MGD confusion...

[Rory]

Hello.. I havent been around for sometime..

Having had dry eyes for 17 years now.. i go through phases of trying to find an answer.. during which i tend to become obsessed and dive deeper and deeper in the whirlpool of dry eye hysterical confusion...and then there are the phases of trying to live with it and not think about it...as far as that is possible. Or at least accepting my condition and not looking for a treatment.

I am now entering a new whirlpool...as I am really struggling to cope again.


So after 17 years and 450,000 useless Drs and quacks.. i am pretty sure that my problem is MGD...i seem to have little problem with the aqueous production... its the evaporation problem for sure.

Now i have tried the lid hygiene routine many times over the years...perhaps for 3-4 months religiously at any one time.

The trouble is..because i never noticed ANY improvement... i stopped. I dont do any extra lid hygiene process at the moment..apart from the odd supranette lid wipe..and the odd trying to unblock glands using my fingers.

Here are my problems and questions with MGD and lid hygiene;

1. The numerous different approaches to lid hygiene... and unblocking glands.
Which is the most effective?

2. How do we know if we have unblocked the glands...apart from feeling an improvement in dryness?

3. Even if we do unblock the glands....perhaps it will have no effect..as i may be producing the wrong type of oil..and this is why they block in the first place?.... or it is the bacterial problem which alters the oil and tear constitution?

4. DOes anyone know anything...and has anyone truly controlled their dryness through a concerted and daily lid hygiene process?

5. Oh yes ..is it possible to feel when you unblock a gland...AND are the lid margins of a normal eyelid.. relatively hard around the lid margins? Am i trying to press too hard to unblock? The questions are endless .. unfortunatley so are the answers?

Regards,

Rory

[irish eyes]

Rory

Your experience mirrors my own. I have been advised to be more zealous with the hygiene and then told that I wasn't being zealous enough.

I put the questions to my consultant that you have just posed - and he couldn't see anything wrong with what I was doing. He said that too much pressure on the lids to express the oil could result in `trauma'. I feared that this was something I may have done unwittingly - how could one know if damage was done to something inside the lid? He reassured me that the glands were blocked and inflamed - but otherwise normal ie no sign of trauma to the glands. The lids themselves remain very swollen and irritated.

I rarely use any commercial products these days because they were causing too much irritation. I find cold rather than heat gives me a modicum of relief. When I'm at home, I make regular trips to the cold tap so that I can splash my eyes for a few minutes. (Even if I'm in the middle of a conversation, this is something I often have to do - just so I can proceed and speak coherently - otherwise I just lose all concentration.)

Sorry I couldn't be more positive. I know that `whirlpool' only too well.