MGD - worried

[cathy8889]

Hi all,

Sorry to start yet another thread. Just having a really bad day and feel quite overwhelmed by this disease and quite scared and sad that I'm going to have to live the rest of my life like this. I've been looking in to mgd, probably too much and scaring myself. I'm worried that I'm too far gone and my meibomian glands may have died out. I've booked an appointment to have a meibography done in London.

I've been put on doxy for a year and been told to do warm compresses, if my mgd was more severe would the oph have advised gland expression?

The ophthalmologist discharged me so unless I ask for another referral I will not know how I am getting on, fe quite concerned about this, is it common to be diagnosed with mgd and then be discharged?

Any help from new or old mgd patients would be really appreciated.

Thanks

Cath

[André Pereira]

Cathy, I visualisei your profile to know the cause of MGD. There is marked "other".

You know the cause of your dry eye? I think the solutions depend heavily on the cause.

My eyes for example, the expression can be performed, but does not leave too much oil. It seems that my gland does not produce it. Have reported that people heard with blepharitis, for example, the oil has the consistency of "toothpaste". In this case the hot compress can help.

Actually, I'm telling you all this just for you post the cause of your dry eye. This helps in tips.

I'm sorry about your bad day. Unfortunately we all go through it.
I'll talk to you expected. Cry if you have to cry, get angry and all that stuff. After this things always better, more or less time.

As my English is not very good, I did not understand when you said "The ophthalmologist discharged me so unless I ask for another referral". What happened? He diagnosed and said nothing more? Is it?

[cathy8889]

Hi Andre,

Thank you for your message, think I've just got to get used to knowing I have mgd now and be grateful it's been diagnosed, but is hard sometimes.

I really have no clue what caused it, I've probably put my body under a lot of stress the last three years with Uni and other things, so possibly brought it on myself. Also worked in a smokey pub for 4 years when I was younger, maybe that caused the start of it all.

Thanks for bringing up cause, I really don't know if I'm not producing enough oil, whether they're blocked, whether the quality of oil is poor. I have a feeling that I'm not producing enough or the quality is poor. I've just read that gland expression is an important part of examination and once again feel frustrated that this didnt happen. Do you know what causes your glands to not produce it?

I was told to do warm compresses but as you point out Andre they help when mg are blocked with toothpaste like oil.

I remember her saying to me now that the quality of my oil was poor and when it was coming out it wasn't spreading properly, I'm hoping this means there is no lack if production. I'm still waiting for blood test results to see if there's any problems there. She also said that the glands in my left eye were worse than my right, which I strange because I have always had most problems with my right, I do wonder whether this means I have a bit of aqueous deficiency too.

You've really helped clear things in my mind so thank you, it's easy to become irrational and fear the worst I think.

Yes that's right sorry (your English is remarkable) they've diagnosed and gave treatment but have not said come back in 6 months. I haven't had letter through from my appointment, maybe when this is back a few things may get explained and it may say to refer me again in so many months time, or not :/.

Thank you again Andre you have given me food for thought and some hope.

Cath x

[cathy8889]

I've just found this article too, it made me giggle as it puts in a good way how I think ophthalmologists and optometrists have perceived me

"To make matters worse, the patient's eyes and eyelids, upon external examination, don't look bad. In fact, the longer you observe them during his tortured report of one failed therapy after another, the more you wonder whether this patient is really one of "those" patients. You know — one of "those" patients who would benefit more from spending their time and money on psychological therapy because you and the eight other eye doctors he's seen can't identify the cause of his discomfort.

Keep in mind, however, that a large number of patients like this one aren't crazy. Instead, they have undiagnosed meibomian gland dysfunction (MGD). The reason it's undiagnosed: MGD can be non-obvious (NOMGD) and exist in the absence of inflamed and/or infected lids and gland orifices.1 Unfortunately this is not widely known, and, therefore, we tend to skip the evaluation of the meibomian glands when the lids and gland orifices appear normal."

http://www.optometricmanagement.com/...ticleID=104403

Cath x

[CharlieGreenEyes]

Hi Cathy,

I don't know if you remember me but we message each-other a few months back. I stopped checking in here because I was finding things so difficult and using a computer was becoming so hard.

I'm sorry things aren't any better for you. It's awful isn't it. I'm still in bad way too.

I love the article you posted. That's exactly how I feel. I tried to ask for tests, etc at my appointment this week but it's hard when they don't seem to know much about MGD. I don't know how to push for anything without being labelling a problem patient or them dismissing it all as psychological!

Do you find the hot compresses help? I just had my most recent appointment with an opthalmologist and told him I'd just stopped doing them. I was doing them for months and they seemed to make things worse. My eye-lids were going puffy, red, and swollen (and looked like slugs). As soon as I stopped, this went away.

I'm not getting anywhere and thinking I'll have to see someone privately. I can't really afford it but don't know what else to do.

All I know about MGD is apparently I have it. The opthalomologist I saw this week told me there are no tests to check for what they look like, if they're producing oil, etc. He seemed very nice (unlike the rude one I saw in the past) but just didn't seem to know much about it all.

[André Pereira]

Cathy,

I think many doctors do a standard service. They do not care much to look deeper into a problem.

As you noticed, with much reading we realize that certain tests can help us.
Expressing the glands is very important to know the quality and the amount of oil coming out of there.

In my entire history of dry eye was so. I went to a query. at home I read the forum and find some test that may be useful. So I go back there and ask for them to do.

My luck was that I found a doctor who converses with me without being overbearing.
So he has studied all sorts of information that I took for him.

I also kept seeing other doctors always try to find useful information.

I made a document that shows the tests I've done, the results (with the date), my symptoms, medications and procedures that I have submitted myself (and the results, positive or negative), my psychological state. Then do a historical listing the elements. Example: 2008 I used restasis. It did not help me. Felt my eyes burning.

So when I go to a query, not hindrance me explaining my symptoms. I deliver this document to the doctor and he decides whether it can or can not help me.

In summary (gee, I talk too much).

Do not be waiting for the doctor to tell you to do something. Go in search of information, connect the dots and always present it to your trusted expert (or more than one).

Good luck with your eyes. If you need anything, we are there. = D (It's a slang word in Portuguese and I do not know if it makes sense in English, but who cares? Hehehe)

[irish eyes]

……"Keep in mind, however, that a large number of patients like this one aren't crazy. Instead, they have undiagnosed meibomian gland dysfunction (MGD). The reason it's undiagnosed: MGD can be non-obvious (NOMGD) and exist in the absence of inflamed and/or infected lids and gland orifices.1 Unfortunately this is not widely known, and, therefore, we tend to skip the evaluation of the meibomian glands when the lids and gland orifices appear normal…." (Cathy's post)

http://www.optometricmanagement.com/...ticleID=104403

Hi Cathy

I was this patient - according to a letter send from the Head of the Eye Dept to my GP. I was 'discharged' from the NHS clinic with the explanation that there was nothing more that could be done, my eyes weren't that bad at all and perhaps I should take anti-depressants etc etc.

My eyes deteriorated and I went to a private clinic - only to find the Head of the Eye Dept. also worked there part time. I refused to be seen by him so his colleague read the letter sent to my GP - explaining my state of mind etc. My eyes were indeed in a poor state; the 'new' consultant had to be professional and not comment too much on his colleague's findings but it was clear he disagreed with him.

[dominorose]

I think mine is a "non obvious" case too. Each time I try to see my MG's, they don't seem to be clogged. I don't see any white heads, and when I express them, I can't see any white goo, just something clear...