Why don't the MGD dry eyes always water?

[hopeful_hiker]

If someone has MGD, I would assume that they would water or have a bit of epiphora here and there. However, that does not seem to be the case. I have met people with dry MGD eyes and no watering. Does anyone know why?
I understand why aqueous deficient eyes rarely water but MGD dry eye patients have normal lacrimal glands.

In my case, I have reflex tears but they only arise for three reasons: poke in the eye (accidental, of course!), getting an irritant in the eye (e.g. accidentally leaking some tea tree oil wipes into the eyes) or mild wind (strong wind blows away all the tears).

[Guest]

I have MGD, mild blepharitis with foamy meibum. My eyes burn like no other when things are bad. However, I never reflex tear. My doctor did say I will end up like that some day. I believe I'm also slightly aqueous deficient...that or I damaged the nerves in my eye so bad from my abrasion, it's not sending the signals to water. I can cry, I can yawn and tons of tears come out, but I don't reflex tear and my normal basal tear production is non existent.

i have assumptions as to why this is happening...I'll list them but I have no way to know if my assumptions are true.

1 nerve damage from my abrasion, my abrasion was odd, it wasn't a single cut, I got potting soil in my eyes when I pushed my garbage can down. Didn't think anything of it and a week later my eyes got blurry, photophobia but no pain. Went to see a doc she never stained my eye, so I went another 3 days with the stuff behind my eyelids just scraping at the cornea. I believe I did serious nerve damage, it's healed A LOT but I believe that's why I don't tear properly.

2 I have MGD due to partial blinking and excess drop usage during the initial insult. That took my mild almost non existent MGD and took it into moderate/severe range.

3 most of my issues are sensory I believe...bevause most doctors look at me and say, itsnot too bad. But my eyes feel like they have soap and sand in them most of the day.

4 I smoke a lot of pot....well, a lot for a normal human, a joint or two a day. Used to be 3-5g of hash per day so that's come down a lot. However, it's very drying, but I need it to treat my bipolar disorder..I tried quitting, I get mentally ill very fast.

[MGD1701]

Hi Dowork123
Do your eyes also feel burning? since your eyes feel like soapy with foamy meibum.
soapy/foamy normally mean bacteria and acid in eyes but you have been using Avenova, right?
This should tackle bacteria issues.

[Guest]

Hi Dowork123
Do your eyes also feel burning? since your eyes feel like soapy with foamy meibum.
soapy/foamy normally mean bacteria and acid in eyes but you have been using Avenova, right?
This should tackle bacteria issues.

Yes, they burn when the meibum is bad. I just recently got things under control really well. I had to do compress 4 times a day for a few days, I always make sure to check the heat on my compress with a laser thermometer (45c I apply to eyes and reheat after 3-5 mins). Once I stopped going too hot or too cold and started going heavy on the compress, things have been much better. I use avenova twice a day morning and night which of course also helps.

The reason I did the compress 4 times a day was because of the burning. I figured if the burning is from the foamy meibum, I should get it out. So any time I felt the burn start, boom, I did a compress. Massaged the glands after the first and second heating of the compress. Then I washed the eyes out with serum tears.

Avenova is great, it can dry my skin some but I just have to be gentle when I wipe it away. If my lids are sticky, I pull my lids down off the eye and expose the glands, and wipe across them with a q-tip that I spray avenova on. Then I wait for it to dry before I let it touch the eye again. People say avenova is non irritating, I disagree. It's definitely mild, but if I get it on my eyeball it stings a bit.

This method has made things very manageable...

[diydry]

Great question! I’m not sure, I think it’s complicated. Speaking from my experience, I had (mild, manageable) MGD for years and I actually teared more. I would tear too much when it was cold or windy outside, with tears running down my cheeks (those were the days!). I conjecture this is because my oils were abnormal and were not keeping tears on the surface of my eye, causing my reflex tearing to kick in to keep the eye coated. Now that my MGD has appeared to worsen, all my tears have gone down too and this could be due to increased inflammation.