meibomian gland dropout?

[ajneedhams]

Hi Everyone!

I've posted here a few times- but mostly I've learned so much by reading everyone's posts. I have heard this term "meibomian gland dropout." Can someone explain it to me? My understanding of it is that it is the result of poor functioning glands over time. Can it never be reversed? Are the glands gone?

I have had dry eyes for 13 months now. It came on suddenly after an eye infection. I often have red irritated lid margins, burning eyes, and a dry but oily eye surface. Dr says it is ocular rosacea. I know I have meibomitis and I worry that instead of ever getting better- it can only get worse. Anyone know about this dropout phenomenon?

Amy

[DrG]

Hi Everyone!

I've posted here a few times- but mostly I've learned so much by reading everyone's posts. I have heard this term "meibomian gland dropout." Can someone explain it to me? My understanding of it is that it is the result of poor functioning glands over time. Can it never be reversed? Are the glands gone?

I have had dry eyes for 13 months now. It came on suddenly after an eye infection. I often have red irritated lid margins, burning eyes, and a dry but oily eye surface. Dr says it is ocular rosacea. I know I have meibomitis and I worry that instead of ever getting better- it can only get worse. Anyone know about this dropout phenomenon?

Amy

What can happen is that over time, chronic inflammation can take its toll in the form of shrinkage and scarring of the ducts. This has been documented. I would imagine that chronic inflammation of the gland itself could take its toll as well in the form of reduced or altered function.

Doxycycline is the standard treatment for ocular rosacea and meibomitis.

DrG

[Delilah]

Doxy for life?

I just have a question and I was wondering if people that suffer from MGD have to take Doxy for life? I have noticed a bit of change in the mucus discharge from my eyes, I am not sure if its the Doxy or the NAC or is it the combo? Anyways that is my question, people that suffer from this disorder,will we have to take Doxy for life? Thank you Dr. G. Delilah

[kkahthesea]

drop out

I was wondering that when you say "over time the ducts can shrink", how much time? weeks, months, or years?

[Rojzen]

even "dropout" is NOT a life sentence

I had dropout/atrophy and even metaplastia (abnormal skin) growing over the openings of my meibomians diagnosed about 10 years ago. I produce very little detectable meibum secretions to this day. I took doxycycline or tetracycline (mostly systemically and sometimes topically) for about 6 years, with little change resultling.

YET:

I am here to report that just as very low lacrimal function is not a perfect (or even reliable) index of how one feels, or even of tear film stability (one can have very unstable film with loads of tears), meibomian damage is not a reliable measure of how one will do, subjectively.

Dry eye is a multifactorial problem. What I've learned is that I, for one, seem to be able to make up for nearly zero meibomian function through treating my corneas with Dwelle.

Without any change in the condition of my meibomians, I brought my tear film break-up time from 0 seconds to more than 5 seconds, just by using Dwelle or FreshKote for 7 months, and sticking with it thereafter. (I also eliminated other non-high-oncotic pressure drops, and quit Restasis for good.) 5 seconds sounds pretty bad, for a TFBUT, but it is enough for me to feel nearly normal, and for me to put my moisture chambers away most of every day. This is probably because it isn't even my TFBUT that is determinative of how I feel. . .Possibly the improved condition of my corneas is the switch.

Objective findings by doctors are very important, yes, but not necessarily for purposes of predicting outcomes; not to mention that in some cases, atrophied meibomians, to the extent one may need them (and I'm not sure of the degree to which that is true), can be revived. This was done experimentally by Scheffer Tseng, M.D., Ph.D. (research scientist and ocular surface disease specialist) many years ago by use of retinoic acid. He found that application of retinoic acid on and inside the meibomian orifices seemed to change the way that gland-tissue DNA worked. This, in turn, sparked a regeneration of functional tissue. The Bascom Palmer medical library, in Miami, contains the journals that reported this finding.