Scared to Express my lids now

[Katewest]

I have MGD and possible corneal neuralgia and have been expressing my top and lower eye lids daily. When i do I can see clear oil coming out some more than other days. If I don't for a few days I will get the little cists that i can scrape off with my nail. I have heard that its ok because the white part of your eye is not sensitive but then there are now studies saying expressing/massaging is bad? i dont do the hot compress not sure if that makes a difference. Just wondering what some thoughts are on this.

[NotADryEye]

I don't express. I leave the mg's alone as much as possible except for warm, not hot, compresses 2x per day, sometimes 3, for only 2 minutes. This warms and melts the meibum to help it flow. I used to get those little cists. Since probing a few times I haven't seen them at all.

Be careful. You don't want to cause trauma to the lid margin and you don't want to send meibum back into the back of the gland.

[Rebecca Petris]

Re lid massage / lid expressing

1) If you have a good doctor that you really trust, take what they say about it seriously, and follow their instructions for expressing carefully. If you're just winging it based on some youtube video... reconsider running it by a doc who's good with MGs, even if only for peace of mind
2) If it can't be accomplished gently & safely, it probably shouldn't be done by yourself at home. These are our eyes we're talking about. Some people get carried away trying to wrestle their MGs into submission. Having said that I know a lot of people who do exactly what you do
3) Don't believe everything you read on the internet, including obviously DEZ Got to weigh it all in context which is a hard job. There are a lot of authoritative sounding voices out there - these voices can be anything from anonymous individuals to "peer-reviewed studies" (and so often a study flatly contradicts another study... who's to know the ins and outs of it all?) and it's easy to be swayed. If you have a well reasoned gentle routine that has been working for you, don't let anybody scare you off it - especially when the end point is to coax you into an expensive treatment of some kind.

[Katewest]

Thanks! I tried to talk to Dr. Latkany and ask him to show me the right way because I am going on his Dry Eye Spa but he cryptically told me not to express. So I think I'll compromise and do it lightly in the am and thats it. I do think it helps.

[sighthound]

Katewest:
Are you seeing dr L again? I saw him 3 months ago and he had me show him how I was expressing. I was not doing it just right. You have to press right near the eyelid margin, because if you are too far from it, then you end up rolling the lid and just pressing the fat pad instead of the M glands. I am really curious why he did not show you how to do expressions. Can you email him since you live so far away from his office? Maybe he has a good reason not to express in your case. Maybe your oil is coming out easily enough with blinking, but only he can see that.

[Katewest]

I wonder why he told you to keep doing it? I think, again I dont know for sure, but I think he thought i was "thinking too much about my eyes". I will email him...good idea. Thanks! Do you find expressing helps and how often do you do it?

[sighthound]

Ask him to be very specific about why he did not want you to express your glands. My glands are in pretty bad shape, so he said that if I did nothing that they would all atrophy. I am also getting expressions done by an opt once a month. I plug up super-fast. Yes massaging lids is bad because you are rubbing the cornea. Expressing is just pressure. Dr L told me to do the compresses but then use a cool compress (not cold) for 30 seconds after the expression to bring down the eyelid inflammation. If I use cold compresses, then my lids swell. A weird reaction because I have rosacea.
Let us know what dr L says.

[hosanna13]

I express my lower eyelids daily. I see clear oil flowing out. I tried expressing my upper eyelids, but nothing ever comes out. Is that normal?