Tiny translucent meibum plugs on gland orifices...

[Milo007]

Hello everyone,
For the last few months, I have been trying to observe my lid margins for gland blockage in front of a mirror with strong back-light. I often see tiny yellowish translucent meibum plugs on my gland orifices some of which are of the size of the ball tip of a ball point pen. The relatively bigger ones are removed upon scaling with a sterile dry cotton q-tip after several attempts to rub it off gently. But the tiny ones are almost as tiny as to only block the gland orifices and they are difficult to remove by scrubbing too. I could see today at least 7-8 tiny plugs on my left eye lower eyelid (the less symptomatic eye) and one big plug on my right eye lower eyelid. The big one was scrapped off by a q-tip but the tiny ones are stubbornly holding their ground. I have tried removing them by repeated hot compresses at 45-47°C for 12-15 minutes but they don't melt away or are expressed off by a lid massage.

I would like to know how many of you have observed such meibum plugs blocking your glands.

How do you remove these blockages effectively without harming your eyelids or glands?

These plugs develop overnight for me. What could be the possible reasons for such change in consistency of meibum?

[Meibum Ian]

These plugs develop overnight for me. What could be the possible reasons for such change in consistency of meibum?

I wonder if you're sleeping with eyelids not fully closed? I know I can clear glands in the daytime and have them blocked again by morning.

Have you tried gel & moisture goggles or taping at night?

[Milo007]

I wonder if you're sleeping with eyelids not fully closed? I know I can clear glands in the daytime and have them blocked again by morning.

Have you tried gel & moisture goggles or taping at night?

Yes quite possibly I am sleeping with my eyes open! I do have that tendency and I don't know if my eyes are partially open after I am into deep sleep. But possibly yes they remain open because I have some degree of nocturnal lagophthalmos.

And yes indeed my gland orifices do get blocked with such yellow meibum plugs over night even though I scrape them off and my eyelids are clear before bedtime the previous day.



No I haven't tried night time gel, moisture goggles or taping yet.

Do you have the same problem after a few hours of sleep?

I would like to know more about taping.

[Guest]

Yes quite possibly I am sleeping with my eyes open! I do have that tendency and I don't know if my eyes are partially open after I am into deep sleep. But possibly yes they remain open because I have some degree of nocturnal lagophthalmos.

And yes indeed my gland orifices do get blocked with such yellow meibum plugs over night even though I scrape them off and my eyelids are clear before bedtime the previous day.



No I haven't tried night time gel, moisture goggles or taping yet.

Do you have the same problem after a few hours of sleep?

I would like to know more about taping.

Do you know if you snore? Are you a side sleeper?

I have sleep apnea and subsequently FES...which leads to nocturnal lagopthalmos. I had to tape my eyes because goggles and bubble bandages only prevented erosions at best. Taping my eyes and using gel before bed is the only way my eyes stay any amount of moist at night.

Meibum Ian

Has a good protocol for taping and gel. He suggested thealoz duo gel, it’s basically genteal gel preservative free with hyloraunic acid...I haven’t gotten it yet but on paper, seems like a perfect night time gel. Let’s hope I’m not allergic to the hypromellose

[Milo007]

Do you know if you snore? Are you a side sleeper?

I have sleep apnea and subsequently FES...which leads to nocturnal lagopthalmos. I had to tape my eyes because goggles and bubble bandages only prevented erosions at best. Taping my eyes and using gel before bed is the only way my eyes stay any amount of moist at night.

Meibum Ian

Has a good protocol for taping and gel. He suggested thealoz duo gel, it’s basically genteal gel preservative free with hyloraunic acid...I haven’t gotten it yet but on paper, seems like a perfect night time gel. Let’s hope I’m not allergic to the hypromellose

No I don't snore while sleeping on a regular basis but yes sometimes my family members have reported occasional snoring.

I am not a side sleeper in general but sleep facing the ceiling fan on my back and I keep changing my positions while I sleep to sides or over my back.

I have been told I sleep with my eyelids open and it's out of control after I fall asleep.

Would sleep masks be of any use without actual taping?

I don't want to use night time gels or anything in the eye. Regarding taping, what kind of tapes are suitable for taping the eye?

[Meibum Ian]

From another thread, this is the protocol I use:

I also tape eyes at night and feel much better when doing so.

I am having success with using Thealoz Duo gel, and wiping excess from my eyelids, then taping with 3M Microfoam tape. I start in the nasal corner, beginning 1-2cm in from the corner of my eye (just down from the bridge of my nose). I then work the tape towards the outside of my eye, finishing about 2cm past the eye socket.

Before taping I close my eyes lightly, then pulse / squeeze them for a couple of minutes. I try to limit muscle activation to those closest to the lids, keeping eyebrows still. This normally gets some oils secreted, and helps with the seal.

The tape stays in place, does not irritate, and is easy enough to remove in the morning (though sometimes needs wetting to do so).

you can skip the gel if you prefer not to use it (why, out of interest?)

If you're visibly sleeping with eyelids open, then that's really going to dry things out. I think of meibomian glands like tubes of glue, and if we sleep with eyes open it's like leaving the cap off

Do you have the same problem after a few hours of sleep?

Yep, dozing off for an hour or 2 in the evening is enough to make everything dry and scratchy.

[MGD1701]

How about upper lids, clear oil?

which zoom mirror you use? I have trouble in seeing lower lids', even with 20-zoom. How do you manage it?
Most doctors say we can not see it especially lowers??

Compress, no idea how quick you repeat but the heat is hard to keep long so the best is constant heat. Wet heat is more effective. Study show Bundle-method is the most effective, according to Dr Korb. You can find video at youtube.

[edmunder]

How about upper lids, clear oil?

which zoom mirror you use? I have trouble in seeing lower lids', even with 20-zoom. How do you manage it?
Most doctors say we can not see it especially lowers??

Compress, no idea how quick you repeat but the heat is hard to keep long so the best is constant heat. Wet heat is more effective. Study show Bundle-method is the most effective, according to Dr Korb. You can find video at youtube.

The lower i find much easier to see the oil. The upper lids i need to pull the lid in a strange way. The upper lid comes down onto the lowerlid. So the upper lid the oil comes out under the lids, while the lower it comes out in top.

[Milo007]

From another thread, this is the protocol I use:



you can skip the gel if you prefer not to use it (why, out of interest?)

If you're visibly sleeping with eyelids open, then that's really going to dry things out. I think of meibomian glands like tubes of glue, and if we sleep with eyes open it's like leaving the cap off



Yep, dozing off for an hour or 2 in the evening is enough to make everything dry and scratchy.

Excellent observation... Indeed I have felt that after a sleep sometimes I suddenly feel my eyes drier.This is also true when I wake up in the morning and my eyes are not that great to start with but as the day passes on I feel more comfortable in the evening or at night.

[Milo007]

How about upper lids, clear oil?

which zoom mirror you use? I have trouble in seeing lower lids', even with 20-zoom. How do you manage it?
Most doctors say we can not see it especially lowers??

Compress, no idea how quick you repeat but the heat is hard to keep long so the best is constant heat. Wet heat is more effective. Study show Bundle-method is the most effective, according to Dr Korb. You can find video at youtube.

Upper lids are mostly clear with no visible clogs but I don't know if they are secreting oil.

I don't use a zoom mirror. I use a normal mirror with naked eyes and my phone flash light. I can see objects very very close very clearly. I don't need a zooming glass. I can even see oils pouting out of gland openings upon a gentle press on my lower eyelids. Maybe I am gifted with good near vision.

I change the washcloth every 30 seconds to a minute and keep the water at 45-47°C by adding hot water every 2 minutes in a certain amount.

[Guest]

No I don't snore while sleeping on a regular basis but yes sometimes my family members have reported occasional snoring.

I am not a side sleeper in general but sleep facing the ceiling fan on my back and I keep changing my positions while I sleep to sides or over my back.

I have been told I sleep with my eyelids open and it's out of control after I fall asleep.

Would sleep masks be of any use without actual taping?

I don't want to use night time gels or anything in the eye. Regarding taping, what kind of tapes are suitable for taping the eye?

Everything you just typed is why I thought sleep apnea couldn’t be the cause. I don’t always snore, I don’t akways sleep on my side. But I’m restless at night and need to change positions often. Even when I think I’m not snoring, I am. Do you have a partner you sleep with every night that can check your eyes and if you’re snoring. I’m not saying you have sleep apnea, but you might want to consider it before you assume it can’t be true.

if you’re sleeping with your eyelids open, and you have sleep apnea, you may be able to fix the problem with a cpap machine, that’s why I brought it up. I’d also say, pull your upper lids and see if they’re stretchy or tight. That will also give you a clue.

You sound just like me...so I’ll tell you this, start doing what you’re comfortable with. If you’re confortable trying tape, start there. If you dry out too much at night, add a gel or ointment. I didn’t want to use them either. But I have to use a gel or my lids will stick to my eye even if I tape them.

I just got the tape meibum ian suggested and I ordered some from the dry eye shop...all different to see if I can find one that’s nicer to my lids.

Yes, an hour nap will leave my eyes toasted. And sadly I can’t apply tape that often or my skin gets raw.

It may take a while to perfect, but you have some good clues and option now on how to proceed.

[Milo007]

The lower i find much easier to see the oil. The upper lids i need to pull the lid in a strange way. The upper lid comes down onto the lowerlid. So the upper lid the oil comes out under the lids, while the lower it comes out in top.

Great observation! Flow against and with the gravity. There's a difference.