MGD - expressing glands and heat tx

[maddy99]

I have been diagnosed with MGD. I used moist heat compresses for several months and then forgot one night and my eyes actually felt better, so I've stopped the heat tx. I don't understand how heat is supposed to open the glands over time (doctor said 6 months), yet heat would seem to make the inflammation worse. I am using Xibrom drops for inflammation. I think the drops are helping.

Is this a catch-22 or am I missing something?

Can anyone see the glands looking in the mirror or do you need a microscope? I can't see a thing. I was shown how to express the oil but there's nothing there.

I also find it hard to understand why people feel better with opposite tx's yet all have MGD; heat versus cold, lid scrubs or no lid scrubs etc.

I also have bad and better days for no apparent reason.


Elaine

At least I found a new eye doctor that will work with me.

[Eli]

Elaine,
I understand how you feel about the warm compresses. I find them uncomfortable to do and didn't see a fast benefit when I started them over 3 years ago. However, I think that with persistence and other treatments, they can be helpful. Basically, the theory is this: a healthy meibomian gland should produce a thin, clear oil that should be liquid when at body temperature. In meibomian gland disorder, the composition of the oil changes, causing it to become white or yellow and much thicker, sometimes almost solid. Doctors have described it as looking like "toothpaste" coming out of the gland when expressed with a finger or Q-Tip. When you apply heat, you help to liquify the oil, allowing it to be expressed more easily. Some doctors think that if you can keep the glands "flowing" then they will regain some of their normal function. Keep in mind that there isn't a lot of oil coming out of those tiny little glands, even in a healthy eye. Dr. Latkany told me that most people can't see anything coming out at all, even when they are expressing them correctly. What you might notice is a significant blurring/fogging of your vision for a few seconds as the oil coats your eye. That's what happens to me. Also, yes there may be a catch with using the Xibrom. Like most topical NSAID's (Non Steroidal Anti-Inflamatory Drug) I don't believe it is indicated/safe for long term use. This would also be true for steroids like TobraDex, PredForte, etc. Be sure to use it only as indicated by your doc!
But, glad to hear it is helping. Lastly, like you, I have had good/bad days seemingly at random. I don't understand why, but am just happy for the good days!

Eli

[msny]

Been using the rice baggy now for about 3 weeks.

Also, I use xibrom along with Restasis, and have for the long
term. My doctor has told me this is safe. I used steriods for
a long time after my surgery, off and on for Iritus infections.
You have to be real carefull with them.

I've noticed a lot of blurryness is now gone, since the rice baggy
and exressing my oils.

I'm hoping that in a few months, when I go on vacation to Alaska
its even better.