mite infestation and MGD from Dr. Tseng

[jjzhao2468]

I get a reply from Dr. Tseng. They have recently found out one major cause for MGD is mite infestation, and can be treated.

Anybody knows how to diagnose MGD to know mite infestation. How to treat it if so? Is it expensive?

Does anybody have experience?

Thanks,

James

[Bart]

Meibomian gland dysfunction, blepharitis and dust mite allergy

Hi James,

My name is Bart (27) and I've been a dry eye sufferer for about 6 years now. My problems started out with contact lens intolerance (eventually visible allergic reactions after taking out my contact lenses; that is instant clogging of my meibomian glands in both eyes after taking them out). In the following years I developed a blepharitis in combination with meibomian gland dysfunction (only in my right eye, my left eye recovered). I believe my right eye was unable to recover after and Giant Pappilary Conjuctivitis (GPC)-reaction I experienced summer a holiday in Turkey. At some point I also had an allergic conjuctivitis and it turned out that I was allergic to dust mites and storage mites. I've been undergoing immunotherapy for almost three years now.

After years of thorough treatment of my eyelids I managed to get the blepharitis under control and largely eliminate the clogged meibomian glands. I haven't cleansed my eyelids for over a month now and hardly suffer from blepharites and haven't had clogged meibomain glands since. Though I had been on doxycycline for the past month as well, for the first time. Still I'm suffering from a evaporative dry eye, which is why I avoid using the computer as much as possible. Anyway, I do think from my experience that it is plausible that dust mite infestation is one of the most common caused of MGD. I had my worst blepharitis when I was living abroad for six months, where I lost almost all my eyelashes in my right eye. After returning to the Netherlands, being diagnosed with dust mite allergy, and taking the neccesary precautions (new floors, protective sheets, etc.) my condition rapidly improved again, although I never fully recovered. I believe that if I would return to the pre-diagnosis contitions, it will only be a matter of time before my blepharits will fully recur.

I don't know to diagnose dust mite infestation, but I've been tested positive for dust mite allergy in relation to my eye problems. What I've done to try and get it under control was starting with immunotherapy, improve the conditions in your house and especially bedroom, thorough lid cleansing, and recently I've been taking doxycycline, amongst other things. I hope people will learn from my experiences with blepharits and MGD.

Regards,
Bart

[np1981]

Hi Bart,

do you mean dust mites or demodex mite? I'm guessing you had an allergy to dust mites?

[jjzhao2468]

THANKS for your reply

Bart,

How did you manage MGD? warm compress or doxycycline

[Bart]

Hello,

I tested positive for two types of dust mite and one type of storage mite. I accidently brought te test results home so I still have them, although not available right now. I believe de dust mites I tested positive for were dermatophagoides pteronyssinus and d. farinae. I'm now taking Oralgen solution to desensibilise for the d. pteronyssinus dust mite, which is the most common variant of dust mite in the Netherlands. I hope it will also make me less sensitive to other types of dust mites, since they are closely related.

As for managing MGD. This is not easy. My situation gradually improved over the past couple of years. Though my meibomian glands are not visibly clogged anymore (at least not regularly), I still suffer from an evaporative dry eye. I've been doing warm compresses for years, by using plastic sandwich bags with two warm (not HOT!) teabags inside. Alhough these warm comprossed hardly had any effect on clearing the clogged meibomian glands; the oily secretion did not easily liquify, even after using warm compresses. I've stopped using warm compresses for about four months now, and I also stopped using lids scrubs about a month ago (which was hard because of the itching). I'm trying restore my natural defenses, and increase the sensitity of my right eye again, in order to produce more reflex tears again. So far I have't seen any signs of my anterior blepharitis recurring. Although my meibomian glands aren't regularly clogged anymore, they not 100% cured yet. The easiest my for me to get my glands clogged was using the computer of for an extended period of time. Because of the reduced blinking rate, my meibomian glands could clog very easily. The oily secretion has a chance to solidfy, and it usually takes days for a clogged gland to clear up again. I think the following steps might help to control MGD:

1. Try to aviod using the computer as much as possible, and if you do, then remember to blink and take brakes regularly (usage of sealed glasses to retain humidity helps to prolong your computer usage).
2. Use fish oils and flax oils (omega-3), I take 1000 mg each every day. Also eat healthy.
3. Doxycycline helps.
4. Maybe N-acetyl-L-cystiene helps (see this forum).

What helps for one person might have an adverse effect for other persons, like eye drops, lids scrubs and warm compresses. Hope this will help you guys!

Good luck and never give up!
Bart

[DESTINY]

Bart

How can you tell if your glands are clogged? What does it look like? I was diagnosed with Demodex mites and am currently doing tea tree oil scrubs. What did you use to scrub your lids? Also, where exactly are you supposed to scrub? I am not sure if I am doing it correctly. Sorry for all of the questions but you seem to know alot about this topic.

Thank you,
Destiny

[jjzhao2468]

lid scrub

I do not perform lid scrub. But I think it is simple.

My doctor told me I had MGD because he saw thick oil. I saw many eye doctors, but most could not tell if the meimebian gland clogged. They just asked how other doctors diagnosed and followed. Tney said I have dry eyes.

I do not know how to tell if meimebian glad clogged. I always try to know it (I checked my eyes and tried to expressed the oil) by pressuring my eyelid, but I never really know.

I do not know if I have mite infestation. Can most of eye doctors check it for me? I do not want to fly to see Dr. Tseng. It is too expensive. Did you buy tea tree oil yourself?

My tear is pus-like. I do not know if it is due to dryness, meimebian gland dysfunction or blepharitis. I can not trust eye doctors too much.

Thanks,

[Rebecca Petris]

Sterilid contains tea tree oil. Does anybody know if it is being pushed as a treatment for the mites?

[Bart]

To treat my blephartis I started using blephasol lid scrubs as well as blephagel. Later I also started using cil-clar scrubs, which are a bit more foamy. All of these are specifically designed for eyelid cleaning.

When one of my meibomian glands was clogged it was obvious for me to see. They were always clogged in my upper eyelids. Just lift the eyelids a bit and see if the is a oily bump on one of the glands visible. Once a gland is clogged it is extremely hard to get it open and get the oil flowing again. The best thing I could to was just to wait for a couple of days. What also may help is using a warm compress long enough for the oil to liquify a bit and then use a lid scrub to remove the oily debri. But this is not advisible because you eyelids don't like this very much. If you have skin flakes on other places it might also be a good idea to do something about this as well. Even if the meibomian glands are not visibly clogged they might not be function very well. Ask your doctor or opticien to check this for you. I developed my MGD after a very long chronic inflammation of my eyelids, which resulted from my contact lens intolerance. I started experimenting with different kinds of lenses instead of doing the sensible thing and just give up on them.

Greetings,
Bart

[DESTINY]

Bart

How do you do the scrubs? What do oyu use to scrub your eye and where do you scrub? What part exactly is the lid? Sorry but I think that I have this problem because of the Demodex mites clogging my glands and I really want to fix it! Also, I have never heard of the medicines that you used. Where do you get them? Does it hurt when you get it in your eye?

Destiny

[jjzhao2468]

lid scrub

I do not know how to do lid scrub. I think you can find somewhere in this website.

[Bart]

I get my scrubs from the Netherlands, but I guess there a plenty of alternatives in the States, such as the theratears sterilid.

Here is a site that shows you how to do lid scrubs: http://www.agingeye.net/otheragingeye/blepharitis.php

Good luck.
Bart

[jjzhao2468]

Pus-like tear (mucus or meibum)

Thank you for your reply. I used Thermipad i bought from drugstore.com for warm compress. But my eyes are always red and have pus-like viscous tear. It can be stetched long. I think it is mucus or dysfunctional meibum. so it bothers me a lot because I see everything a liitle dark. I do not know why.

Can you tell how you do warm compress and the temperature you hold? I think I may irritate my eyes too much.

[np1981]

Update on Mite Treatment

I have been doing daily eyelash scrubs with the Tea-Tree Shampoo, as well as the weekly lid scrub with the 50% Tea Tree Oil. I wasn't sure what to
expect, but after 4 weeks things seem to be getting better. I used to get
quite frequent intermittant inflammation during the day, and a lot of this
has subsided for the most part!

I am not sure this improvement is anything to do with the mites though.
Daily lid cleaning like this seems to clear 'debris' away in the morning,
and my eyelashes/eyelids seem 'cleaner'. I know that cylindrical dandruff
was found on my eyelashes, which may have been causing me problems somehow.

Anyway I will continue the treatment for the full course and see how things
are in another 4 weeks time. I may keep up the eyelash shampoo scrubs
indefinately, as a sort of preventative measure.

In fact my main discomfort at the moment is with annoying eye "strain" which
seems to be absent in the morning, but appear and get progressively worse
during the course of the day. By the evening it feels like a constant 'ache'
around and behind my eyes, sometimes coupled with a headache. Does anyone else get these eye strains/aches? Warm compresses seem to help, but not for long. My daily routine still consists of saline rinses before and after
sleep, and 2x1000mg fish-oil capsules.

[Maria1972]

np1981, I have the same experience as you as far as eye strain and headaches. The pain even goes to my neck, shoulders and back. It can be very debilitating.
My routine doesn't include saline rinses or eye lid scrubs. My dr never mentioned the scrubs. I wonder if that's for people that have debris or muccus? I have bad MGD. I do warm compreses, Systaine, Omega oils, I started tranquileyes a few days ago and wrap around googles and use it for a few hrs a day.
Sometimes when headache/pain is too bad I take a pain medication called Darvocet but I don't do that often b/c pain meds can cause more dry eye + I don't want to abuse pain meds.