds of Blepharitis & MGD. I have tried Azasite, Lotemax drops and ointment, and Bacitracin ointment (all only on lids/lash line). I cannot use steroids in my eye due to a pressure problem. Nothing seems to be working for me. I don't think I have Ocular Roseacea. I do have some reddness on my cheeks etc. but not the classic symptoms.
How often/how long do you do your warm compresses?. Even when the lids are puffy??
Also, don't you think that all these drops we use to keep our eye moist can make this worse??

[Hopeful2]

I don't use drops much anymore and I think my eyes are feeling better. Drops had a very short lasting wetness effect and then my eyes were back to just feeling uncomfortable. I also learned to relax my facial muscles, and this seemed to give me moister eyes. My meibomian glands are producing more oil and my eyes feel more moist with regular blinking. When I started to use fewer drops, I noticed that after putting drops in, I didn't blink as much. . . I am not recommending that someone stop using drops . . . I just think we need to be paying attention to how are eyes are feeling. I do continue to use ointment before bed becuase my eyes do feel dry through the night.

I do warm compresses for 5 min. once or twice a day, late afternon &/evening. My lids are not puffy, just maybe a little red.

[skygoddess]

I think it is a first chicken? or egg ? condition. probably if you have one, you probably do, or will develop the other. Also once I asked my Dr was my blepharitis bacterial or seborrhea in nature ? He said blepharitis is always bacterial. Well maybe so, but after two years of treatment and not a lot of improvement, I decided to treat it as seborrhea and bacterial, and finally saw some improvement. I had never had acne or dandruff, so I had just assumed it was only bacterial, but it was both.
I use a super magnifying mirror and a eyebrow wand brush to remove all the flaky stuff from my lashes every morning. I use a tar shampoo, and have had great results with dermablend long wear remover and face wash. It cleans all the built up mgd secretions from my face and lashes, where the bacterial growth take place.

[abbygirl]

skygoddess
Do you use the tar shampoo on your eyelashes??? I like your idea of using the eyebrow brush wand to brush the lashes clean. I will look into the dermablend washes. My doctor recommended Cetaphil facial cleanser but I don't notice any improvement. My lids a much redder in the inner 1/4 of the upper lid and my whole eyelid tends to look oily by afternoon even though my face is dry. Are you the same??

[skygoddess]

I use the shampoo on my scalp,and eyelashes and eyebrows. I read you have to treat the scalp, even if you don't have dandruff, because seborrhea is a sensitivity to , and or, overgrowth of a particular yeast. It said to rotate types of dandruff shampoos. I have tried them all, but the tar works best for me. It could be coincidental, and the improvement may have occurred during that particular rotation , but I am sticking with it for now. It smells horrid, but otherwise no problems.
My eyelids are definitely different than the skin elsewhere.I have tried all types of cleansers , baby shampoo, sterilid, etc, but the dermablend really cleans, without over drying or irritation. My lids feel really clean, less sticky and red, almost normal. It is sold at department stores that carry dermablend cosmetics. Dermablend is a really long wearing , high coverage cosmetic.
I think all eye drops, in particular the thicker drops, build up on the lash line and provide a growth medium for bacteria and yeast.
I can see the dried secretions with a 20 0r 10 x mirror. The wand brush acts like Velcro and pulls all that build up off my skin. Skipping even one day causes me trouble.