Can Clearing Up of MGD Cause Vision Blurriness, Temporary Rx Changes?

[Randal]

I've been reading Dry Eye Talk for over a month now, but this is my first post, so please be kind in your responses.

My recent history:

About four months ago I switched from soft contact lenses to RGP, mainly for dry eye issues, but also for durability issues. (I got tired of throwing away soft lenses, and they usually irritated my eyes the last week or so before I was supposed to change them for a new pair.) Because of residual (lenticular) astigmatism, I had to go to front-toric RGPs. (Usually RGPs automatically correct astigmatism, but my eyes had to be "special.") I was also diagnosed with DES, and my optometrist gave me a sample bottle of Dakrina. Since then, I have bought all three types of drops: Dwelle, Dakrina, and NutraTear. I've now used them very faithfully for about three weeks, and they seem to have helped quite a bit; it seems that the less they sting when I put them in, the better my eyes are doing.

I also have allergies. (Surprise, surprise!) About three weeks ago I saw my doctor about that and talked him into giving me a Rx for doxycycline (I think 50 mg twice a day) for my self-diagnosed MGD. (Based on everything I've read and my symptoms, I'm pretty sure that's the underlying cause of my DES.)

At the recommendation of my optometrist, I have, for about the last week, been applying warm compresses to my eyelids, usually once or twice a day. This was after I had pointed out to him a slightly thick-feeling, "squishy" (for lack of a better word) area in my left eyelid, near the nose, that I self-diagnosed as being a backed-up tear gland. (The optometrist never felt this; I guess he just took my word for it.) After a treatment, I perform eyelid massage. (BTW, I always remove my contacts before doing any of this.) Between the doxycycline and the warm compresses, I think this area has gone down somewhat. So far, so good.

But here's what's going on now:

I just got a new RGP lens for that same eye, the left one, because the last one was riding a bit low and possibly irritating my eyelid, not getting good tear exchange underneath the lens, and so on. However, the new lens, although it feels very comfortable, does not give me very good vision, and I think it goes back to the MGD therapy.

Whenever I've used a warm compress, my vision in my left eye seems "smeared" or "streaky." (Again, this is without contacts in my eyes.) Could this be from the previously clogged "oil" coming out of the tear gland as a result of the warm-compress treatment? If so, is this side-effect actually a *good* thing?

Even if it is a good thing, could this possibly be causing (hopefully temporary) vision problems with the contact in this eye? Before I call my optometrist and complain that this new contact must have been ground to the wrong prescription, would it be better for me just to wait a while (a few weeks?) and see how the MGD therapy progresses?

Sorry for being so long-winded. Thank you so much.

Randal

[GeorgeT]

I have the same problem

Hi Randal,
I experience the same blurriness after hot compresses (rice bags) for about 2-3 min. I don't wear contacts. I would like to get an answer for this too.
Take care !!!

George

[Randal]

Re: I Have the Same Problem

One thing I should have clarified is that the streakiness lasts quite a while--perhaps up to half an hour. (I guess I should time it.)

The only thing, though, is that even after this streakiness has gone away (at least I think it has), I still find this new contact lens giving poor vision. I hate to be too much of a pest to my optometrist, since he so far has been very patient and good about not charging me for all the visits (and replacement lenses, each time a new one is made). That's why I think I'll wait a while before calling him again, just to make sure the problem is with my contact and not with my eye. At this point, I think it could end up being either one.

[Rebecca Petris]

Hi Randal and welcome! I'll try to be nice this time around (no promises in my next post )

I'm not a doctor... but as a longtime wearer of "special" RGPs - reverse geo macrolenses, and now sclerals, plus having MGD myself, here's my 2cents.

I get blur from MG secretions lasting quite awhile after my rice baggy compresses. When I need them I usually do them just before bed, or very early in the morning or both.

As regards seeing poorly with the lenses: If I understand right, the new lens did not give you good vision from the get-go, right? Sounds to me like some change to curvature to make it fit better would explain that. Certainly possible that improvements to the tear film could change the vision enough to notice but if you never saw well with that particular lens, it sounds a lot more likely that the fit and/or Rx needs some adjustment.

[Randal]

Rebecca:

Thanks for responding so promptly. I suspect you're right that the lens may be not quite right. It seemed perfect when I first put it in last Friday (four days ago), but it hasn't seemed right since then. (That was also about the time I started the warm compresses.) I think I'll probably give it another week or so, since I'm sure the compresses probably complicate matters.

Maybe I should temporarily suspend the warm compresses, until I get a better feel for how well this new contact lens is doing for me. Any opinions?

Thanks.

Randal