Clogged glands could mean atrophy, if no meibography?

[MGD1701]

Hi
Just curious, is it correct to assume:
1) Dr can not detect glands status unless taking Meibography/images, right?
2) If so, clogged glands could also mean glands atrophy, since no oil secrets?


Grateful for any inputs. So curious to know. Thanks!

[PhoenixEyes]

I was told by my cornea specialist that "all" my lower glands had dropped out/atrophied. I freaked out and wanted proof so I had a meibography done. It showed that most, about 90% of my glands are fine, they had not dropped or atrophied. My condition post-LASIK is that I am oil deficient. I had my meibography done at a local school of optometry. I would start researching by contacting any local universities or optometry schools and asking around. It was a beautiful thing to see all my glands winding their way to the lid margin. So very relieved. It's an invaluable tool in assessing the true state of your glands. A doctor can't truly evaluate your glands via a slit lamp.

http://www.dryeyezone.com/talk/forum...733#post137733

Also a discussion regarding the potential for conflicting interpretations from Lipiview:

http://www.dryeyezone.com/talk/forum...-85-in-one-eye

[MGD1701]

Thanks Phoenix

Do you also share the same view that doctor can not detect glands status unless taking Meibography?

Thanks again!

[PhoenixEyes]

I contacted a research doctor at a local university about getting Meibography on their Keratograph 5M but they said ultimately whatever the scan showed, the treatment would be the same as what I'm doing now after being diagnosed with MGD through manual gland expression. They suggested trying autologous blood / serum instead.

[MGD1701]

Thank you!!!!!!

[PhoenixEyes]

Well when I say manual gland expression I just mean they pressed on the glands as a diagnostic tool, not as a treatment. For treatment they just suggest warm compresses and eyelid wipes. They don't regularly do expression, probing or anything.

Have you looked into Gerd Geerling in Germany? They sem to have done a lot of research on the topic:

http://www.theocularsurfacejournal.c...019-8/abstract

https://en.wikipedia.org/wiki/Gerd_Geerling

[MGD1701]

Do you know Dry Eye Center London offers glands expression http://dryeyecentre.co.uk/in-house-treatment/

Thanks for the article. I have read it before. Will read it again see if I can find the answer.

[PhoenixEyes]

Do you know Dry Eye Center London offers glands expression http://dryeyecentre.co.uk/in-house-treatment/

I didn't, no, thanks for the link. Might be expensive to go there though as they'll likely charge for a consultation too.

I hope that Oxarol Vitamin D3 ointment makes its way over here.

Thanks for the article. I have read it before. Will read it again see if I can find the answer.

Maybe you can see Dr. Geerling himself if you're in Germany.

[MGD1701]

..........

[PhoenixEyes]

If you look up slit lamp imaging some devices have this option, some rooms at the hospital I go to has it so sometimes they show me the fluorescein dye test and lid margin.

[MGD1701]

Just read an article from Dr Whitney Hauser, O.D. (Jan. 2017)
http://www.optometricmanagement.com/...inical-dry-eye
and this is what I believe too. She wrote:

''Congested glands visualized at the slit lamp can literally be the tip of the iceberg.
Superficial inspection does little to establish the severity or steer an effective treatment plan.
The slit lamp view shows only what’s at the surface.
Meibography, however, enables you to see the threat that lies below.

STRUCTURE = TREATMENT
Whether you transilluminate glands or use high-resolution imaging, visualization is needed to
identify gland atrophy, dilation, tortuosity and other anatomical changes.
Seeing the gland’s structure within the lids helps you, the doctor, recognize the opportunities and limitations for therapy.
It can also help determine how aggressive treatment should be, should you determine the patient’s lids do show signs of MGD.''

If your doctors are KNOWLEDGEABLE to analyse your glands structures/changes, you are lucky.

[Hokucat]

MGD1701, thanks for this article. I tend to agree having meibography can be beneficial to identify UPFRONT what treatment to pursue, and also what would not be helpful. Too many of us, including myself, have gone through the list of treatments from A to Z on a trial and error basis, only to end up spending a lot of money, time, and extending our discomfort when the meibography may help cut to the chase. I would have done it, if I knew about it several years ago.

[MGD1701]

Can anyone read the full text, how?? Maybe need to pay the fee?
http://www.optometricmanagement.com/...inical-dry-eye

Last parts are, what does OM stand for??:
''...So many of my patients tell me that I gave them information they’d never heard before when we discussed their images. After all, The More You Know....… OM''

[PhoenixEyes]

It's possible that is the full article. The OM likely just stands for Optometric Management, the name of the magazine.