My Story - Blepharitis & Allergies

[Marco-T]

Hi, I'm new to this forum so thought I'd post my first thread!

Im 24, male from UK.

Started having problems with my eyes around 4 years ago, it seemed to be when we moved house and converted the garage at this house into my bedroom.

The room was quite stuffy and near a main road and this is when I really started to notice my allergy. (Dust mite) The first eye doc I saw said the problem was allergies and gave me patanol drops. I tried these for quite a while, around 6 months! I noticed that fairly soon into the treatment my left eye started to feel better but my right never fully recovered...

Over the next few years I would have a battle trying to get to the bottom of what was the problem (it is worth saying at this point that some of this was due to my views and skepticism).

The next person I saw said I had MGD and told me to do the warm compresses, cleaning etc... So I did this for no more than a month, didnt notice much of an improvement and gave up!

Symptoms continued but in a more extreme fashion, e.g some days they would be fairly good and symptom free and other times they would awful! Not easy to deal with as a 22yr old when you want to take over the world!

I think a lot of people with MGD/bleph experience this flare of symptoms, it seemed like I could do nothing (no drops, compresses even allergy meds) and some days they would seem okay, but others wouldn't.

The most recent optometrist I saw explained to me that this is the nature of the condition, and the aim is to get rid of all the bad times and just have the good!

So up until recently my symptoms have been fairly prominent, e.g. at some point of every day at any severity I notice there is a problem.

There has been a steady improvement, which I also think is due to getting my allergy under control and aging. (Have generally had quite oily skin and I think this is one of the main causes of my MGD), which is now hopefully slowing down! I am now on my maintenance dose for allergy shots. I think allergies can worsen almost any other condition anyone has as it weakens your immune system and makes you feel crap! Some, such as dust mite and pollen are also notorious for affecting sinus and eyes.

Aaaanyway, this doc I saw recently took one look at them and said MGD (despite seeing someone at Moorfields in London for £200 and him saying that wasn't the problem... another wild goose chase!!)

He gave me some wise words, the main one being persistence!

I think where I stopped in the past was thinking that it was some sort of overnight cure, this, as many of you out there know isn't the case!

As im already waffling this is what has helped me:

• Warm compresses (Eye Bag) used for around 3 or 4 mins twice a day, once in morning, once at night.
• Eyelid clean at night, for this i used ocusoft. Find it is the most gentle one on my eyelid skin.
• Omega 3 oil supplement, not entirely sure how much this does and is also beneficial in other ways so may as well take it.
• Getting my allergies under control! Allergy proof bedding, antihistamines, (very recently) sinus rinsing, which has helped a lot especially with a congested feeling. Although this may have nothing to do with my eyes but there could be a link..
• Drinking water and exercising.

I know this is probably nothing you haven't heard before but I'm sure there are a few people out there who haven't stuck with it for long enough, please give it a go its worth it!

My eyes are now SO much better, I didnt suffer from redness too much but I had bad swelling, light sensitivity, tiredness and general irritation.

My right eye is still slightly symptomatic but I believe this is just a matter of time until it gets better.

However, there are a few questions I have about further treatment/prevention measures...

- Has anyone used azasite (tablets) to good effect? And can you get hold of these in UK?

- How long has it taken people to get the condition fully under control?

- Is MGP really as good as it sounds? I have read some encouraging posts on this... it is expensive and how long does it las for?

I hope this post has helped someone out there, I wish that I would have stuck at it for longer a few years ago. Although sometimes I feel if you have the condition when your'e younger then sometimes it needs to run its course if its due to hormones.

Thanks for reading and I welcome any questions. Marco

[littlemermaid]

I'm sure there are a few people out there who haven't stuck with it for long enough, please give it a go its worth it

Marco, I am so grateful for this. What you describe is pretty much what's happening to my daughter - persistence with the blepharitis treatments and attention to eliminating allergens and improving diet has brought us to a good point where she uses minimum steroid for control and self-manages just on saline eyedrops and careful warm compress and cleaning. Hormones (puberty) started this problem for the oily glands, but also reactivity to various chemicals and the products of various biota.

I think allergies can worsen almost any other condition anyone has as it weakens your immune system and makes you feel crap

Same. We're also getting quite serious viral flareup of eyes (also, interestingly, she has intracranial hypertension and we get flareup of that). So it's about the immune system and reactivity. As you say, eliminating allergens, getting fresh air and exercise - no flareups on holiday, I'm noticing!

We used topical Azyter ointment (Azithromycin) which has become available NHS (any probs, a doc can order it from Moorfields Pharmaceuticals). It cleared the MGs in 2/day x 3 days' careful use wiping along the eyelid margin rather than bunging straight on the surface (stung) and we continued 2 more days on 1/day. However, got nasty cherry red flareup under the lower eyelids which shows they weren't happy. But it did clear the MGs for a bit as required. I'm not seeing the point of using it more than pulse therapy.

We have been under control since we found His Holiness the Ophth who actually recognised mgd secondary to rosacea (not allergy, not bacterial conjunctivitis, not viral - misdiagnosed for 1y) - but in chronic steroid use, so we are looking at cyclosporine but need the base formulated.

Very good luck, and thanks so much for your encouraging experience.

[Marco-T]

Thanks for your reply, I am glad to hear she is getting it under control

I was wondering, on the road to her eyes getting better did she experience stinging and tearing?

I have experienced this quite a bit recently, it happens more on some days than others and I was thinking it may be related to my glands producing more/better quality oil again and it could be the oil that causes my eye to sting?

How it happens: I have a sensation to blink and the eyes feel irritated, if I dont blink and just leave them they sting then tear then after this has happened they feel good.

Its quite a weird feeling but hopefully its a sign of improvement.

Cheers, Marco.

[littlemermaid]

stinging and tearing

Yep, she does get stinging but when infected meibomian glands are pumping bacterial enzyme products which are burning the already stressed eye surface, then she gets damage to the cornea surface which takes a while to heal up and we have to use steroid eyedrops, possibly antibacterials, and frequent artificial tear, then taper off meds, keeping going with tear subs, to get back to a decent eye surface.

However, I guess everyone's different, especially if you haven't got a chalazia problem. Reflex tearing has to be good - we are happy to see it, whatever the circumstance, because she has been short of tears for years. And now, like you, reflex tearing seems to be improving.

Omega 3s: this is about altering the meibom to healthy, for us, so we have periods of not taking them - skin flares, too much diet oils eg salad dressing that day or oily fish. I think supplementing with these oils really works to improve meibom but it has to be part of healthy diet ie ditching the junk and processed fats. Flaxseed oil supplements are definitely inflammatory for her and she gets strange red/golden eye flares, not just meibomian - but fishoil is great. Some people are like that in their lipid metabolism.

If her eyes were stinging as you describe without infected MGs, we might be looking at allergies, environment, computer time etc. One problem has been that the eye surface has got so desensitised over the years that even though there is great improvement generally, she still has very little impulse to blink normally esp gaming or on computer or in dry environment - until the discomfort starts, like stinging or an inflammation feeling.

Do you think it's that? Otherwise, yes, maybe it's the consistency of the oils. Maybe tinker about with the oil supplement v diet thing and see if it helps. Do you think you're generally quite sebaceous?

[Marco-T]

Yep, she does get stinging but when infected meibomian glands are pumping bacterial enzyme products

Sorry not really sure what this bit means? :/

I have never really had chalazia or styes which is one of the reason that I didnt think MGD was a problem but it seems it has been!

Do you think it can be allergies if they just sting and tear and tend not to itch? When they do itch it tends to be in the corner of the eye and quite intense which does always make me think like its an allergy problem.. Sometimes I have used allergy drops to great effect in the short term but it is just that, so I guess both of them could be a problem. I remember reading somewhere that its not uncommon for people to have MGD/bleph and eye allergies.

Yeah I do think that the tear film is unstable for her could have something to do with that. Generally around the home my eyes feel pretty good and then I can go outside and the wind and sunlight can have a bad affect.

Do you know much about MGP?

Thanks for all your input so far

Marco.

[littlemermaid]

Do you know much about MGP?

No sorry. These guys might have a view http://www.centreforsight.com/ (thanks, Robster) if anyone's innovating with gadgets in the private sector. The key would be to get past the front desk to find someone who's qualified to give advice. I've read here docs are concerned probing damages the glands. Seems like you're thinking your mgd may be more allergic inflammation rather than chronic obstruction?

All Centre for Sight surgeons are fellowship trained in the Cornea

I don't know if they do NHS work in return for the NHS training they had. I always feel safer with a proper 24/7 state-of-the-art NHS teaching hospital.

Sorry, Marco, hopefully someone else will chat about MGP. Also, I think Pritzzy describes symptoms very like yours - maybe click on the name to read past posts.

[rach05]

Hi Marco.

How are you getting on now? You make some good points and i think you may be right. I think the fact we dont tear enough definitely makes us victims of allergies. I am a 25 yr old female and have quite similar symtoms to you.
This all started when i was 22 from wearing contact lenses. My right eye was so swollen i could hardly open it. I went to the optician who said i had an allergy and was given drops.... Didnt work so i was referred to the eye hospital. She said something about my glands in my eyes and gave me steroid drops. My eyes were extremely dry but i was never told to do anything else. I couldn't wear mascara, my eyes would burn and dry up. I was given celluvisc eye drops and left to it.

Over the years i have kept mascara off and got on with it. I went for an eye test last yr, again he said i had an allergy and after last time i was thinking pfft you're all the same its not an allergy so again ignored him.

But then in sept 2012 my eye started tearing ( very unusual for me) silly me thought my eyes might be getting better. My eyes were bloodshot, swollen and i felt really ill. Went back to my optician, he said allergy and mild belpharitis. Again i thought quit with the allergy! But that was the first time id been told about bleph and it made sense. I got opticrom drops from the doctors but didnt really help. I was also using hot compresses but this was makin my alot worse i dont know if this is because my eye is so inflamed. The skin under my eyes were red and sore with tiny bumps, nothing like i had before. Another doctor has now given me antibiotic drops and it seeems to be clearing.

Back to my point, my eyes are still watering every morning and i violently sneeze. I now think the optician was right about allergies and i think it could be dust mites. When i go on holiday i take antihistamines for prickily heat and guess what my eyes are alwaya good and i can even wear mascara? I hope i am right about dust mites being my problem. I am now on a mission .

Please let me know how you are getting on and any advice or inputs are much appreciated.