Just diagnosed with MGD

[villfan22]

Hi,

I have been looking at the forum posts for a few months now and thought it is about time I got involved, it goes without saying, this forum has provided me with a wealth of information, and I am grateful to Rebecca and Co for it's existence.

I'm Matthew, 30 yrs old and first started having problems about five years ago when i developed viral conjunctivitis. For a year after that i was dogged with sore, gritty eyes and after numerous visits to the eye docs I was given Patonol and packed on my way. I can't remember exact details but I used the Patanol and artificial tears for a year or so and thing improved to the point I stopped thinking about my eyes and stopped the meds and artificial tears.

Fast forward to now and following Christmas 2011 I became aware of my eyes again with the gritty feeling and redness. After trying to self medicate with artificial tears again, I popped into the local eye casualty and saw a eye doc who proclaimed, "you have dry eyes, take some artificial tears", ...cheers mate!

Having found this forum I now know we can break this 'diagnosis' down somewhat and try and be more specific. Having found no further improvement with artificial tears, I went to my GP who has referred me a Consultant at the same hospital. Currently on week 8 of 24 of his waiting list! Got to love the NHS, I actually work in the NHS as well, so can appreciate the constraints we have to work with and also the frustration of patients waiting. For the reasons i'll outline I intend not to line this guys pockets with a private appointment.

Decided to see an optometrist yesterday who at least gave a more specific diagnosis. He basically said my tear film is a little poor, with the lower part of the eye breaking up too soon, around the 6 second mark. He saw a few blocked glands on my worst eye, less on my better eye. Having read around the topic I would say this fits into my symptoms. No much sign of Bleph either, but he could not rule it out.

So, starting today, this is my treatment regime I am about to embark on and would appreciate some advice:

1. Eat Better. This has coincided with a period of poor diet, after my last episode a few years ago, I got relatively fit and I wonder if that contributed to the healing.

2. Exercise more.

3. Fish oil and Flax oil daily. 3000mg fish, 2000mg flax, Holland and Barrett.

4. Dr Latkany home spa (daily? twice daily?). I have flirted with doing this for the past few months, have got a commercial rice bag. done it for a couple of days then jacked it in, but now appreciate that isn't going to do much! How long and what frequency?

5. Humidifer. looking into this, i get dry eyes at night so need to look into night eye protection as well.

6. Adopt a positive outlook! This has been a bit of a preoccupation over the past few months, bordering on the obsessive. I need to be a better father to my two little girls (3yrs and 7 months) and a better husband to my wife (who incidently, doesn't quite get whats going on). So i hope 1-5 above gets me somewhere along the way.

So, I'm hoping, by the time I get to see the hospital consultant, by adopting the above, things will have improved. If not, at least i can tell him what i have tried and look for a more agressive therapy.

Thanks in advance,
Matthew

Small addendum...forgot to mention also use artifical tears regularily. Up to now i have had a strange wanting to try and use them as sparingly as possible. But I will try and use them at least four times a day to start, with the hope of reducing frequency when (hopefully!) things improve. Currently using blink intensive PF.

[dijon84]

Hi there and welcome. Hope me you and HYPERHEAD (Mario) can meet up soon to have a chat, as we're all in Cardiff / South Wales. What you say in 1-5 sounds like a good plan. I started off doing the MGD eyebag twice a day for 10 minutes - possibly thats ok for the first week or two, but should go down to once a day or less frequently after that. I carried on doing it twice a day for months - too much I think. I've found it is important to do a little bit of massage straight after the eye bag to help the MGD. Alot of people recommend the massage solely next to the eyelashes. I have found it more helpful to do a massage of a larger area of the eyelids. Something like in the video below, although I don't move my fingers over the eyelids like that. I just put my finger in one place on the eyelid, then move my finger around but do it with the skin - the finger is not moving over the skin. Then pick my finger up and do the same thing in an adjacent place on the eyelid etc. Shouldn't take more than 30s to 1 minute.
http://www.bupa.co.uk/individuals/he...ids-transcript

When you do this, I would say become more aware of how your eyes feel and look - your eyes will tell you if you're doing heat/massage too much or not enough. I wrote a post about an 'eye diary' recently - I've found this helps to find out what works / what doesn't.

You will want to be aware of this post about overdoing massage / expression
http://www.dryeyezone.com/talk/showt...ghlight=sandra

Cheers
Dave

[villfan22]

Hi and thanks for the welcome.

Just coming up to a week now and fingers crossed I think I have noticed some improvement. It is slightly subjective, but I do a DIY TBUT test by trying not to blink and seeing how long it takes for me to feel my eyes. Before I started, I was around 4-6 seconds and I'm now up to 5-8 depending on what time of the day, so hopefully heading in the right direction. Another week of twice a day and then i'll reasses. I'd rather (not do the eye bag at all of course!) not do it twice a day long term as it is a bit of a faff, would be great to get down to 2/3 times a week, but we'll see.

Have been massaging as per your suggestions as well after the heat. Trying not to overdo it as per the article, once you get into teritory such as cotton buds and pressing hard I think that might be pushing it a little to far, each to their own.

If I don't get full relief from another week or two, I'm half tempted to get my GP to prescribe some systemic antibiotics, which seems the second stage treatment. The other thing they might try is topical antibiotics, but to be honest I have been messing / poking my eyes for the past five months and probably not done them any good. At a preference, i'd rather pop a pill and see what happens than smeer more gunk on my eyes! What I want and what I get will depend on which GP I see no doubt!

In any case, I'm eating well and exercising as well so, hopefully that will have an affect at some point down the line.

Cheers,
Matt

[dijon84]

Hi
Glad you've seen some improvement. Just wanted to add my experience of what it felt like when I first did the massage as I described. I had been doing the eyebag without massage for several months. When I added in the massage after, my eyes felt really 'gooey', but not necessarily in a good way. It felt like some bad substance had been put in my eye and there was an unusual burning sensation. I really think what my eyes felt like aligned with what physically happened. I think my MGs were a bit clogged and the oil had stagnated, and the oil changes composition when it does this. So the clogged oil was loosened up by the heat then massage and seeped out into the eye. This clogged oil would effectively be toxic to the eye, which explains the burning sensation. Have you had any experience like this?
What you say about the GP - could be a good idea, although I don't really know.
Dave

[villfan22]

Hi,
I cant honestly say my eyes feel much better in the immediate aftermath of heat/massage, just a lot redder! What you say seems a fair point, that some of the poor quality oils get expressed onto the ocular surface and hence might sting a little. Some of the heat / massage techniques suggest emptying a vial of a artfifical tears into your eyes afterwards to wash all the crud out. This is what i do.

Into the second week of twice a day heat/massage, not sure if it is doing all that but will stick with it for another week.

[HYPERHEAD]

Hi dave and villa fan..


Trouble is with this condition it's so up and down..one day you feel great and the next day you can feel awful!

I have also become obsessive over curing this condition due to its severity and slow improvements...I use drops but over time find they make my eyes more swollen and red,heat also makes my lids very red and swollen ,and inflammation is now causing lashes to fallout

Right now my eyes are ok but I have a burning sensation in them lately maybe due to the mucus thinning caused by the NAC supplements which is releasing toxic oils into the eyes. I honestly think the only effective treatment for decent tearfilm is heat and massaging the lids, but then my lids get red and causes an inflammatory response which then causes further problems with meimobiam glands.

I'm finding that all these lids scrubs are just to harsh to the eyes over continued use and really irritate my delicate eyes...I'm just thinking of using saline or bicarb soda to see if that more soothing to the eyes. I miss My eyes feeling good and not looking red

[HYPERHEAD]

Dave how's it going with the NAC ..have you noticed and improvements as I noticed changes within a couple of days...looks like you had a good time at Coldplay concert

Right now my eyeballs feel greasy and hot !,

[villfan22]

Hi Hyper,

I'll agree with the Ups and Downs, Yesterday my eyes were ruined after a good nights sleep and drinking plenty of water, eating well. Today, after a few tins last night watching the Jubilee concert and a broken sleep, only one eye drop required at lunch time. Don't get it at all.

Hyper, have you thought about Doxy anti-biotics? My limited research says that they dish them out like sweeties in the US, putting them into packs with lid scrubs for managing MGD. I'm going to ask my GP for a script for this but am prepared for a barrage of hostility! So will go prepared!

[dijon84]

villfan - yes, my eyes probably don't feel 'better' straight after the compress / massage. Pay attention to how your eyes feel during and after, then you will be able to identify if there is too much / too little heat, and if the massages are too gentle / too irritating. The ups and downs are unpredictable. I may have mentioned the eye diary I have started (I talked about it in another forum post) - it can help identify causes of bad days / good days over time. I'm tempted to do what you mention about asking the GP for doxy antibiotics. MGD is one of my main problems I think so doxy would hopefully help. I definitely spotted some white residue coming out of one of the glands last night.

Mario - I've just taken 150mg NAC and 500mg sustained release Vitamin C for the 4th day. My eyes feel a bit greasy but that sensation is preferrable to the grittiness I was feeling. Yesterday I was getting much less grittiness than usual - my eyes haven't felt so normal for a long time. Unsurprisingly, yesterday I wasn't getting the mucus balls build up in the inner corner of the eye. But I will keep tabs on how I feel as I don't want to take too much NAC. And the Coldplay concert was great!

[Jenn1]

Is meibomian liquid supposed to be clear in colour or white?

[littlemermaid]

Healthy meibom is clear, like tiny dots of baby oil along the eyelid margin. Problem meibom is whitish - what are you seeing?

[villfan22]

Hi, it's been a while since i posted so here is a update. Good days, bad days sums it up. Currently week 20 of 24 waiting to see a consultant! I have slacked off the warm compresses recently and i think i'm paying for it now. Today, my left eye has been burning all day, not my right, not sure how that can be. Went to my GP and having read about Doxycycline I asked for it and to my surprise he gave it to me. 50mg a day, is that about right? Going to get back on the massage as well as the heat, along with the doxycycline, hopefully there is light at the end of the tunell as today has been emotionally challenging! trying to keep positive but as most will know, its hard.