A question for oil deficient females ---Could this work???

[Ariel]

I've never had my MGs expressed by a doctor but on one of the photos on this link there is a mastrota paddle on one side of the lower eyelid and a expressor being rolled against it on the opposite side. The eyelid is squeezed in between the two to get the oil out.

http://www.guldenophthalmics.com/ima...Expressor3.pdf

http://www.youtube.com/watch?v=RinkMHGIKO4

I'd like to know if there are "wide tweezers". By "wide" I mean wider than the kind you normally see which are about 3mm.

If there are tweezers with a base of 5-6mm I wonder if they could be used to pinch the eyelid, grabbing it from both sides, exerting the necessary pressure to force the oil out. I've heard that some doctors use a Q-tip on the inside and another one on the outside, but shouldn't a tweezer do a better job? It would also require the use of only one hand which would allow us to use the other one to pull the eyelid away while we're working on it.

These may do the job as you can shaw them down to whatever length and width is more suitable.
http://www.p-wholesale.com/cn-pro/10...rs-436265.html

[magoo]

the tweezers I've used all have sharp edges. Your idea sounds interesting, though.

Qtips always leave little fibers in my eyes, I end up with a lot of irritation from them so that is out, for me anyway.

The link wouldn't open for me.

[Ariel]

magoo--- The links work now.

[regina]

mastrota paddle

Looks great...I knew about this before..but havent been able to get one...buy one or even find on the internet. This was about a year ago...maybe they will start selling them to us. But Im afraid they might not because then we wouldnt have to go to eye doc to get expressed...hmmmm
Anyone out there that can get these and sell them to us?

[Ariel]

Regina--- Since eye doctors don't do MGE in Spain I got the three of them.

Meibomian gland expressor:
http://www.guldenophthalmics.com/ccp...ing=expressor:

Microscope camera:
http://www.youtube.com/watch?v=HpqCR...eature=related

[Spoon]

Not a bad idea, my opth told me about a colleague who actually uses tweezers in the office to aggressively express the glands. Also, i bought the MG expresser kit from gulden ophthalmics. Its rather expensive for what it is but the device itself is good in that it provides a more sterile and precise way of applying pressure to the glands post heating.

[Ariel]

My reason for wanting to test the possibility of expressing the meibomian glands with a pair of tweezers is to find the best way of getting the job done.

Using the mastrotta paddle and expressor still requires two hands and putting the MP on the inside of the eyelid is more traumatic that pinching the eyelid with a plastic tweezer which only requires for you to go 3-4 mm over the inner side of the eyelid. When you use the MP you have to go much deeper.

With plastic tweezers, it may also be possible to press top and bottom eyelid margins against each other from the outside without ever having to go inside the lid margin. As of now, we don't have a way of doing this with a MG expressor or any other device.

I'm going to order the 5mm tweezer from this place:
http://www.edmundoptics.com/onlineca...productid=1617

[Spoon]

Oh yea nice, i hope they work well for you and let us know if they do. Although to me it makes more sense that a wider instrument with rounded edges such as the paddle would be less traumatic to the palpebral conjunctiva. Also the paddle has a slightly concave front surface. I think i will machine my own one rather that pay $70 though.

[Ariel]

$70 is nothing for me. I would sell my life to the devil if that brought some relief. Nothing does so I'm desperate. They say the end of the world is coming in December 2012, and I wish I didn't have to wait that long. I tried to kill myself before and it didn't work. I was supposed to die in an accident also and I didn't. I just want it to end. They have assisted suicide in Switzerland but they probably won't take me. I'm an unlucky bastard!

[Spoon]

Hey I know what it’s like to think like this when your eyes are dry, inflamed & painful but trust me you’re not thinking rationally right now. I was thinking the same thing 4 months ago after about 6 months of horrible dry eye that had a sudden onset and wouldn’t improve with treatment. Firstly I’ll tell you that this will get better and there’s a damn good chance you will see huge improvement, especially if you’re motivated. I don’t even know your medical history and I would bet everything I own on a good outcome the odds are so good. The fact that four months ago I would have given everything I own to find relief and now I’m thinking twice about spending $70 is a testament to my improvement because I’m not strapped for cash.

What I think you need to do right now is give yourself a break. A break from all the research on ways to fix it and thinking about the worry about whether or not you can or will find relief. If you’re working, take a few days off; humidify your room/put on some moisture chamber goggles and then fully engage in a hobby you like, maybe play or start playing an instrument (Jack Johnson learnt guitar when he was in hospital after getting hitting the reef while surfing in the pipeline masters), who knows just putting it out there.

And if not for your mental health, basic psychoneuroimmunology tells me that distressing and taking your mind off this problem is by far the best thing you could do for this condition right now. I can’t think of any current theories for dry eye and MGD that don’t relate to stress. Off the top of my head there is: (and I can back these claims up with credible research):

1. Androgen imbalance – specifically believed that testosterone improves function. Stress response increases Cortisol that blocks
2. Skin conditions – stress triggers, exacerbates and probably plays a major role in the etiology of both rosacea and seborrheic dermatitis
3. Stress exacerbates the allergic response and autoimmune conditions
4. Here’s a study where researchers use 2% epinephrine to induce Meibomian gland dysfunction in rats. (http://www.iovs.org/cgi/reprint/30/5/946.pdf) Epinephrine is released in humans as part of the ‘fight or flight’ stress response.
5. Prolonged stress has effects on the Hypothalamic–pituitary–adrenal axis that causes what some refer to as sympathetic dominance & some research suggests parasympathetic nerves at least partially control tear secretion.
6. There are even a few papers I have read about where stress altered both the intestinal and ocular flora (but there’s no evidence whether this influenced dry eye).

Also it’s also good to realize that the members of this forum probably have the most recalcitrant cases and even then the vibes are relatively positive from most.

Ok enough from me. Just one more thing: try moving environments. Go beach if possible. If you’re eyes itch then this is a no brainer but also don’t disregard the possibility of a Type IV hypersensitivity reaction to airborne substances. Dust mites have protease activity independent of their allergenicity that can make things worse.

Good luck. I hope this helps.

[Ariel]

Spoon--- Thanks for your thoughtful reply. You mentioned a lot of things that can only be having an adverse effect on my DE condition, some of which have also been mentioned today but other fellow members.

Stress is playing a big role in my life. I has been in the last five years, and when I say "stress" and don't mean what you'd regard as the worst kind of stress but something I'm sure would go well beyond. I'm used of controlling everything around me and being at the mercy of a medical condition that controls me is something I'm not used to.

I feel like I'm at the end of my rope, before I'm doing everything to overcome this condition and I feel helpless. Your support means a lot to me so thanks again for it.