Need your input please!

[dominorose]

3 months after my sudden dry eye onset, Ive been doing warm compresses religiously at least once a day. My main problem is: I just can't figure where my lower MG's are. Each time I try to express them, I dont see any yellow or white thick secretions anywhere.

Ive just took pics of my eyes - they're gross, sorry my eyes are greasy after using castor oil drops -. Can you tell me if you guys can see anything?

Can you see the foam on some pics? Does it mean my MG's are secreting oil?
Thank you

[dominorose]

No one, really...?

[tealeaf]

Dominorose,
I am no expert. Just find that your MG looks ok. Did your opth. say if there is oil?
Maybe others can give more input.

[DryLondoner]

Dominorose, I did this for a while (a couple of months back) and never saw anything come out nor could I see my glands. My doctor would use the slit lamp when checking the glands worked properly.

Do your eyes feel better after a hot compress? Sometimes the vision goes blurry which I've been told is a sign that oil has been excreted.

One ophthalmologists suggested I gently (very gently) tap the upper and lower eyelid working my way closer the to eye lashes - be gentle though. your eyes may already be irritated and once you loosened the oil is should flow out. Also I was always told to make sure my eyes were closed when I did this.

Have you checked through old threads on here? Someone may already have asked a similar questions. Also, I always love YouTube for this kind of thing, although you do have to be careful and research any suggestions, sometimes it's better to watch someone as they explain it.

Good luck!

[DryLondoner]

Also, your eyes aren't gross. They are very pretty!

[littlemermaid]

I can see your lower MGs really clearly. Even with normal MGs the drop of oil that comes out is very tiny, not like the ghastly squirty YouTube videos. We can never see anything after warm compress or expression when LM has blocked MGs - the only sign of success has been slightly blurry vision, like Drylondoner. However, when the MGs are normal, which they have been sometimes, there is a tiny, tiny drop of oil which looks like Johnsons baby oil - this is after quite firm pressure with 2 fingers upwards underneath the eyelash line. Best not to poke about too much making your eyes even more sore. Warm compress for us has been something that only matters when she skips it. Then the eyes suffer. The nearest I can describe the lower MG gland ends in your photo is that they look like tiny octopus suckers or targets from above (sorry, searching for descriptive words here) along the eyelid margin. Can't see much tear meniscus though. Can't see foam just now - but are you still on doxycycline and monthly Azyter because that is supposed to change seb bleph, if that's what the foam is? Maybe have a look at a normal person where the tear pools along the lower eyelid. Your photos are so very good I can even see sweat glands along the eyelash bases. Have you still got lower punctal plugs in? Amazing photos x

[dominorose]

Tealeaf : yes I also think they look ok, not clogged, no whiteheads etc. Been told I have MGD/ocular rosacea (but zero TBUT or Schirmer done, so who knows)...

Drylondoner : Ive been watching tons of videos on Youtube and pics of clogged MG's yes, but mine dont look like that. I do warm compress for 5-10 min twice a day, vision NEVER gets blurry, and I never see anything coming out with lid massages with Q tips etc. Sometimes my lid margins get "sticky" and when I take a look at them I can see clear oil bumps on it... Dont know if its my meibum or aqueous layer...

[DryLondoner]

Aqueous layer would be watery....

Do you feel the warm compress makes your eyes worse?

Could you see someone and ask them to do another exam? Perhaps ask on the phone or email if they do a TBUT and schirmer test before booking the appointment.

Mine did so I stopped, and when they tell me do it, I say no, because I can tell it is making me feel worse. At one point a junior doctor said I had blepth. when I looked in the mirror after the exam I noticed some dried drops clogging up my lashes! I should have known then that you have to look after yourself and go with your gut.

(Disclaimer: I am pretty new to this dry eye malarkey, so please don't take my word as gospel!)

[dominorose]

Drylondoner thank you

Thx LM, it was hard to take them!

LM, I dont have any plugs in and DONT want to have any. Im too sensitive and the idea of a foreign body in my eyes is impossible for me...

I just dont get what my problem is as my MGs dont look clogged. Not enough meibum maybe? Too much?
My hormone results show I am VERY low on estradiol and progesterone. My skin is dry, I have scalp cysts (horrible and disgusting), and flaky eyebrows in winter.

For the foam: I often get "bubbles" in my tear film, and toxic tears. I use Vismed drops because they are very soothing (hypotonic), but if I have froth it means my MGs DO secrete oil (as Ive read a frothy tear film is the result of meibum mixed with bacteria)

[dominorose]

Dryeyelondoner, warm compresses don't do any harm for me... But dont seem to make a real difference either.

(Sorry if my english is not perfect Im french!)

[dominorose]

LM : what is the tear meniscus please?

[littlemermaid]

http://en.wikipedia.org/wiki/Meniscus Eye docs sometimes use the term to measure the amount of tears that (hopefully) pool above the lower eyelid margin. I really think these measurements, like Schirmers etc, are very useful for the Medical Notes, especially to record changes, but we mustn't take them too seriously for our own diagnosis x

Even little children and babies have punctal plugs these days, sweetheart - are you sure they won't help you? You have had tattoos and piercings, I think?

[dominorose]

Oh ok... Now Im really worried. Does it mean I have MGD AND aqueous deficiency?

And yes, I have tons of tattoos (no more piercings now Im too old haha). Youre right about the plugs, if they can help...

[littlemermaid]

If you don't like them, the docs can easily take them out. It's a decision about whether 'inflammatory mediators' pooling in the tear film would irritate the eye surface. We have done well for 1y, then there was an infection so we took them out. They did help keep the surface moist for a bit, and now she is doing a lot better generally (looked great after lots of exercise in Netherlands actually). It's a 'management' issue, maybe experimental as to whether they help. I'm wondering why you have froth if you are using topical/oral antibacs?

[dominorose]

For the froth, I dont get it either. The bubbles mostly appear in my inner lower eyelids and dont really look like soap, the bubbles are quite "big" (2 mm aproximately)