Meibomian gland expression: maintenance or murder?

[irish eyes]

Michael

Are you still having IPL treatments or are you staying with the gland expression? I haven't done anything with my lids for a few days - not since reading the article anyway. I had been thinking of Lipiflow because it's available in UK but might leave it a while longer to see how my lids go on.

[sazy123]

This article really confirmed everything ive been thinking about my MG's for years. Alot of us have reduced production of oil not blocked glands. DR L once said to have MGD one must have blocked glands, not true, I dont and Dr T confirmed it, 90% open.

First, not all meibomian gland problems are due to blockage of the orifices. If the glands are simply under-producing oils (a common problem in peri-menopausal women) pushing on them won't do anything. If the lid margin inflammation is not under control and the orifices are tightly blocked, oils may not express even with hard pressure. So the treatment is not helpful. But secondly, self-expression can be harmful.

Also, if lack of oil is common among peri menopausal that makes sense because ive been having irregular periods last few years and possibly have PCOS.

This explains why IPL didnt help me despite helping MOST young people, and why hot compresses never improved it either.

[sazy123]

The article does say that lack oil due to hormones produces inflammed eyelid margins which further reduces the quanity and quality of oil. Do you have red inner eyelid margins? this is easy to see. I think this is the case for me.

[Michael2]

So you think maybe you have a lack of oil in general...that, in turn, produced the inflammation- hence your MGD. And now, even though your glands are more healthy, the problem isn't solved. That makes the most sense.

When you got IPL, did you notice any difference? If you did, that would probably be a sign that the lack of oil is your biggest culprit. I think its good this article came out because the only way we can each get better is by getting the EXACT right diagnosis.

[Anthony16]

This article really confirmed everything ive been thinking about my MG's for years. Alot of us have reduced production of oil not blocked glands. DR L once said to have MGD one must have blocked glands, not true, I dont and Dr T confirmed it, 90% open.

Really?90% open?wow.
`i was thinking i had a similar problem like that due to accutane but Dr Latkany confirmed my secretions were very thick,plus ocular rosacea so i guess they must be clogged.
Did Dr T manage to secrete clear fluid from your glands?
I really believe this disease is not well understood
A

[dijon84]

Thanks very much for this Rebecca. I am wondering if this applies to me. I am going to see my optometrist on Tuesday so will show him the article to discuss (this optometrist seems clued up about MGD, bleph and dry eyes). Thinking back to all the appointments with health professionals over the past 8 months, I don't think any one has recommended massage for me. It's just something I found out online that can help with the blepharitis.
My eyelids don't have the same appearance as many of the MGD / blocked gland images online (lots of yellow or white dots). There are thin red lines just above the lash line on the lower eyelids (they run inwards to the eyes), and the tarsal plate region is red in both lower eyelids.
Thanks
Dave

[sazy123]

Yes my secretions are very thick also, DR T confirmed this, and when i press on my eyelid I get thick oil come out (causes some bluring), but glands are mostly open- which is why i think the glands are dysfunctional due to inflammation and not producing enough quanity or quality of oil like the article says. I do think that the inflammation turns off the oil prduction as well as disrupting the quality, otherwise people would have really swollen eyelids with all that oil that can't get out. Where did the oil go? The glands must not be making enough. When you have alot of inflammation preventing the oil from getting to the surface (as i do) hot compression and IPL wont help because the inflammation is blocking it. Thats why IPL and Hot compresses didnt help me because they help remove the blockage so the oil can flow. IPL will treat outer lid inflammation- which may be causing inflammation in the gland, but it wont treat inner eyelid inflammation- which is my problem.

In essence, my glands were 90% open before starting IPL (not much visible evidence of caps/blockage), but with thick secretions. IPL did not resolve the inner eyelid inflammation (conjuctivitis) which is causing the thick secretions and low production of oil, so it did not help me.

I may lack oil which is causing eyelid inflammation - and the inflammation in turns causes lack of quanity and quality of oil.

Its confusing, but I know that when i have another health issue going on- the inner eyelid inflammation goes away and my eyes feel great, my tear film looks alot thicker as well.

[Anthony16]

Personally,i think that inflammation causes the secretions to become thick(though im just guessing).I think warm compress/massage would work way better for lots of people if they could get their inflammation under control(from allergies,rosacea etc)

Lack of oil,im not sure about.If all glands were open and only a small quantity of clear(non thick) oil comes out then maybe.
To be fair,i dont think doctors are fully sure of this either

Yes my secretions are very thick also, DR T confirmed this, and when i press on my eyelid I get thick oil come out (causes some bluring), but glands are mostly open- which is why i think the glands are dysfunctional due to inflammation and not producing enough quanity or quality of oil like the article says. I do think that the inflammation turns off the oil prduction as well as disrupting the quality, otherwise people would have really swollen eyelids with all that oil that can't get out. Where did the oil go? The glands must not be making enough. When you have alot of inflammation preventing the oil from getting to the surface (as i do) hot compression and IPL wont help because the inflammation is blocking it. Thats why IPL and Hot compresses didnt help me because they help remove the blockage so the oil can flow. IPL will treat outer lid inflammation- which may be causing inflammation in the gland, but it wont treat inner eyelid inflammation- which is my problem.

In essence, my glands were 90% open before starting IPL (not much visible evidence of caps/blockage), but with thick secretions. IPL did not resolve the inner eyelid inflammation (conjuctivitis) which is causing the thick secretions and low production of oil, so it did not help me.

I may lack oil which is causing eyelid inflammation - and the inflammation in turns causes lack of quanity and quality of oil.

Its confusing, but I know that when i have another health issue going on- the inner eyelid inflammation goes away and my eyes feel great, my tear film looks alot thicker as well.

[gilligan_1434]

I've noticed that my pillow does wonders in this regard. The eye that is down on the pillow when side-sleeping feels amazing after a few hours rest. Actually, the glands in the outside corners of my eyes seem to be the champs that do the all the work. I wonder if gentle pressure all night helps them produce more or just expresses them. Have any other side-sleepers noticed this?

[Guest]

I've noticed that my pillow does wonders in this regard. The eye that is down on the pillow when side-sleeping feels amazing after a few hours rest. Actually, the glands in the outside corners of my eyes seem to be the champs that do the all the work. I wonder if gentle pressure all night helps them produce more or just expresses them. Have any other side-sleepers noticed this?

Yup.. totally noticed this difference - the eye against the pillow is always more moist compared to the eye that's on the outside. If I switch sides, it still works... so something about being against the pillow is helping. Makes me think I might sleep with my eyes a tiny a bit open and maybe the pillow squishes that eye shut a bit? (On that note, tried tranquileyes goggles for a few months ages ago and they didn't help... thought maybe they'd make the outside eye feel the same as the one against the pillow, but no such luck...I currently sleep with a plain eye mask, just because I've grown to love the complete darkness it provides after sunrise)

[Colin P]

SAAG, could this be due to Heat, as in your side of face against pillow where as the other side of face at room temp.
Ive noticed in other circumstances that heat, like well fitting sunglasses (retains my own body heat) against cold outdoor air helps me a lot.
As does Hot sunny days, warmer air carries more moisture. So maybe it could be down to Heat/warmth..

[Guest]

Hmmm... that's something I hadn't considered... maybe I'll try those heated inserts that go into the tranquileyes goggles... wonder if that might help...

[Colin P]

Dont try this one at home kids!!......
.................................................
SAAG maybe sleeping face down into pillow all night may help? ..


Only joking of course i hope the warm inserts help...

[Guest]

Dont try this one at home kids!!......
.................................................
SAAG maybe sleeping face down into pillow all night may help? ..


Only joking of course i hope the warm inserts help...

LOL... errr, let's refine your idea... maybe I ought to try sleeping face down on one of those massage tables... that way at least I could breathe

[Colin P]

Or maybe invest in one of these-LOL... (also available in Pink)...