Manuel expression of Meiombian glands by doctor

[autumnn]

Hi All- Has anyone had this done? I visited an opthamologist today (at the request of my primary physician- I prefer my dry eye specialist) who said that he could manuely express my glands. He stated that it can be a bit "barbaric" in terms of pain and bruising/swelling and can't guarantee it will help. He also did mention that he has clients to whom this helps a lot and for a year or more. I am of course wanting relief in my left eye but I dont want to take too desperate of measures. Does anyone have advice on this?

Also, this may sound like a dumb question but could this manuel expression make me lose my intracanicular (sp?) plugs?

[Teri]

Autumn,

I know that others have had this and will likely have interesting things to contribute to this discussion. Here's my two cents.

My eye doc has expressed my lower meibomian glands twice. He said the upper ones were too hard to get to. He also said a friend of his (well-known dry eye doc) expresses all the glands each time his dry eye patients come in and swears it helps.

My experience was like this: he went down the line and squeezed the glands between two q-tips and then swiped the eye lid clean with a moist q-tip. It was very uncomfortable -- I had to hold my eye open and look up and the squeezing with the q-tips pinches and hurts a bit.

The result: my eyes felt noticeably better for the rest of the day. Like I could hold my eye open for quite a while without it hurting or drying out and I didn't have the "thick" feeling I usually have. But my eye lids were irritated and uncomfortable. The effect was not lasting for me (< 24 hours), and I don't know if I'll ask him to do it again.

I don't know if there have been any studies into 1. how to express the glands well, 2. how often to do it, or 3. if you have to express the upper and lower both. My impression is that it would have to be done regularly for a period of time (like weekly for a few months?) to have any lasting effect. But that's just my wild guess.

It probably wouldn't hurt to try it! And I think that if your doc knows what he/she is doing, you won't lose a plug.

Teri

[HOSADOS]

Hi All- Has anyone had this done? I visited an opthamologist today (at the request of my primary physician- I prefer my dry eye specialist) who said that he could manuely express my glands. He stated that it can be a bit "barbaric" in terms of pain and bruising/swelling and can't guarantee it will help. He also did mention that he has clients to whom this helps a lot and for a year or more. I am of course wanting relief in my left eye but I dont want to take too desperate of measures. Does anyone have advice on this?

Also, this may sound like a dumb question but could this manuel expression make me lose my intracanicular (sp?) plugs?

My experience with this kind of services by specialst, is that it's usually more primitive than the the routine I suggested, and at least based on my limited encouters, rarely do they do it in the following way
So don't put your hope up and expect for miracles. Though if this work for you go for it ! I suggest you ask for some clarification on how exactly does his technique work.

I heard from a few specialist about this service, and at least in my situation I know that there is no way it would last for a year, nor for a month or a week, and that is regardless to the method used, since it's a chronic condition (maybe for some individual with a mild problem this might be the case, but personally I think that a one year promise is doubtful-but hey I'm no expert) I got the feeling they don't really understand it the way a patient does-only you could feel what is the best way to it, how frequent and to what extent. I also had many of them refuse to tell me how they do it- they wanted me to pay first and the to see...don't fall into this trap. If they have something unique they would be happy to tell you

Some people may find the technique I suggested for instant too complicated due to age, other diseases or any other limitation. It took me a while to get a hold on this and if you ask me it's doable. It's also a question of money. So for some people going to a specialist for that is a GREAT idea, but bear in mind that maintenance is a KEY and after he open it for you, it's always advisable to follow a daily routine (hygiene-i.e lidcare, some squeezing, etc)

There was a post here about a new patented technique by Paul Gilwit-you could call his office for any further explanation or assistance 954-772-9911

[HOSADOS]

Autumn,

I know that others have had this and will likely have interesting things to contribute to this discussion. Here's my two cents.

My eye doc has expressed my lower meibomian glands twice. He said the upper ones were too hard to get to. He also said a friend of his (well-known dry eye doc) expresses all the glands each time his dry eye patients come in and swears it helps.

My experience was like this: he went down the line and squeezed the glands between two q-tips and then swiped the eye lid clean with a moist q-tip. It was very uncomfortable -- I had to hold my eye open and look up and the squeezing with the q-tips pinches and hurts a bit.

The result: my eyes felt noticeably better for the rest of the day. Like I could hold my eye open for quite a while without it hurting or drying out and I didn't have the "thick" feeling I usually have. But my eye lids were irritated and uncomfortable. The effect was not lasting for me (< 24 hours), and I don't know if I'll ask him to do it again.

I don't know if there have been any studies into 1. how to express the glands well, 2. how often to do it, or 3. if you have to express the upper and lower both. My impression is that it would have to be done regularly for a period of time (like weekly for a few months?) to have any lasting effect. But that's just my wild guess.

It probably wouldn't hurt to try it! And I think that if your doc knows what he/she is doing, you won't lose a plug.

Teri

my take is that only you could know yourself best. Let me add additional 2 cents if you will usually MGD is chronic as the as suggested by its name 'dysfunction' that usually means that the quality of the oil being produced is poor, and this oil production is taking place continuously and it essential to the stability of your tear film and hence to the health of your eyes. If I take myself as an example in begining when it was much worst I did it 3-4 times a day, those days I find that doing it twice a day is mandatory, for me three times a day would be ideal but who has the time...in the worst case I don't see how you could avoid doing this routine at least once a day. Once you give it a fair trial and enjoy the benefit you would probably find a daily routine irresistible.

All Ophthamologists I saw, didn't realize how troubling my MGD is for me, and that MGD adverse the eyes in a matter of hours (when it's bad even less), from their questions and what they told, I got the impression they don't really get it- that was my personal experience, and I'm sure their specialist (I like the word) that have more insight into those kind of things-I guess those who are actually listening to their patients

[autumnn]

Thanks for the replies! Yeah, I am feeling a bit skeptical, especially since my regular eye doctor pointed out the my oil seems healthy and to flow freely with gentle pressure- why would I need all that force? I have no "capped" glands nor "toothpaste like" oil coming out. Plus, if I am increasing TBUT with time and compresses/scrubs maybe I should stick with that for a few more months at least. Apparantly, according to this eye doctor, the upper eye lids are difficult for a patient to express- hmmm, again, I dont know. Anyone who has had this done feel free to reply!

As far as the method- it would involve sticking a needle into the lids to numb them and then clamping them down with something and scrubbing the glands clean/expressing the oil forcefully- ouch!

[lboogie]

good grief! that sounds horrible...Autum, you've had lasik too right? I'd also a bit careful with too much messing around in there. But I guess the doc would know best.

[stella]

Try doing your own -- I do - every night
After heating take each lid seperately off the eye ball and pinch along the line of lid between finger and thumb
You can do this as gently or firmly as YOU wish

[Meebo]

My experience with this kind of services by specialst, is that it's usually more primitive than the the routine I suggested, and at least based on my limited encouters, rarely do they do it in the following way
So don't put your hope up and expect for miracles. Though if this work for you go for it ! I suggest you ask for some clarification on how exactly does his technique work.

I heard from a few specialist about this service, and at least in my situation I know that there is no way it would last for a year, nor for a month or a week, and that is regardless to the method used, since it's a chronic condition (maybe for some individual with a mild problem this might be the case, but personally I think that a one year promise is doubtful-but hey I'm no expert) I got the feeling they don't really understand it the way a patient does-only you could feel what is the best way to it, how frequent and to what extent. I also had many of them refuse to tell me how they do it- they wanted me to pay first and the to see...don't fall into this trap. If they have something unique they would be happy to tell you

Some people may find the technique I suggested for instant too complicated due to age, other diseases or any other limitation. It took me a while to get a hold on this and if you ask me it's doable. It's also a question of money. So for some people going to a specialist for that is a GREAT idea, but bear in mind that maintenance is a KEY and after he open it for you, it's always advisable to follow a daily routine (hygiene-i.e lidcare, some squeezing, etc)

There was a post here about a new patented technique by Paul Gilwit-you could call his office for any further explanation or assistance 954-772-9911

Are you positive the hyperlink you provided is the actual device that Dr. Gilwit patented? I did not find his name in the entire patent document.

Also, I have contacted his office. However, I am still not sure what the procedure endures.

[eva b]

Hi All- Has anyone had this done? I visited an opthamologist today (at the request of my primary physician- I prefer my dry eye specialist) who said that he could manuely express my glands. He stated that it can be a bit "barbaric" in terms of pain and bruising/swelling and can't guarantee it will help. He also did mention that he has clients to whom this helps a lot and for a year or more. I am of course wanting relief in my left eye but I dont want to take too desperate of measures. Does anyone have advice on this? Also, this may sound like a dumb question but could this manuel expression make me lose my intracanicular (sp?) plugs?

when I read your first post, my initial reaction was to say "go for it"...because I've experienced a lot of benefit as a result of my own optometrist (who has a special interest in MGD) manually expressing glands where I've had obvious blockages, and has prevented at least 2 or 3 cysts forming. It's not a pleasant experience, can be quite painful - but bearable - and you can always ask them to stop if it gets too much.

He only used his fingers and a tiny plastic spatula to press the surface of the eyelid, I hever had any bruising or anything afterwards, and the relief was marked - after the initial soreness (which lasts up to 24 hours) had gone away.

BUT...he never used any needles, anaesthetics (I can't tolerate anything at all going into my eyes) or other instruments, and only works to the limits of my tolerance.

My blockages seems to go in fits and starts...weeks will go by and things aren't too bad - then I have a week like this week where I've had to see him 3 times...but I think we've managed once again to avoid a chalazion forming.

On reading your last post, though, another big BUT comes up:

you say your fluid comes out nice and clear and you have to obvious blockages or white head...so why on earth would anyone think the glands needed to be expressed???

I would think long and hard about this.

In my own case, I just "know" when I've got a blockage...or I can actually see it...which is a very different scenario.

I wish you the very best of luck anyway.

Eva

[HOSADOS]

Are you positive the hyperlink you provided is the actual device that Dr. Gilwit patented? I did not find his name in the entire patent document.

Also, I have contacted his office. However, I am still not sure what the procedure endures.

To be honest - I don' t really know. I copy and pasted it from another post.
There should be a name attach to the patent.

It might be useful to search Paul Gilwit in the patent data base-I just did but with no luck, so it might still be pending.

What did they tell you ? did the describe the procedure vaguely ?