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Update from optometrist appointment & how to relieve the grittiness?

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  • Update from optometrist appointment & how to relieve the grittiness?

    Hi

    I've been dealing with seborrheic blepharitis and MGD for 18 months now (plus the related issues of acne and scalp dandruff for longer). I had an optometrist appointment today and am a bit puzzled with what is going on.

    The comments from the optometrist were that my tear film is quite oily. The MGs aren't completely blocked but my upper MGs look worse than the lower ones. He said I should also try using eye drops 2-3 times a day (I often don't use eye drops each day). The tear break up time was over 10 seconds for both eyes, an improvement from 2 seconds and 4 seconds a year ago with this optician. Yet I am still getting the gritty eyes sensation most the time (to some degree) - I would say it is the main symptom I experience. So I can only conclude that TBUT and the gritty sensation aren't related (also that it is possible to have an 'oily' tear film yet have a normal TBUT). I've heard an explanation for the gritty sensation as it is the inflamed MGs rubbing over the surface of the eye while blinking - is this correct?

    An ophthamologist made a similar comment about my tear film being oily about 6 months ago (said my MGs were 'working overtime'). So I suppose it is good to have that confirmed from two different professionals. It is not overly surprising as the skin around my eyes often looks and feels very greasy (excess sebum secretions I think), so the MGs would behave in the same way.

    I don't quite understand how the MGs can be looking sort of blocked yet my tear film be oily though.

    Regarding the gritty sensation, I find it is generally worse the day after I do a warm compress with an Eyebag (followed by eyelid massage). Then it improves a bit the day after that etc. I had been doing a warm compress twice a day earlier in the year, reducing to once a day, then reducing again to once or twice a week (from about 2 months ago). Although the warm compress and massage is obviously expressing oils, could it be irritating the MGs, hence the increased gritty sensation? Or could another explanation be that the compress is expressing 'stagnated oils' into the tear film so the tear film is not as good the following day? If that is the case, I'm thinking an eye rinse with saline solution might be useful after the compress and massage.

    Does anyone have any recommendations for relieving the gritty sensation, either with eyedrops or with other remedies? Any particular brands of eyedrop that I should try?

    Would really appreciate some comments and advice on my post - apologies for waffling a bit tonight!
    Dave
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