New to MGD...what to do?

[piot0020]

I've had dry eyes for a while but I am new to MGD. I clearly have clogged oil glands. What are some things I can do at home to help my eyes?

[sporta]

I have MGD and what has really helped me is upping my fish oil intake to 2400mg in the am and 2400mg before bed. I also use a foam eye lid cleanser religiously every night (letting is sit on my closed eye lids for 1 minute before washing off) before I go to bed. I also use a heated rice bag before bed for about 10 minutes. I have trouble with my lids staying partially open when I sleep so what has helped is using genteal ointment over my eye lids when I sleep.
My last eye appt the doctor said my lids looked better then they did from the last visit. I still have good days and bad days...who knows why but I continue my daily routine and I have noticed a significant difference in how my eyes feel.

[MeibomianGlandman]

Ill give you the best advice I can 5 years into Meibomian gland Dysfunction and 3 years of research later.

Step 1. Visit A Dry Eye Specialist, There hard to find but look for one, Call rhein medical and ask them who they sold their ****** meibomian gland Duct surgical probe to in your area.

Step 2. Make an appointment with that Doctor, Have the whole 9 yards. Diagnosis, everything find out the severity.
Have him get you on Tetracyclines.

Step 3. For Treatment, and Pain management, go Buy a Visor, and Wrap around safety Glasses. Keeps the wind off your eyes.
Use OTC Eye Drops, NON PRESERVED. Find which one works for you. Also Buy Ocusoft eyelid foam or thera tears foam this made by professionals for this thing, Use this to Wash your eyelids once in the mornings. Also at night if its really dry at night for sleep, you might try using Preservative free Nighttime ointment. This will help... The lesser the mineral oil in it the better. I was sensitive to mineral oil, but thats all they got so inflammation probably still be there. In the mornings, Lid Expression and wash the mineral oil off with the foam. Once a day Don't do it very often,...get a Doc to show you how to do the expression. TAKE OMEGA SUPPLEMENTS FISH OIL DAILY.

ALSO THIS IS BIG, DO NOT USE HOT WET WASHCLOTHS TO DO WARM COMPRESSES< THIS IS DANGEROUS AND DOESN"T DO ANYTHING YOU CAN BURN YOUR EYELIDS CAUSING PERMANENT DAMAGE BE CAREFUL I DID. MAKE SURE YOU GRAB THE PROFESSIONAL THING, FIRE AND ICE PACK FROM REHIN MEDICAL...SAFE, EFFECTIVE

Also, Figure out the Source Of the Inflammation and the Clogging of the Glands...

SEE A DERMATOLOGIST TO DETERMINE IF YOU HAVE seborrheic dermatitis of the Scalp THIS CAN CAUSE BLEPHARITIS AND MGD IN THE EYES, MAKE SURE YOU GOT CLEAN PILLOW CASES AND BEDSHEETS...

Also Another note, This disease can be caused By preservatives in soap, Medications such as Decongestants or antihistamines, or even allergies, or auto immune disorders...Be sure to rule out all of these, but if its simple inflammation caused by skin infection;

do this for the seborrheic dermatitis of the Scalp. AKA dandruff...

Have the dermatologist give you the effective Shampoo for treatment.
Also, I suggest you go to your General practitioner and Demand for a Stool Diagnostic Test to determine why this happening, have that stool test sent to a lab to determine what micro organisms are causing the inflammation/infected meibomian glands. the Intestinal flora will give you the answers you seek about skin conditions.

If you discover, that the results reveal harmful bacteria and yeast in your gut...that could be the culprit.

Visit a naturopathic doctor, Quit Drinking Fluoridated water to heal the gut, Make sure your eye Doc got you on the Tetracycline and have the naturopathic doc prescribe you enteric coated garlic capsules to battle the yeast. If Demodex is the problem, Use Jojoba Oil on the eyelids to restore moisture while coating the skin in it, DO NOT GET IT IN YOUR EYE. The excess jojoba oil Kills those little Critters the suffocate in it, while the oil heals the skin, its safe cuz there no alcohols in it.

Once Done Eliminate all possibilities of Cause of Inflammation,...INFLAMMATION IS BAD, LONGER YOU GOT INFLAMED MGD, HARDER IT IS TO CURE! THE GLAND FORM SCAR TISSUE OVER THE ORFACES FROM PROLONGED INFLAMMATION I BELIEVE 6 months Longer and you get Atrophy....even after only like 2 to 3 years, The GLands start to Waste Away. SO don't wait. If you got Atrophy or Scar tissue of the glands, Your gonna need Surgery. BUT BEFORE SURGERY ELIMINATE INFLAMMATION Discover cause of problem...after that then

Meibomian gland Duct probing surgery. This May or May not be covered by insurance, like 4,000 dollar procedure out of pocket...and lastly the New Procedure to follow up with it is lipiflow this is a ,2000 dollar procedure...this cures or brings most patients back to normal...Though Cost is expensive...I have heard many stories over the years about nothing Works or Most people try those procedures and it don't fix the problem, the Disease Keep returning...Thats why you got to pinpoint the cause of the problem, rather than treating it...Key is to find underlying skin condition, infection or immune/hormone problems causing the issues in your gland in your eyelids...

9 times out of 10 I have heard from the experts that say this MGD disease is caused by bacteria, it makes the oils in Meibomian gland Dysfunction solidified like tooth paste, thus causing dry eye. However, in my case, It was yeast that were the culprit on top of the bacteria, thus all the antibiotics in the world, wouldn't cure the inflammation in my eyes, and the oil in my glands wasn't like tooth paste but Dried Crusts...This is worst kind because Conventional medicine cannot treat for yeast. They have oral anti fungal medication, but it can cause kidney and liver failure and is only given to aids/cancer patients. Thus if that is your case, like me You have to use alternative medicine to solve the problem without the life threatening side effects of the medications. Beware though, don't take alternative medicine lightly as I did, the stuff is as potent as regular medication.

Lastly, Keep a Good Relationship with Your Dry Eye Specialist.

I hope this answers all your questions as to the disease and what you can do, Let me know if you are successful in getting over this disease. I mean if I could go back in time and know all what i know now I know recovery would be quick...but don't let it go, fight this disease with all you got...Cuz in severe cases Dry eye can cause your eyelids to scratch your corneas causing blindness...its a serious disease! Good Luck to you my friend and gods speed, may you beat this disease!

[littlemermaid]

@piot - Hello What are you using now, Piot? do you think there are any gaps in the regime?

Here are some useful links for meibomian gland dysfunction and blepharitis in case you haven't seen them while you've been dealing with this post-LASIK:
YouTube dry eye video - Prof Christophe Baudouin
http://www.tearfilm.org/dewsreport Tear Film & Ocular Surface society report 2007 Dry Eye Workshop
American Academy of Ophthalmology website Current clinical guidelines
Also see American Academy of Optometry website for guidelines on treating blepharitis (they don't really address the causes though like a doctor should)
Book 'The Dry Eye Remedy' by Dr Robert Latkany

Specialist ophthalmologists tweak their regimes according to what they think is happening - mgd, aqueous deficient, state of the eye surface and inflammation - but basically we use: very close and careful cleaning (eyelid margins and follicles) + daily warm compresses (cool if there is inflammation) + take fishoil - and this keeps the eyes good.

Sometimes we have infections and inflammation and have to use antibacterial eyedrops and even steroids but obviously this needs the doc to manage flareups and monitor. Some good docs use a 'minimum' regime with antibacs and immunomodulators to keep the eyes good (eg we used to use 2/wk antibac + 1/wk steroid long-term because we had uncontrolled skin problems causing the eye problems).

While working on keeping the eye glands good with cleaning and warming compresses, protecting the eye surface has been very important - humidifier, removing allergens from the house, wraparounds - and keeping the eye surface wet with drops. This has enabled some eye surface healing and stops the spiralling into problems again.

NB everyone has a different aetiology so it's a question of being sensitive to what makes things better/worse (esp what suits your eyes for cleaning because different recipes work for different people depending on their sensitivities and needs), and asking various docs what they think is going on and what would help, and finding one you like to work with.

@mgman - Hi Grant, Still following your experience with interest because we are similar xpt paediatric (from age 11) with the added joys of:
. rosacea
. food intolerances causing skin and eye flareups
. chronic intracranial hypertension with flares

Have you tried very diluted tea tree products around the eyes (see Hankm) for the seb bleph-type mgd for demodex overgrowth?

We use anti-dandruff shampoo Head & Shoulders sensitive to keep things good, and if it washes over the eyes and face in the shower we think that helps. I've always felt there's a problem with the gut (definitely Tinea versicolor or Malassezia furfur around the eyes) but I won't use an oral med paediatric without a knowledgeable and interested doc (particularly because IH started from oral tetracycline).

I'm struggling with the gut problems even though we have direct correlation with quite serious rosacea flares (periorificial bumpy, chronic rhinophyma - obviously not acne) which reinfects the MGs and has caused chronic keratitis controllabe only with steroids (search PubMed 'child rosacea' or 'child blepharokeratoconjunctivitis'). (She won't eat sauerkraut or vinegar or probiotics but she likes yoghurt.) I don't understand whether the stomach and bowel needs to be acid or alkaline - seems different in different parts - do you get this?

Just in case it helps, to manage the symptoms we do a blitz and taper, even with the TTO or when we use antibacterial eyedrops to clear the MGs (azithromycin has been the best). But we use a heck of a lot of normal saline 0.9% eydrops and Hylotears to keep the eye surface good (at least 6/7 /day, more if needed eg a/c).

Thanks for what you're doing posting up - it helps me a lot and we seem to read the same stuff

I'd just add that there must be lots of reasons for hormone imbalances to affect the eyes esp in females - although interestingly our pathway with the puberty changes sounds similar to yours.

We've found that, esp paediatric, it's best to intervene quite firmly to fix, then taper to minimum intervention to allow the eyes to heal. With the rosacea, the danger is setting up increasing sensitivity (type IV), topical and systemic (just in case it's relevant to anyone).

But with the 'rosacea' sensitive skin treatments, a regular gentle, but rotating, maintenance regime recipe (various antibacs, moisturisers, hypersensitive shampoos inc antifungal and TTO, eye hygiene) has been the best approach.

The eyes have been much better excluding all possible chemical ingredients and allergens - preservatives, perfumes, SLS, parabens - even shower and bath cleaners make the eyes worse.

[piot0020]

THanks for your help. What do you mean don't use a warm wet washcloth over your eyes? Are you referring to any heat on your eyes or just don't get it too hot? Right now I am use the rice pack on my eyes for 10 minutes at night and 10 minutes in the morning. I also take Doxy (50 mg/2 times a day) I have dry eyes because of lasik and just recently I've noticed big bumps on my eyes lids. I don't know why this is starting up now, after a year of not having it.

[littlemermaid]

Piot, The warm washcloth has been the easiest way for us, paediatric, esp in the bath or shower, until we graduated to the rice bag. No bumps although we've got increased veins on the eyelids. http://www.spectrum-thea.co.uk/bleph...ephasteam.aspx I'm just linking to the instructions for this Blephasteam gadget to show you about the temperature Spectrum Thea have discovered we need to use to melt the meibom - 32 degrees normal, 35 degrees for mgd.

[MeibomianGlandman]

Warm Wet Washcloths Don't Work Very well at effective heating of the solidified meibum oils, Rhein Medical Makes something called the Fire and Ice Pack, Its a little eye baggie that you pop in the microwave for like 15 seconds to achieve the correct prolonged temperature to Heat up the solidified oils in the glands before Lid expression. Rice Baggies are a good cheap alternative, but here's the drawback, My doctor who is a Dry Eye Specialist is the one who recommended the Rhein Medical Fire and Ice Masks, As you see he sells them, There what you called the professional way, You can get by with a rice baggy, but, I fear That if you don't use a digital thermometer to measure the temperature of the bag when you take it out of the microwave, you could burn your eyelids or skin! This is very serious, because Burns to the eyelids can cause permanent damage to the Meibomian glands. Just Putting the old washcloth underneath the sink and using hot water isn't effective, and its dangerous...Theres no way you can figure out how hot it can get. Rehin medicals Fire and Ice mask was made for that specific purpose cuz you don't put it in the Microwave for more than 15 seconds. However, since not all microwaves are created equally its difficult to measure the amount of affective heat you need on your eyelids to improve oil consistency. My best Suggestion, Go up to your local pharmacy, Buy a digital Thermometer for measuring body temp. Then Put your rice baggie in the microwave warm it for a few seconds, take the digital thermometer and figure out what temperature it is by wrapping the baggie in the thermometer. Hold it there until it beeps. If the temp Goes over 110 degrees you got the baggie too hot, I have seen results after like 20 seconds of a rice baggie being over 125 degrees. According to the local Fire department, heat applied to the skin 115 degrees and higher will burn you, and cause like 1st degree burns. This could cause damage to your eyelids...thats why I say the things I do. I know, cuz I learned the hard way and lost some tissue. The Key is to get the temp around 105 because at 98 degrees is where the effect on the oil starts to begin. Cheers to you all, I hope this advice helps... And as for you piot You said big bumps on your eyelids? Do they form little crusts? I mean is it on the Eyelid Margin? Let me know I may be able to explain some of it for you.

[MeibomianGlandman]

@Littlemermaid

(QUOTE)
Have you tried very diluted tea tree products around the eyes (see Hankm) for the seb bleph-type mgd for demodex overgrowth?

(REPLY)

As far as Demodex are concerned, I have seen a Dry Eye Specialist and they did a culture of my eyelashes and looked at them under a microscope to determine if Demodex were the problem, The eye Doc however confirmed that there was barely any of them there, that those that were there, were already dead. There is a Solution I use in the mornings, It has Minute Amounts of tea tree oil in it. Its a professional Solution called Thera Tears a eyelid soap/foam, it seems to do the job at keeping the eyelids sterile and keeping demodex away. However I am not sure if Ocusoft Eyelid Foam has the same ingredients. Now I have done much research in this about Demodex, As you see Tea tree oil has been proven in clinical trials to kill them, but there is one drawback to tea tree oil. It is photo toxic to the eye and its tissues. Not recommended for use near the eyes, Now I did some more research into bugs and things of the sort and discovered that dogs and cats get a condition known as sarcoptic mange Which is caused by Demodex the same condition that can happen in Meibomian gland dysfunction. I pawned over the internet for answers and determined that when most animal get such a problem they are given oral pesticides to kill such said mites, however for our pets, this treatment is ok, but for human beings its toxic, Also Pets are also Given things like Frontline plus, to kill these critters and ticks and such, which uses a base ingredient of Oil to pesticide ratio that is put on the animals back. The irony of it all, is I actually have a cat in my family who has such problems. However what is interesting about it is when I gave my cat front-line, It did absolutely nothing to the mites. It actually didn't help him very much, he would use it go on steroids and he would be fine for a while and then scratch away again. Needless to say, after much visits to the vet with him and my family member things got expensive an we were seeing no effect. So we stopped treatment, he would sit there and meow and scratch and I felt bad for the poor guy. So I decided to do some research on the problem. I was looking over the internet and I noticed that some physicians at the veterinary clinic had dealt with the same problem, You see new born puppies are prone to this problem and so are kittens. I had heard that they used mayonnaise to cure Puppies and Kitties of Mange which is caused by demodex. I wondered if it would work, so i figured what would it hurt. So i tried it, ironically the cat smelled like a salad but very soon he started to clear up it was amazing. I thought to myself, mayonnaise, this is silly! I was like I wonder why it works? I think started thinking, could it be the oil in the mayo that kills these little critters, and I had a great Idea. I studied the anatomy of these mites and realized that they don't breathe the same way people do, their airways are on the sides of their bodies, In fact most other insects breathe through their abdomens. Then came the answers! I discovered that most insects cannot breathe when submerged in oil, Then it hit me, How ironic is it that most pesticides have oil in their base ingredient to kill bugs, they inhale the oils and the pesticide kills them. But ironically most of the killing is through the oil. Then I had a great idea!

I got to thinking about the skin and how its so dry all the time, and I asked myself, What does the skin naturally produce to keep it from drying out, OIL! It was all so clear then to get rid of dead dry skin the food source for those demodex and for killing them all you had to do was add oil! It was as simple as that, you see thats why most people don't have problems with these little creatures because the oil keeps them at bay that the body naturally produces.

This was an amazing discovery, But I had to ask myself, what sort of oil could be used that is not toxic to the eye? I learned from a dry eye doc just what it was. Jojoba oil, the physician actually used it in his surgeries for MGD as a base in the anesthesia medicine. I done some more research on this oil and amazingly enough, in clinical studies they stated that this oil actually mimics human sebum the oil that is already created by our body. Sure enough I tried using it, trying to not get it into my eyes due that it was not sterile, but it was non toxic, and I applied it all over my skin, after it was wet. Sure enough, the replacing of the moisture healed the skin, and got rid of the dryness, reducing the infection and inflammation.

I have not tested my theory yet, that demodex can drown in oil, but I know they feed off of it, I believe that they can drown or at least be put at bay or caught in the oil slick at night to be washed off in the mornings. Cuz I know that they have to lay eggs Every 2 weeks or so, and they come out of the skin at night on to the eyelashes to lay eggs. I believe that if globs of oil are present there, in closed eyes, they wont be able to lay eggs and the colony will die out, also if they get submerged in the oil they will suffocate, I know that other insects do. So that's my best theory, I know its a good one, after all the oil added to the routine of washing the eyelids, helps restore the skins health. Like the body would do normally. Restoring ones health is one way to battle disease effectively, cuz the body can then take over the battle.

Thats all I learned on demodex...I hope that helps.

(QUOTE)

I'm struggling with the gut problems even though we have direct correlation with quite serious rosacea flares (periorificial bumpy, chronic rhinophyma - obviously not acne) which reinfects the MGs and has caused chronic keratitis controllabe only with steroids (search PubMed 'child rosacea' or 'child blepharokeratoconjunctivitis'). (She won't eat sauerkraut or vinegar or probiotics but she likes yoghurt.) I don't understand whether the stomach and bowel needs to be acid or alkaline - seems different in different parts - do you get this?

(REPLY)

I have done much research on skin related Disease, such as rosacea and other skin infections, However here is what I found.

This is a Theory however, not been proven but I believe all skin diseases, Allergies, Chemical Sensitivities and auto immune disorders are related to intestinal health.

There is an emerging consensus between physicians now that the intestines, play a Huge Part of the Immune system.

I believe according to my theory, that perforations of the mucosa lining of the intestine leave the body prone to disease. This could be anything from chemicals in our food, to Genetically modified foods, to bacteria, yeast, viruses and parasites that are present on food coming in contact with the bloodstream and our body through perforations in our intestines. Combine that problem with Antibiotics, Steroids use, which are taken orally, these medications can leave our intestine and the flora in them that are responsible for turning liquid in to solid waste, in a mess. Meaning the flora in our gut can be changed into more harmful bacteria, yeast. It was interesting to know that even a top physician who is on television talked about this on one of his shows, his name was Dr. Oz, You may have heard of him, however anyway, having all these things combined with steroid use which suppresses the immune system can cause infection to set up in the intestine, thus taxing the immune system everyday. Combine that with chemicals in our food and when you eat certain foods, your immune system, skin and everything around it, gets taxed terribly I believe this is how chronic Disorders are born. Thus Auto Immune disorders, skin diseases, Allergies, Chemical Sensitives are born, due to that taxing of that immune system.

The question remains How does our guts mucosa become perforated in the first place? I believe it it not due to bad flora as some suggest but with poor quality water. There has been a few clinical trials in the last few years that have been testing additives to the tap water. One additive in particular that has been used for a long time is called sodium fluoride. Fluoride in fact since the 1930's has been added to tap water, to improve dental health. However after all these years, and the advances in tooth paste we still add it to our water. It is weird and ironic that we still do, despite the warnings on the labels on our tooth paste that states that fluoride is poisonous to eat, that is why it says on the back of the container, not to swallow tooth paste.

Anyway There has been some lab studies recently that have proven that fluoride has been linked to Alzheimer's, diabetes, Hormone problems, Ect. Why would this happen you may ask? In some lab studies they have concluded that fluoride calcifies in the body and actually calcifies the in the glands in the body, causing them to malfunction. Take Alzheimer's for example they have proven that calcification by fluoride ions in the brain, in certain glandular structure leads to Alzheimer. But for some odd reason, it is still added to the tap.

Regardless of what fluoride does to the glands in the body, it does have a negative effect on the bowels, People have proven that it causes the mysterious gastrointestinal disorder called Irritable bowel syndrome. Which is when fluoride perforates the mucosa lining of the intestines allowing infection to set in causing all these hosts of problems.

So It is my theory, if one Drinks Better Quality water without Fluoride in it, with the proper minerals added. The Intestines will have a chance to heal the mucosa lining preventing chemicals, and other germs that are in our food from entering the bloodstream or body. I have heard that a lot of health problems stem from lack of proper minerals in your diet, because vitamins are not the only important thing.

However Improving the Health of the mucosa of the bowels Doesn't completely solve the problem. Like I said Before bad flora can do some damage to the health.

Now You did mention you studied about this acid, alkaline diet trend where some Naturopathic Physicans have agreed that Yeast is the cause of Leaky gut Syndrome. And they say that Leaky Gut Syndrome is the cause of all auto immune disorders, skin issues ect. But I have done some studies on this as well. The answer is Yes the flora are a problem, but I have read the Skeptics on this idea and made some startling conclusions.

Naturopathic Physicians don't address the poor quality water problem, with the fluoride which I believe is the cause of a lot of diseases. Also Technically all the food you put in your mouth has to go through Harsh Stomach acids, thus all food we eat that enters the bowels, PH is changed. There is no way to change the acidity or alkaline of your blood. This is impossible to change blood PH I have heard according to the experts. But Regardless of fact these specific Naturopathic Physicians still believe that if you change to an alkaline diet your blood will be come alkaline killing off harmful yeast that supposedly perforate the bowel causing the disease. But Like I mentioned in the paragraph earlier about fluoride, bad flora is not entirely the case. However these Specific Naturopathic Physicians believe to improve gut flora, that this akaline diet that they perscribe can change the PH of your body, due to PH testing of the Urine. The Facts however do not point to changing of the PH of the blood Stream, but a Change in the Blood Sugar Levels. It is ironic how the Acid Alkaline diet does closely follow the diet of a diabetic. Which regulates blood sugar in the types of foods that you eat, this blood sugar Is what changes the PH of your urine and does regulate cellular growth. I believe the whole Acid alkaline diet, does kill yeast and fungi in the body but does it through the means of blood sugar regulation, not alkalinity.

Speaking of Improving the intestinal flora Acid is your number one enemy when it comes to improving the Gut's flora.

Here's why I want to say eating yoghurt will not do anything to change the flora in your gut, That yoghurt has to go through your stomach acids, which will kill any helpful bacteria that may reach your intestine. That is why probiotics is the only way, enteric coated in fact, that way it bypasses the stomach acids. I mean I have tried Enteric Coated Garlic before as well and has amazing effects, you would be amazed by what it does for the skin. The thing is, you have to be careful, As you see Naturopathic science is partly a pseudoscience, My best suggestion is, Contact your local General Doctor, and order a stool diagnostic test and have it sent off to a lab to determine what is really going on. Then you can add your Natural medicine accordingly to what they find.

Many may ask me why have I turned to natural medicine for some diseases? Because it helps fill in the gaps that our traditional medicine cannot, or will not address at the current time, however natural medicine, is partly a pseudoscience, but if used correctly and scientifically can help one overcome disease.

I mean How often are we told when we are kids to eat right and exercise, that its the key to good health?

I believe this is true, sometimes we live too fast paced lives to pay attention to the most basic things we use everyday that affect our heath, are environment, our food, our water and our air.

I mean how many people have we seen who die of lung cancer are smokers. It kind of makes since to stop smoking and breathe clean air to solve the problem.

That's why I have taken this approach, due to that our Traditional medicine in this day and age can only go so far.

I hope the research I have done over the years helps!

Thanks,

MeibomianGlandMan

[littlemermaid]

Wow MGman ~ Thanks, I am thinking about this. I really appreciate your time. I'm just going to look up some research. Oral antifungals and oral insecticides are available of course for advanced cases, in conjunction with topicals (search PubMed 'Tinea versicolor' for some great work in Tunisia and Ankara on bugs in eyelids causing unresolved blepharitis; particularly in Tunisia ophth and microbiology are working together on previously unidentified bacteria, fungi, amoeba for keratitis and bleph). I'm pretty sure there's an oral + topical oil-based insecticide for your poor cat (teatree is fatal to cats) although I know mites come back if there are systemic problems and that's why vets use vitamin + mineral supplements in addition.

Using oils sounds like a good plan. I always remove eyemakeup with oils rather than detergent. Surprisingly, we've been OK with organic teatree shampoo:warm water 1:50 as an eyecleaner and the bleph has cleared. Dr Scheffer Tseng uses TTO:macademia nut oil 50:50 along the eyelid margin for ongoing prevention after the initial fix http://www.eyeworld.org/article.php?sid=4381. I know TTO is toxic and we are risking sensitivities developing, maybe most things are depending on quantity and exposure, esp with rosacea.

After working in primary schools, I'm a bit of headlice geek. The best technique is to suffocate them with conditioner (leave in hair over 25 mins because that's their breathing cycle through the probiscis) and fine-comb out. Then repeat at 5 day intervals as the eggs hatch. http://www.nhs.uk/conditions/Head-li...roduction.aspx Just as an example, insecticides don't do the job with them really so I understand what you're saying.

So we are looking at demodex life cycle here. And regimes that prevent things developing. This is why I like your jojoba oil idea for maintenance although I would like to poison the little *ers too and I'm not sure jojoba would do it. TTO seems to be the only thing that actually kills them (see Hankm). Washing the bedding at 60 degrees frequently has to be a good plan. Animal demodex is known now to be transferable to people.

It is true some rosacea people get clearance by eliminating fluoride but maybe these are individual sensitivities - maybe it's easier to get testing in the US. Here in UK the docs suggest elimination regimes for intolerance on chemicals and foods, which is flippin' difficult with a teenager. And some rosacea flares up as the face adjusts to different water supplies. http://rosaceagroup.org/new/

Just a few initial thoughts ~ my ophth says he wants 2 refs for every point, so I need to do some homework. Thanks again

[piot0020]

MeibomianGlandman- Thanks so much for the info on eye heat. I didn't realize the temp could damage your meibomian glands. I am going to look into the fire and ice masks. As for the white bumps on my eyelid margin. I dont have any crust around my eyes but the bumps come and go. When I apply heat, they seem to go away faster. I don't know if they bumps are from the muro 128 that I use at night...maybe it clogs my glands?? Not sure but I haven't had this problem for very long.

Thanks for your insight and sharing your knowledge.

[piot0020]

Also...where can I purchase the Rhein Fire and Ice mask?

[MeibomianGlandman]

From the Company called Rhein Medical hince the name

[MeibomianGlandman]

MeibomianGlandman- I dont have any crust around my eyes but the bumps come and go. When I apply heat, they seem to go away faster. I don't know if they bumps are from the muro 128 that I use at night...maybe it clogs my glands?? Not sure but I haven't had this problem for very long.

Hey I just ran into something amazing, I have had blepharitis for a long while now, the inflammation has been caused by the nighttime ointment I have been using that has mineral oil in it. Make sure to check to see if mineral oil is the cause of your blepharitis.

I believe Now I'm going to follow rebecca's route and Switch to Genteal-gel with the Rubber moisture chamber goggles for nighttime use. I mean I think the mineral Oil and the petroleum jelly in the nighttime ointment I have using has been clogging the glands for some time, and causing the inflammation on me. I would check that out to see if the inflammation could be caused by mineral oil sensitivity. Make sure you check that out...something recently I found out today that was a cause of my MGD/Blepharitis after 3 years.

[piot0020]

Now that I think about...thats something to look into! My oil glands were never this clogged when I used GenTeal at night. However, GenTeal has a preservative in it. Its suppose to dissolve when it hits your eye but I don't think it did for me...I know this b/c it burned. Maybe b/c my eyes were just that dry. Anyways, do you know of anything else to use at night?? Also, I just checked my heat temperature I have been using on my eyes- 110 degrees! Thats not good! I'm hoping that I didn't damage anything but it really worries me....One more thing to add to my list of worries

[MeibomianGlandman]

piot now Don't get too worried now, Last I checked I do believe Genteal-gel does make a preservative free version, if not, consult a compounding pharmacy to have some made for you. As far as the Heat on the eyes, Like i said 115 degrees Fahrenheit and above will burn your skin, so get it down to a science in the seconds you put those masks in the microwave. Its easy once you get the right temperature, you just put the mask in the microwave for the right amount of time. The target temperature you wanna hit is between 110 degrees and 98 degrees, as the meibum oils liquify at 98 degrees Fahrenheit hince your body temperature. So it should clear up the bumps.