MGD-White lines on inner eyelid?

[Johno_87]

Hey, I believe my meibomian glands are blocked, and when I pull down my inner eyelid I can see white lines where the glands should be (see attached picture).

1) How ****ed am I?
2) Can they go away? I'm currently doing hot compresses twice a day, lid wipes, and doxycycline.

Symptoms:eyelid feels like it's sticking to my eye when I blink, soreness, gritty feeling

My ophthalmologist diagnosed me with blepharitis.

[hopeful_hiker]

The white lines are actually the meibomian glands. They look like piano keys. I also have a sticking sensation, ugh!

[Hokucat]

Yes, it's good you have those white lines because those are your glands, as per Hopeful. If you have atrophied glands, you would not see any white lines or very short or disfigured white lines.

Have you had meibography to evaluate the status of your glands? Here some slides on meibography, which also includes some pictures of the glands:

https://www.slideshare.net/mobile/Ra...ri/meibography

If your condition doesn't improve or gets worse, you may need to do next degree treatments like gland expression, IPL, etc.

[Johno_87]

Yes, it's good you have those white lines because those are your glands, as per Hopeful. If you have atrophied glands, you would not see any white lines or very short or disfigured white lines.

Have you had meibography to evaluate the status of your glands? Here some slides on meibography, which also includes some pictures of the glands:

https://www.slideshare.net/mobile/Ra...ri/meibography

If your condition doesn't improve or gets worse, you may need to do next degree treatments like gland expression, IPL, etc.

Thanks for the replies guys. I have not had a meibography yet (I have an appointment with my optometrist on Saturday and my ophthalmologist in another 2 weeks and will ask then). I have looked at other eyelids of my friends (weird I know) and they do not seem to have any visible lines. Do they vary from person to person?

[Hokucat]

Lol, it's not weird you're looking at your friends eyelids, I did the same except I looked at my husband and kids eyelids :-). I do think how the glands look varies by person. Probably just like how some people's veins stand out more. And really the only clear way to see the glands completely is meibography, which thankfully is more available these days than before.

[Johno_87]

Lol, it's not weird you're looking at your friends eyelids, I did the same except I looked at my husband and kids eyelids :-). I do think how the glands look varies by person. Probably just like how some people's veins stand out more. And really the only clear way to see the glands completely is meibography, which thankfully is more available these days than before.

lol thanks. I've looked at pictures online too and can't seem to find many/any that look like mine.

[farmgirl]

Could be they are full of toothpaste like oil which is why you can see them....get your doc to express them.

[Johno_87]

Could be they are full of toothpaste like oil which is why you can see them....get your doc to express them.

Yea I saw an optometrist who tried to do that. Said they got some out but I need to compress for another 2 months before she tries again :S

[Johno_87]

Follow up question, can meibomian glands be repaired and return to normal function?

[farmgirl]

Then you really need a new doc who is equipped to do IPL, lipiflow and or probing. If they can't express them and think that 2 months of compresses is going to fix it they are sadly mistaken. Where do you live?

[Johno_87]

Then you really need a new doc who is equipped to do IPL, lipiflow and or probing. If they can't express them and think that 2 months of compresses is going to fix it they are sadly mistaken. Where do you live?

Vancouver, Canada. I also have an ophthalmologist who works out of our largest hospital, so I think he's trying me on the conservative route before other treatments. I see him again in about 2 weeks.

[Guest]

Vancouver, Canada. I also have an ophthalmologist who works out of our largest hospital, so I think he's trying me on the conservative route before other treatments. I see him again in about 2 weeks.

If I were you and compress wasn't expressing the oil I'd look into exactly what farmgirl said, lipiflow, IPL and probing in that order.

So let me ask, how do you do your compress and for how long? Do you use the bundle method or a beaded mask? The amount of heat you apply is crucial. I was underheating my mask and when I finally did it right, all that toothpaste liquid came out. Felt like my eyelashes were glued together.

[Johno_87]

If I were you and compress wasn't expressing the oil I'd look into exactly what farmgirl said, lipiflow, IPL and probing in that order.

So let me ask, how do you do your compress and for how long? Do you use the bundle method or a beaded mask? The amount of heat you apply is crucial. I was underheating my mask and when I finally did it right, all that toothpaste liquid came out. Felt like my eyelashes were glued together.

I use a beaded mask similar to the Bruder for 10 minutes twice a day.

[Guest]

I use a beaded mask similar to the Bruder for 10 minutes twice a day.

I use a laser thermometer to check the temp and I apply it at around 117-120F...I still check it on my wrist but that's my sweet spot and it only stays the right temp for about 5-6 mins (I have a bruder as well). So I have to set a timer, then reheat it to 120 or so then do another 5-6 mins.

So go to youtube and type David kading when to use warm compress. You can watch the whole thing or skip to the 3 min mark where he explains the temperature needed to get the glands flowing. You need the back of your eyelid to hit 104F and in order to do that the mask has to be at least 113F and sustain that temp. The added heat is needed to get past the musculature and vasculature of the lid, back to the gland. That's why lipiflow is kinda sexy and I'd suggest it for you. It heats the eyelid from the inside, at a constant 104F and pulses to milk the gland. No lie, I'm doing WAY better with my MGD right now, however I may still have lipiflow done to really clean those glands. I massage after each application of my mask but it's clearly not the same as a massage and heat at the same damn time lol.

im going to hold my reservations until after I have lipiflow done. But if my assumptions are correct. I think I'm going to do it once or twice a year just to keep my glands clean. Dr cremers suggests it's a great method for getting glands moving.

let me add...before I was temping my mask and making sure it wasn't too hot and wasn't too cold, I was getting barely any relief. Once I decided to literaly temp the damn mask that finally glue came out of my eyes. Was insane!

[Johno_87]

I use a laser thermometer to check the temp and I apply it at around 117-120F...I still check it on my wrist but that's my sweet spot and it only stays the right temp for about 5-6 mins (I have a bruder as well). So I have to set a timer, then reheat it to 120 or so then do another 5-6 mins.

So go to youtube and type David kading when to use warm compress. You can watch the whole thing or skip to the 3 min mark where he explains the temperature needed to get the glands flowing. You need the back of your eyelid to hit 104F and in order to do that the mask has to be at least 113F and sustain that temp. The added heat is needed to get past the musculature and vasculature of the lid, back to the gland. That's why lipiflow is kinda sexy and I'd suggest it for you. It heats the eyelid from the inside, at a constant 104F and pulses to milk the gland. No lie, I'm doing WAY better with my MGD right now, however I may still have lipiflow done to really clean those glands. I massage after each application of my mask but it's clearly not the same as a massage and heat at the same damn time lol.

im going to hold my reservations until after I have lipiflow done. But if my assumptions are correct. I think I'm going to do it once or twice a year just to keep my glands clean. Dr cremers suggests it's a great method for getting glands moving.

let me add...before I was temping my mask and making sure it wasn't too hot and wasn't too cold, I was getting barely any relief. Once I decided to literaly temp the damn mask that finally glue came out of my eyes. Was insane!

Thanks man, I have to order one of those laser thermometers! Also, let me know how the Lipiflow goes. I'm going to ask my eye doctor if I would be a candidate for it as well.