Jonathan, 29 years old : MGD causing evaporative dry eyes

[soundjona]

Hi all,

I'm Jonathan, 29 years old, software engineer from Belgium.

I have MGD with one eyelid more advance than other (50% completely disappeared on one, ~20% on others). I have recently started to have symptoms since June. It started with a foreign body in the corner of the eye, then it started to itch, then it was like someone had fun stabbing needles in my eyes. Fortunately, I already took an appointment with the first symptoms and when it really worsen, I had 3 IPL sessions (100€/each). It did not helped a lot, or I should say it didn't help at all, all my shutdown glands are totally blocked. My eye doctor adviced me to try the Lipiflow (410€ here) since I have a really good tear production, and it's clearly an evaporative tears from that MGD.

I also talked to my general doctor, which funny enough helped me more than my eye doctor, since he gave me directly corticoid eye drop for one week which shutdown all the pain and after that, with good hygiene and warm compress, I succeed to not let the symptoms come back as hard. He also find that I had a lot of little chalazion (multiple on lower lid) and gave me Zinc to try to improve my condition since I tend to have acnea and he said that Zinc can help to improve the sebum

In the mean times, since I was very afraid of the pain that quickly started to increase week after week, I started to auto-medicate, which I know isn't the smartest idea, but I can't stay inactive, since I feel like doctors are too rushed to really listen to you and your eating regiment, etc. I tried :
1. Anti-histamine eye drop : Too little effect. I'm allergic to mites, dust, trees and grass, so I thought my eyes could get helped from them, not really. It doesn't do much. I tried two different brands but no effect.
2. Anti-biotic : Tried tobradex & fusidic acid. Tobradex didn't do much, but fusidic REALLY helped to reduce symptoms.
3. Hypochlorous acid : Don't help much, I don't have lot of inflammation strangely, my pain is more "sharped" and "acute", I don't have any red eye. I however continue to use it since it's very soft on skin and it seems to protect from bad bacteria.
4. Supplements : I took omega 3 since 2 years, so I can't say it helps me a lot, I just increased my intake to ~10gr fish oil per day (~6g EPA/DHA), but it doesn't change much. However I suspect some Omega 6 (borrage oil) combined with fish oil helps a bit more. I also tried Omega 7 and anti-oxyidant like Astaxanthine/Lutein, but no real results. I started taking Zinc as my doctor adviced me and it seems to help
5. Warm Compress : THIS HELPS ME THE MOST. Since my problem is oil thickening and blocking my glands, it's logic. Cold Compress on the other end really hurts me few hours after, so I've stopped them completely. Combined with blinking exercise, I really start to be able to unblock my glands, but it blocks quite quickly afterward.
6. Green Tea + Lemon : Holy cow that really helped the first few days ! I read a story on the internet about a woman that was helped by it, and tried it. After the few days, the pain came back a little, but I can clearly see that the day I drink Green Tea + Lemon, my condition really really improves. After some research, I concluded that my diet right now may be healthy (no processed food, no sugar, good fat ...) but I don't eat a lot of source of poly-phenol neither vitamine C (I eat vegetables but the dosage is low compared to green tea). So Green Tea + Lemon is a good thing to add in my diet in my case.
7. Hygiene with sterile gel : Really helps me after warm compress to clear the mess
8. Eye Bath : Really appeasing and when I have white discharge blocked behind my lids, it helps me to reduce the foreign body symptoms
9. Blue Filter / 20-20-20 : No effect. It helps me to have less tired eyes, but it doesn't correlated with less pain from dry eyes.
10. Sleep helps a lot (specially for mood, days I'm tired my MGD really depressed me to the point I could cry, but with good sleeps I can handle it) but drinking more water just a little.

Even if Lipiflow has bad reviews from people I read on the internet, I'm confident it has some chances to helps me since it could get me a little help to try to recover some glands (I read on the internet the two opposites : lost glands can't come back, and lost glands are sometimes coming back, so I take the chances, even if it costs) and afterwards to keep them safe by continuing to take care of them + trying to finally find what's causing that blockages ... I don't think it's normal to have so many little chalazion, but the eye doctor's assistant just told me to keep putting warm compress, so I guess that's what I'll do, but the next time I see him in face, I'll tell him.

Thank you a lot for the numerous posts I've already read on that forum and specially to the Lemon/Green-Tea advocate

[bcn90]

Hi Jonathan! You are lucky you still have some glands left, you should try the lipiflow every 6 months and and see in the meibography if there is some improvement,
I cant believe i paid 700 eur in Spain for a lipiflow, for me it was too late and didnt feel ant better, I tried optima IPL from dr toyos and works well, but the key is if they use the high frequency, if its low its a waste of money and time. My story is similar to you, during the quarantine i just wanted to sleep a lot, and crying a lot during the day, you feel alone like nobody understand you, Now Im better as my cornea is almost recovered, Im doing the Endoret plasma drops. Take care!

[soundjona]

A tiny follow up :

Condition is improving step by step, very slowly, but it's more and more under control.

I did the lipiflow, it unlocked quite a bit of oil since I had lot of discharge next hours and few days later I even had a gland that was a bit yellow and by massaging it a lot of yellow oil get out (size of a small bean). I also used this experience to "feel" how lipiflow worked. In the end, it's quite simple : 2 min of heating, then ~10min of pression by small pulse repeated ~3-5 seconds. I've tried to replicate that at home with a Warm Compress (10min) + Eye Massage Device (by pression, I found a product on amazon, I can link it even though I think lot would do the job) that apply pressure every 3-5 seconds. And indeed, I had hardened oil that get out by that way.

I feel like expressing glands are not really a question of "how hot" or "how hard" you manage to apply your compress. It looks that for me at least, small pressure and gentle warm (even though my girlfriend says my compress are very hot, I mesured them with a meter and they are ~45-50°) repeated a lot of time works better than "a big and single good pressure". It's just a bit slow (~20-25min to do all that cycle) but at least it unclog them !

I've also tried new eye drop which doesn't contain water, but "Perfluorohexyloctane" (EvoTears in Belgium made them), the feeling is a bit strange at first (you don't have the feeling of having hydrated eye) but my doctor seems to really like them so I gave them a try. They are quite effective when you understand what they achieve (creating a film over your tears to not allow them to evaporate) and what other applications that substance have (eye treatment after surgery, ...) but they still are quite "unorthodox" and I still alternate those with my Systane Ultra

All in all, like any chronic disease, I think it needs lot of care and understanding to be able to help. As I had migraine for about 15 years, I can clearly see how the process is quite similar. I just hope I won't need 15 years this time to manage ton control it

[Dog2012]

Dear Scoundjona Please give me link to eye Massage please?

[jack1988]

A tiny follow up :

Condition is improving step by step, very slowly, but it's more and more under control.

I did the lipiflow, it unlocked quite a bit of oil since I had lot of discharge next hours and few days later I even had a gland that was a bit yellow and by massaging it a lot of yellow oil get out (size of a small bean). I also used this experience to "feel" how lipiflow worked. In the end, it's quite simple : 2 min of heating, then ~10min of pression by small pulse repeated ~3-5 seconds. I've tried to replicate that at home with a Warm Compress (10min) + Eye Massage Device (by pression, I found a product on amazon, I can link it even though I think lot would do the job) that apply pressure every 3-5 seconds. And indeed, I had hardened oil that get out by that way.

I feel like expressing glands are not really a question of "how hot" or "how hard" you manage to apply your compress. It looks that for me at least, small pressure and gentle warm (even though my girlfriend says my compress are very hot, I mesured them with a meter and they are ~45-50°) repeated a lot of time works better than "a big and single good pressure". It's just a bit slow (~20-25min to do all that cycle) but at least it unclog them !

I've also tried new eye drop which doesn't contain water, but "Perfluorohexyloctane" (EvoTears in Belgium made them), the feeling is a bit strange at first (you don't have the feeling of having hydrated eye) but my doctor seems to really like them so I gave them a try. They are quite effective when you understand what they achieve (creating a film over your tears to not allow them to evaporate) and what other applications that substance have (eye treatment after surgery, ...) but they still are quite "unorthodox" and I still alternate those with my Systane Ultra

All in all, like any chronic disease, I think it needs lot of care and understanding to be able to help. As I had migraine for about 15 years, I can clearly see how the process is quite similar. I just hope I won't need 15 years this time to manage ton control it

This is a great write up. Can you please tell me which hot compress you use and how long you spend with it on your face? You said around 20 minutes? And after you use warm compress do you express with your fingers?

Also, what do you do at night?