Meibomian glands STILL blocked!!!

[autumnn]

I had a pretty good doctors appointment yesterday and while he said that he saw progress in my corneas- he actually called them "pristine" and said that a month ago they looked "angry" (the change he said is probably due to the lacriserts always keeping them moist) then he took a picture of my lids and showed me the blocked glands. I am so frustrated that these are still blocked even though for tyhe last 6 months I have been doing a warm rice baggy compress every night and use steralid, doxy, omegas, etc. The doctor suggested that moist heat is better and that I switch to wet warm washcloths every morning and night instead. He believed that in a few weeks/months I will see a difference. I know that we talk a lot about MGD on this forum but does anyone have any new/novel ideas as to how to get these darn glands unblocked and keep them that way???
Thanks in advance

[odydnas]

I know how you feel! Mine are still blocked after a year and a half! One thing I haven't tried is Azasite....but my doc doesn't believe in it.

Have you tried that yet?

[autumnn]

I tried Azasite in the past. I wasnt sure if it helped. I am going to ask about it again and maybe do another month of it. I was also thinking of increasing my doxy from 100mg to 200mg and adding more fish oil. In the past I had one doc say that he could do a manuel expression of the glands (his description of it was quite barbaric) and I am thinking about perhaps doing this...hmm, anyone else have any ideas?

BTW, it is strange that all my other docs said that my glands weren't blocked and then this one took a picture and actually showed me to "blockage" which looked like little white bumps.

[odydnas]

Interesting thing about moist heat vs. dry heat. My doc recommended the same thing...I just can't seem to keep my towel warm for more than 15 seconds...

I've been to a lot of docs who told me my glands were perfectly fine...until I went to Dr. Latkany who told me otherwise, and so when I went back home, I searched for a doc (my current doc) that would give me the same diagnosis. Increasing doxy dosage might be good. I am on the max dosage of minocycline...I"m allergic to doxy. My doc told me that she's had patients who don't respond to oral antibiotics at a low dosage, but will at a super high dosage, although it can take months. Just because there is no change at a low dose doesn't mean that oral antibiotics don't work (contrary to what some docs think), you need to try at a high dose. I dunno...

I see that you're from CA. My grandma recommended me to see a doc named Dr.Bokosky, a corneal specialist, at San Diego because two of her friends finallly found relief there. I don't know where in CA you're at, but maybe you can check him out too.

[autumnn]

Odydnas- Thanks for the doctor rec. I will look him up as I am in So Cal. If I try the Azasite again I will definitely report back as to its effectiveness. Have you tried NAC? I have read good things on this forum about that supplement. I just switched to moist heat and am trying to do 10 min twice a day....I am not sure what the consensus is on how long to do these. What do you do? Have you had any improvement in the last year and a half with your blocked glands? Supposedly Dr. Tseng in Miami has ways of opening them- other docs must have ideas as well.....even though it is annoying to have them blocked, I feel a bit better having something to work on insted of just hearing that they don't produce enough oil....

I know that this has been posted before, but if anyone has MGD success stories I am sure we'd love to hear them again!

[bernmee]

Autumn...

What is this NAC...is it a natural herbal product?

Bernadette

[autumnn]

yes, NAC is a supplement. It is an amino acid that is supposed to be helpful with MGD....if you do a search on this forum you will see some posts where it has helped some people....

[eva b]

autumn,
I can really empathise with your problems, my MGs are constantly threatening with blockage - they are usually slow at the best of times.

I have found a local optometrist who manually expresses them on a regular basis (weekly at the moment) which seems to help a great deal...it gets rid of the hard stuff, and so allows the fluid to flow more freely out of the glands.

I believe it has helped me enormously - he certainly has prevented at least 2 cysts forming!

It's not a particularly pleasant experience - they have to squeeze quite hard - but it's quite bearable, and trust me, I'm not one of these super-brave people who can put up with a lot of pain...quite the contrary.

So if you find someone who can do this for you, and you trust, I would certainly give it a go.

Eva

[advocate]

Consider allergy!

I'm convinced that a lot of us who are experiencing MGD/Bleph are actually having allergies to things in our environment that are ubiquitous, like dust mites, mold spores, etc. The allergic reactions irritate our MG's and they produce white stuff instead of oily stuff like they're supposed to.

Here's my latest list of things you should try to control ocular allergies/Bleph/MGD. They are working great for me.

See an allergist. Ask your allergist to do an intradermal test (using a needle) for every pin prick that came back negative, especially molds. Ask your allergist to treat you with allergy shots for everything you are allergic to, including molds.

Ask your allergist for a prescription for Allegra (an oral antihistamine) and Pataday (an optical antihistamine). Pataday is a stronger version of Patanol. Avoid Benadryl and Zyrtec, which will make you drowsy. You should know that antihistamine drugs require time to build up in your system. The longer you take them, the better they work. So don't give up if you don't see an improvement the same day. Give it a week. I've found that antihistamines only offer moderate improvement.

Clean your house, thoroughly. Clean on top of, under, and behind everything, including books, bookshelves, pictures, etc. Clean behind your TV, in your light fixtures, on top of your window treatments. Take your PC outside, open the case, and use canned air to blow out all the dust. Wear an N95 Particulate Mask while you clean (3M Makes the most popular ones).

Keep your windows and doors closed as much as possible in order to prevent pollution, mold spores, and other allergens from getting inside. I air out my house once every two weeks for about 15 minutes, late at night, but otherwise keep everything closed.

If you have a furnace, install the best 3M Filtrete Furnance Filter that will fit and run your furnace 24/7.

Buy a HEPA Filter for the rooms you spend the most time in (Honeywell 50250 and IQAir both work fairly well).

Clean your hairbrush (which accumulates skin cells and is a breeding ground for dust mites).

Vacuum your carpet, your mattress and other fabric furniture weekly using a HEPA vacuum (Miele is the best and most expensive HEPA vacuum cleaner. If you can't afford it, get the Electrolux Oxygen 3). You should vacuum your carpet and hard floors twice a week.

If you have a front loading washing machine, check the rubber gasket for mold growth. After you clean all the mold off, wash all your clothes again. Keep the door open when not in use to prevent a recurrance. Search Google for more information on this problem.

Wash your pillow, sheets, comforter, etc. in HOT water once a week. Vacuum your mattress once a week (this makes a huge difference especially if you wake up with problems).

Try cold compresses instead of warm compresses. I've found that cold works much better to reduce inflammation. That's what any competent doctor would recommend if you had inflamation on any other part of your body, and it works well on my eyelids too..

Try nasal irrigation to remove accumulated allergens from your nose and sinuses.

Exercise 30 minutes every day. Exercise has been proven to improve chronic inflammatory conditions, and you might live longer...

Rinse your hair twice a day (I do it in the shower). Your hair accumulates allergens, and is often near your eyes.

Moisurize your eyelids. I use Eucerin, but you can experiment with different kinds of moisturizer.

Minimize your use of eyedrops that have preservatives in them. Whenever possible, use unpreserved drops and saline solutions. I rinse my eyes out with Unisol (which is a preservative free saline solution). Read the instructions on the eyedrops and use them correctly, by pulling on your lower eyelid to form a pouch, putting the drop in, and then closing your eye as long as possible so that your eye can absorb the water/drugs, etc.

Vary your diet and see if eliminating certain types of foods makes any difference.

Try using different skin care products. Change your soap, shampoo, etc. and see what happens.

Try using different laundry detergent.

This regimen is working very well for me. In fact, it's working so well that I've stopped taking meds and am getting 6-8 hours of contact lens wear a day (which was impossible when things were really bad).

[kitty]

Have you talked with your doctor about using Lotemax, then Doxy, then Azazite? That is my treatment plan. My doc does not believe in warm compresses. I was on Lotemax 4 times a day for 2 weeks, then twice a day for two weeks. After that I saw my doc and he said my MGD was significantly improved, my glands were no longer blocked and my TBUT had gone from 2 to 6. I'm now on Doxy, tapering off the Lotemax. My doc said that in his experience, Azazite is most effective for maintenance, but he usually brings out the big guns with Lotemax followed by Doxy first. There are many different treatment approaches. I'm just sharing what is working for me.

[mjf79]

wet cloth and rice bag

I made a rice bag with a knee high stocking, which is quite thin. I heat this up for about 30 seconds. I then get my kid's thin washcloths and moisten one. I put this on my eyes and the rice bag over that....it provides warm, moist heat. Just a suggestion.
My therapy is daily warm compresses, 50 mg of doxy, 1 tsp flax oil with yogurt, and azasite as needed.

[advocate]

Antibiotics probably work because they have an anti-inflammatory effect. I'm glad to see that some doctors are abandoning warm compresses. Eye doctors are the only physicians I've ever met who think that heat is good for inflamed tissue.

Have you tried cold compresses? Have you tried my suggestion about treating your condition like it was allergy?

Have you talked with your doctor about using Lotemax, then Doxy, then Azazite? That is my treatment plan. My doc does not believe in warm compresses. I was on Lotemax 4 times a day for 2 weeks, then twice a day for two weeks. After that I saw my doc and he said my MGD was significantly improved, my glands were no longer blocked and my TBUT had gone from 2 to 6. I'm now on Doxy, tapering off the Lotemax. My doc said that in his experience, Azazite is most effective for maintenance, but he usually brings out the big guns with Lotemax followed by Doxy first. There are many different treatment approaches. I'm just sharing what is working for me.