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what do docs do for severe MGD if they dont express the glands???

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  • what do docs do for severe MGD if they dont express the glands???

    i have called so many corneal specialists and about 99% of them say they do not express glands--and this in larger cities.. i dont get it..

    does anyone on here manage their MGD without gland expression? do some docs just not agree with it?? please help me understand. I am allergic to preservatives like BAK so i cannot do azasite.. what else can be done??? thanks...
    Jenny

  • #2
    Maybe this? http://www.dryeyezone.com/talk/showt...ance-or-murder

    IMO, a lot of terms like MGD have a variety of symptoms and two people with MGD may have very different issues. For instance, I have been diagnosed with MGD and while warm compresses are soothing, anytime I press on my glands, I rarely see anything come out or if I do, it looks like a super light version of what should happen with normal eyelids. I've pressed VERY hard and lightly, all with the same result. Other people on the Dry Eye Zone describe toothpaste-like excretions when they press on their lids. I think it would be easier on doctors and patients if they further distinguished what some of these terms mean but until then, we, as patients, are left a little blind (no pun intended).

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    • #3
      I have had my glands expressed by optometrists who saw they were plugged during a slit lamp exam and expressed them. Easy peasy. No need for a specialist. Only once (the first time) did a surprising amount of crud come out. Surprising to me, anyway since it clouded my vison when the crud squirted free . I am much more diligent about gland maintenance now; consequently, the gland expressions by the doc are not so dramatic.
      Cindy

      "People may not always remember exactly what you said or what you did, but they will always remember how you made them feel." ~ Unknown

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      • #4
        I've been told that I have MGD, but no ophthalmologist has ever recommended that I express the glands, or do lid scrubs. They have encouraged me to use warm compresses, which I did for awhile. I noticed no difference. What makes my eyes feel the best is to to take a hot shower, and let the steam steep in my eyes. That feels the best - for a brief time, the time I take a shower. After I get out, I must use drops because my eyes are once again miserable. The steam, of course, moisturizes the eye, but since it is totally aqueous, it does not stay in the eye. I make no/virtually no oil, so there's nothing to prevent evaporation. I wonder if my goblet cells have also given up the ghost...

        Maria

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        • #5
          hey there
          finally found someone in my little town who expressed my glands--it is really tough to find a doc to do it.. a lot that i called (corneal specialists) flat out told me they didnt believe in it!!

          anyway, i found a reg opthamlogist -he did a good job but is semi retired which means he is gone sometimes up to 8 weeks.. the other 2 guys in his practice do it too but not the same technique.. o well. hpeflly i eventually wont have to have it done so much..
          Jenny

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          • #6
            Another tip is to wear a moisture barrier at night. I use Onyix. They are comfortable, and don't move around at night. The barriers over the eyes at night create a moisture chamber, that reduces evaporation, reducing the MGD. Eyes should be more comfortable in the morning.

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            • #7
              i have never heard of that? did your doctor tell you that wearing a moisture chamber reduces MGD?
              Jenny

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              • #8
                My corneal docs never even mentioned wearing moisture chamber glasses. My one corneal specialist, who was at U MD at the time, had never even seen them til I came in wearing them. We truly have alot of work to do in educating our docs. I never have had any thought that moisture chamber glasses improve the Meibomian gland production. I can't see why they would. But maybe someone else on the forum knows more about it. They do enable me to keep my eyes open inside, which is a blessing. My L eye was so dry, I could barely keep it open (and often didn't) before I found this type of glasses.

                Maria

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