How Do I know if oil is being expressed?

[MyDryEyes]

Hi All,

I was recently diagnosed with MGD and was told that my glands are pretty much all blocked. Yikes! (FYI - my dry eyes were induced by laser surgery. I suspect that I had mild to moderate problems with dryness prior and that the surgery made it 150% worse). According to my new doctor, warm compresses are not helping to release the oil.

I am not sure that any oil is coming out after the compress/lid expression (I am using Dr. L.'s method).

My vision is blurry after the compress and my eyes feel better, but it clears almost immediately. When I do the lid expression, it seems that nothing comes out. I get no oily sensation that many of you speak of.

Perhaps the blurred vision is just caused by the heat of the warm compress on my corneas?

I am a bit concerned that the compress is doing more harm than good. I am clearly very inflammed at this point.

Also, I have been reading a few posts about atrophied MG's and I am just wondering how one makes the determination that this is the issue. I hope this isn't my issue - my MGD diagnosis is new, but I often wonder how long my MG's have been dysfunctional given that I was having contact lens intolerance for a few years prior to my surgery (and clueless that it was dry eyes!! No mention by my eye doc either).

Thanks for your input.

MDE

[Rebecca Petris]

My vision is blurry after the compress and my eyes feel better, but it clears almost immediately. When I do the lid expression, it seems that nothing comes out. I get no oily sensation that many of you speak of.

Perhaps the blurred vision is just caused by the heat of the warm compress on my corneas?

Oil, heat or weight or a combination can do it.

I am a bit concerned that the compress is doing more harm than good. I am clearly very inflammed at this point.

If you think it may be contributing then I'd definitely back off.

Also, I have been reading a few posts about atrophied MG's and I am just wondering how one makes the determination that this is the issue.

It's a toughie. If I wanted to be quite sure I'd go to one of the experts that knows how to do meibography - or I'd print the instructions and take it to a smart and willing doc.

Personally I can't say I have any visible evidence of what's happening with my oil when I do compresses. I just know that if I leave off for long enough, I get worse and I start getting little lumps eventually in my upper lid margins.

[untkicker29]

I have have similar experiences as Rebecca when it comes to noticing what is going on with the oil in the meibomian glands when I do warm compresses. I do warm compresses twice a day and can't say I ever notice oil is secreting out of the glands, but if I lay off of the compresses even for just a couple days, I begin to notice the small lumps on my lid margins.

[Judy]

I'm the same way. If I do warm compresses nightly, my eyes tend to do better. If I let off (say for instance for 2 to 3 days on a weekend getaway), my eyes get redder and redder, dryer and dryer. So although I don't see the oil action from the warm compresses, I figure they must be helping!

[lorca]

When I do warm compresses, I don't notice any oils coming out either. No blurry vision or any changes. I went to my optometrist and asked him to check on my oil glands as I was scared they might have dropped out or atropied.

I did a warm compress in his office for 5 minutes using Rebecca's rice baggy and had him examine me afterwards under a slit-lamp. He was amazed as how easily the oils were coming out of the glands, even without putting much pressure when expressing them. He took some pictures of what he saw under the slit-lamp and showed them to me on his computer. I was relieved!

Only 3 weeks ago, he couldn't get anything out of most of them and when something was expressed, it was this gross yellow stuff. I had started doxycycline 3 weeks ago and it seems to be working! He is confident that things will get better and we will reevaluate at the 3 month mark of doxycylline.

[MyDryEyes]

[QUOTE=Rebecca Petris;29835]If I wanted to be quite sure I'd go to one of the experts that knows how to do meibography - or I'd print the instructions and take it to a smart and willing doc.

QUOTE]

Who are the experts and where are the instructions on how to do a meibography?

[jads]

When I do warm compresses, I don't notice any oils coming out either. No blurry vision or any changes. I went to my optometrist and asked him to check on my oil glands as I was scared they might have dropped out or atropied.

More often than not I notice that after using a compress for 5-10 minutes, when I then lightly massage along the top lid margin and upper eyelid, the tip of my index finger gets wet from what I presume is the oil flowing out.

Try it and see.

[Rebecca Petris]

Who are the experts and where are the instructions on how to do a meibography?

Sorry MDE - I missed this one.

Here's a couple of links:

http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract

http://www.revoptom.com/index.asp?page=2_786.htm