Gland expression without warm compresses

[redandunhappy]

Hi all,

Dr Latkany suggested that there might be a video available to watch which shows how best to do gland expression (without warm compresses).

Ideally I'd be able to do it without warming my eyes and without using a lid scrub (haven't found one which doesn't irritate my eyes yet - even Ocusoft seems to irritate), which is difficult because I don't want to drag my fingers over my eyes and pull the skin unnecessarily.

Can anyone post a link to a good video? Or tell me the best way to do gland expression...

Many thanks

[Royal Eyeness]

Dr. Latkany recommends that you DO NOT use a lid scrub or baby shampoo or anything else. You also don't have to use a hot compress first. He suggests for people who are sensitive (i.e., rosacea), that while you are in the shower, you keep your eyes closed with your face in the spray of water from the shower and let the hot or warm water hit your eyelids for awhile. Then, as soon as you get out of the shower and dry off, do your lid compressions. And you should be using a Q-Tip - not your fingertip - if you're doing it the way Dr. L prefers.

[redandunhappy]

Thanks so much for the suggestion - I remember it from Dr L's book.

But I can't do it as I usually take baths and not showers!

I might trying using shot glasses filled with water and letting the steam penetrate my eyelids.

However with both of the above methods, there is still heat involved, so not sure how different it really is from using warm compresses.

Re massage - do you know why he prefers Q tips to finger massage?
Also, how do you stop pulling the delicate skin around the eyes?

[Royal Eyeness]

I would skip the shot glass idea. Just hold a warm (not hot) compress briefly on the lid.
You are not rubbing your lid or yanking on it. You're simply pressing into it and the Q-Tip concentrates the pressure into a small area. So you press, release, press the next spot, release, press the next spot, release, and continue so you are making sort of a dotted line. You can't do that with your finger. I use a Q-Tip that I dampen with saline liquid - I find it more comfortable than a dry one. Saline, if it gets into your eye, does not bother your eye at all. Water does.

[redandunhappy]

Thanks Royal Eyeness.

I didn't realise we were supposed to do more of a pressing action, I've been told to do more of a sweeping action

Just looked at Dr L's book again and I see what you mean....so it's just below/above the eyelid margin and not on the whole eyelid (which I've been told to by opthamologists here).

Also, when you say hold a warm compress on the lid briefly - what do you mean by brief? one minute? Do you use a flannel or an eyebag?

[Royal Eyeness]

It's just below on the lower and just above on the upper lid. You are compressing the glands and they are not all over the place. It's like where you'd be putting on eye liner and the point is to press - to compress the glands.

If you are not sensitive, you'd hold the compress for 3-5 minutes. But some of us can't even tolerate the heat that long (I have rosacea and am too sensitive). So try it for just a minute. And since you're sensitive, don't make it hot - make it warm. And if you can't even do that, try the shower thing, and if you can't even do that, skip the compress. The idea of the heat is to soften the oil and gunk in the clogged glands so that it come out more easily.

But, again - per Dr. Latkany - do NOT use a lid scrub or soap or baby shampoo. That is simply more irritating. You really ought to re-read the chapter in his book, too, so you don't include steps that other doctors suggest that are, ultimately, a bad idea.

[redandunhappy]

thanks Royal Eyeness, your advice is much appreciated.

Just one point though...I'm not sure about the lower eyelid (perhaps someone can clarify), but in the upper eyelid, the meibomian glands do appear to be in much of the eyelid and not just by or on the eyelid margin.

see this diagram:

http://www.contactlens.org.nz/extra1.aspx

That's why I wonder whether it might make more sense to apply pressure on more of the top eyelid than just above the eyelid margin

As per this leaflet from Moorfields:
http://www.moorfields.ae/Libraries/E...epharitis.sflb

Although obviously all of their recommendations are not to be followed (baby shampoo etc)

[Royal Eyeness]

What I described, above, is how Dr. Latkany showed me how to do it. I wouldn't presume to guess at whether there is any reason to do it another way. That's all I can tell you.