MGD/Debris in tear film/Red veins in eyes

[sleek822]

Hi I live in New Zealand and I was diagnosed with blepharitis/MGD/dry eye 8 years ago, and have regularly visited this site. I think the dry eye came from using Accutane the previous year. Last year my eye specialist said I had debris in the tear film. I believe this to be demodex brevis. No eye specialists I talk to agree with me when I say I suspect demodex mites or even ocular rosacea.
I dont have any discomfort, but what really troubles me is the red veins (neovascularization of the conjunctiva). They have gradually covered more and more of my eyes over the years.
I have tried so many things but nothing seems to work . Some things seem to help such as TheraTears Nutrition (3 capsules daily), NAC (375mg daily), and Sterilid (after the irritation subsides which can take a couple of days).
Ive been wanting to try Lipiflow. I dont know if any of my glands are atrophied. It is so hard to find any specialists that are familiar enough with this subject. Ive heard that Lipiflow can make the eyes whiter.
Ive also looked into eye-whitening surgery by Dr Kim or Dr Boxer Wachler. But this wouldnt fix the underlying problem, so I fear the problem would just come back.
I've appreciated all the posts everyone has made, so we can all learn a lot more about this disease.

[hankm9]

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[sleek822]

thanks hankm9
i just saw on your demodex forum you were going to a doctor to have Dr McKellar's technique done. Hope you have some success there.
I may go see him soon. I emailed him asking him if he has a way for testing for mites, but I havent heard from him.
One other thing I get with my blepharitis is white stringy mucus in the corner of my eyes every day. I never have "solidified" sleep.
Tonight I came across this post from AprilShowers (May 2012) -
Well this past week something happened. All of a sudden my eyes were clear, no slime, at all. Even when I wake up in the morning. Well I started taking these vitamins for the hair, seemed like my eyes cleared up two days later. So I read the ingredients, I notice they had silica in them so did some research and found where it says silica stops the production of excess mucous in your body. So I went to the store and got another bottle of just silica and added that to list of other vits. I have not had any white stringy mucous in my eyes since. First time in 15 yrs. Seems like your body requires this.
It made me think of the NAC that Im taking that helps somewhat with making my eyes clearer so there's less hyperemia. (Doesnt get rid of the veins but does give the conjunctiva a clearer, wetter appearance). NAC is a mucolytic so thins the mucus.

[hankm9]

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[MeibomianGlandman]

Well Sleek What you need is a video meibography this should tell you about the atrophy of the glands, I had one done at the university of Iowa Eye Institute in The United States. They have new machines to do this in Japan now, but it hasn't quite made a trend among doctors right at the moment I think the company name is Topcon Medical. As for Demodex, I have done a lot of research on said subject and I do believe that these mites are a symptom of a underlying condition. Such as yeast or bacterial overgrowth especially seborrheic dermatitis. However I have done much research on the subject and discovered that demodex are put at bay when you use the Eyelid foam, from thera tears, when I visited the clinic in St Louis I had a culture done for demodex and she said that the demodex were all dead or gone. I wondered how is this possible, When I looked at the eyelid foam I was using it contained small amount of Tea Tree oil. I know that one famous doctor proved in clinical trials that this killed demodex. However I also learned that tea tree oil is toxic to the eye, so its not advised to put it in the eye or near it. I did discover however that these little mites food source is oil, now the question is, how does one kill a mite that eats oil? You give them more food than they can handle. I have heard the success stories of how people discovered this fact with the new eye drop called restasis For some reason they drown in the castor oils, I know that Oil lubricates the skin and locks in the moisture getting rid of dry skin and infection much like the body does on its own thus getting rid of a food source for those pesky demodex. I have tried castor and jojoba oil for moisturizing the skin on my eyelids, it seems to help, But I make sure I don't get it in my eyes that's the most important part. I believe that if it were possible if they could make these oils sterile to use in this area, just globing it on with the eyes clothed would do the Job, all demodex would suffocate in the oil. Since your not using Tea Tree Oil, its not harmful to the skin or eye, but it has to be sterile. I mean they have demonstrated this theory with crickets too, for some reason the little critters can't breathe submerged in oil. I would consult with your dermatologist about this however though it should help.

[sleek822]

thanks MeibomianGlandman and hankm9 for your informative posts.
ive used TheraTears Sterillid from time to time, since 2007. The next day after using it the whites of the eyes are a little shinier, but sometimes new permanent veins appear from it which worries me.I find its very easy for it to irritate the eyes, even though I try really hard to keep lids closed when applying it. But I know the tea tree is instrumental in removing the debris (demodex?) I asked Dr McKellar about demodex, and he said he was not aware of any cases of it in New Zealand. After several years of looking for it, he has given up. I also asked him about rosacea. He says Rosacea is a much easier disease to diagnose. It can simply be done clinically.
Regarding Lipiflow stabilizing the tear film (perhaps repairing the damage from Accutane?), his feeling and the feeling of many of his colleagues is that it is likely to be unhelpful. It doesn't in itself make a diagnosis. This is best performed by someone familiar with lid margin disease. Although the results seem very promising it is likely that people with moderate to severe lid changes will do much better with manual expression of the meibomian glands.

[sleek822]

Yes I would like to go see Dr McKellar. Since hes in the south island and im in the north, he was concerned it was a long way for me to travel, and he recommended two other doctors that were closer, but hes the only doctor that performs the meibomian expressions. So I will try book in with him soon.

[MeibomianGlandman]

Sounds Like a Great Start Sleek, Its always best to go to the Experts first, than to waste time with someone who cant help Keep me informed of your Progress