Eyelid inflammation

[ebi1368]

My upper lid is really inflamed and tender in the morning and it gradually gets better in few hours. However, I always have this minimum inflammation.

Has anybody found a solution for this?

Should I explore probing?

[Milo007]

Do you have a history of blepharitis?

Have you checked your eyelashes for a demodex infestation?

Do you observe crusting and/or "eye gunk" in your eyelashes or along the eyelid margins as in blepharitis?

If no then you might have some completely blocked glands that are filled with meibum and not having a passage to release their contents to the lid margins, so they are increasing inter glandular pressure and causing inflammation. My personal advice would be to find a good opthalmologist who specializes in dry eye treatment and seek his or her advice. It's impossible to tell if you have blepharitis or obstructed meibomian glands unless your eyelid margins are closely observed using a slit lamp microscope.

Long term obstruction and inflammation can destroy your glands permanently.

[ebi1368]

Do you have a history of blepharitis?

Have you checked your eyelashes for a demodex infestation?

Do you observe crusting and/or "eye gunk" in your eyelashes or along the eyelid margins as in blepharitis?

If no then you might have some completely blocked glands that are filled with meibum and not having a passage to release their contents to the lid margins, so they are increasing inter glandular pressure and causing inflammation. My personal advice would be to find a good opthalmologist who specializes in dry eye treatment and seek his or her advice. It's impossible to tell if you have blepharitis or obstructed meibomian glands unless your eyelid margins are closely observed using a slit lamp microscope.

Long term obstruction and inflammation can destroy your glands permanently.

Thanks for your response.

When my doctor express my upper gland, she always says there is good oil coming out. Does it mean that I do not have blockage or maybe just some of them are blocked?

Before my lasik (8 month ago) I never noticed any inflammation. My docotor could not find demodex but I did lid scrub for two months.

Sometimes, I notice a little bump on my eyelid which goes away in a day.

[Milo007]

Thanks for your response.

When my doctor express my upper gland, she always says there is good oil coming out. Does it mean that I do not have blockage or maybe just some of them are blocked?

Before my lasik (8 month ago) I never noticed any inflammation. My docotor could not find demodex but I did lid scrub for two months.

Sometimes, I notice a little bump on my eyelid which goes away in a day.

Good oil could be coming out of some of the glands and maybe some of them are internally blocked. Did your doctor tell you that all your glands were actively secreting oil?

I think you should ask your doctor politely next time if all your upper eyelid glands are functional and if any of them are blocked. You may also see another doctor if you think your current doctor is not that friendly. But at all costs clarify your doubts and don't shy away putting things on hold. Time is crucial for dry eye patients.

Could you please explain the "bump" you are taking about on your eyelid?

The location of the bump and it's description would be very helpful to understand exactly what is your issue.


LASIK disrupts the tear film homeostasis by affecting the lacrimal functioning first which later translates to MGD anyway. Every aspect of the different forms of dry eye is so much related to one another that if one occurs the others will follow consequently.

[ebi1368]

Good oil could be coming out of some of the glands and maybe some of them are internally blocked. Did your doctor tell you that all your glands were actively secreting oil?

I think you should ask your doctor politely next time if all your upper eyelid glands are functional and if any of them are blocked. You may also see another doctor if you think your current doctor is not that friendly. But at all costs clarify your doubts and don't shy away putting things on hold. Time is crucial for dry eye patients.

Could you please explain the "bump" you are taking about on your eyelid?

The location of the bump and it's description would be very helpful to understand exactly what is your issue.


LASIK disrupts the tear film homeostasis by affecting the lacrimal functioning first which later translates to MGD anyway. Every aspect of the different forms of dry eye is so much related to one another that if one occurs the others will follow consequently.

Thanks for informative response.

The bump are like the one picture you uploaded a few days ago. It is yellowish clear bump on my eyelid and it just lasts one day. It is on the lid margin where the gland expressing oil. I see them once every two weeks.

My doctor said there is good oil coming out of 100% upper gland. I have seen many doctor and she is the only one pressing my gland. I am seeing another doctor in Toronto in near future and I will ask him too.

I heard that the lacrimal gland gets better with time after Lasik. Do you think the MGD will get better as well? I think my MGD has gotten worse in the last 2 3 months.

[Milo007]

Thanks for informative response.

The bump are like the one picture you uploaded a few days ago. It is yellowish clear bump on my eyelid and it just lasts one day. It is on the lid margin where the gland expressing oil. I see them once every two weeks.

My doctor said there is good oil coming out of 100% upper gland. I have seen many doctor and she is the only one pressing my gland. I am seeing another doctor in Toronto in near future and I will ask him too.

I heard that the lacrimal gland gets better with time after Lasik. Do you think the MGD will get better as well? I think my MGD has gotten worse in the last 2 3 months.

The "bumps" in your case as mine are "meibomian gland cappings" which are basically epithelial tissue blocking the meibomian gland orifices and forming lipid filled globules thereafter. You can pop them using a medical grade sterilized needle. But inflammation and increased epithelial cell turnover is most likely the cause of development of such cappings.

From the words of your doctor your upper eyelids don't have "fully" blocked glands so oils are coming out of each gland in some amount. But even then you could have partially blocked glands i.e.,blockages anywhere along the length of the glands from the top that makes upper part of a gland blocked and lower part of the gland open to its duct to drain out lipids through the openings.

Instruments like lipiscan or keratograph 5M can provide evidence of "external" scar tissues over the glands while an internal scar tissue blockage can only be confirmed through careful lid margin examination and probing which makes a characteristic "pop" if scar tissue is cleared within or outside the glands.

I would suggest you to visit an ophthalmologist who performs probing and has experience with it.


Yes both lacrimal gland and meibomian glands do get better with time provided you restore the ideal environment for their functioning as in normal circumstances. For lacrimal gland problems the main stay of treatment is anti inflammatory medications that work topically such as optical steroids, restatis and xiidra. For meibomian gland dysfunction the management depends largely on the problem. Blockages in "any form" must be addressed on a daily basis, bacterial overgrowth must be brought under control and simultaneous control of inflammation is necessary to break out of the vicious cycle of inflammation and blockage to restore tear film homeostasis.

If you have MGD moisture chamber glasses are a must for reducing dessication stress because evaporative stress would make tears hyperosmolar and toxic to the conjunctiva which would induce inflammation and begin the cycle of inflammation and related events eventually leading to a MGD like situation. In plain words moisture chamber glasses are equally important for your eyes to give them time to heal and break out of the 'vicious circle' of MGD.

[ebi1368]

Thanks for your informative message.

I will try moisture chamber. It is so hard for me to wear them at work but I am wearing them at home right now.

I am planning doing prokera soon as they are supposed to heal nerve. Should I do it before probing or after?

tnx again

[Milo007]

Thanks for your informative message.

I will try moisture chamber. It is so hard for me to wear them at work but I am wearing them at home right now.

I am planning doing prokera soon as they are supposed to heal nerve. Should I do it before probing or after?

tnx again

Since you underwent LASIK you should proceed with prokera irrespective of probing.

Probing should an independent step forward. Try all your options as proactively as you can. You could save more of your meibomian glands depending on how soon you find out the problems and address them.

[Guest]

You may be sleeping on that side and tugging on that eye in your sleep. My left eye is worse because I always sleep on my left side. The fact that it goes away as the day progresses has me assuming that the irritation is happening during your sleep. I could be wrong but worth looking into.

[Milo007]

You may be sleeping on that side and tugging on that eye in your sleep. My left eye is worse because I always sleep on my left side. The fact that it goes away as the day progresses has me assuming that the irritation is happening during your sleep. I could be wrong but worth looking into.

Hey Dowork123

How do your eyes feel in moisture chamber glasses?

I read in your posts you tried both ziena eyewear and 7eye.

Do moisture chamber glasses make a significant difference while performing activities like reading or working on computers?

I need some advice on selection of moisture chambers for myself. Haven't found out any manufacturers in my locality yet. I think I will have to order them overseas.

[Guest]

Hey Dowork123

How do your eyes feel in moisture chamber glasses?

I read in your posts you tried both ziena eyewear and 7eye.

Do moisture chamber glasses make a significant difference while performing activities like reading or working on computers?

I need some advice on selection of moisture chambers for myself. Haven't found out any manufacturers in my locality yet. I think I will have to order them overseas.

The moisture chamber glasses are one of the best and cheapest purchases I’ve made for my eyes. With my prescription lenses, they cost about 430 US dollars. They give me so much relief it’s insane. Let me put it this way, I rented a convertible corvette last week in Las Vegas (the desert) and I had pretty much zero dry eye. I used no drops and drove with the top down the whole time. No way I could have done that without the glasses.

[ebi1368]

The moisture chamber glasses are one of the best and cheapest purchases I’ve made for my eyes. With my prescription lenses, they cost about 430 US dollars. They give me so much relief it’s insane. Let me put it this way, I rented a convertible corvette last week in Las Vegas (the desert) and I had pretty much zero dry eye. I used no drops and drove with the top down the whole time. No way I could have done that without the glasses.

Are you still wearing you mositure chamber glasses all the time or just in windy condition?

[Guest]

Are you still wearing you mositure chamber glasses all the time or just in windy condition?

I wear them all day. I took them off yesterday and wore regular glasses for a couple hours. Wasn’t much of an issue, but I definitely feel just a touch better with them on, so why not.

[ebi1368]

Since you underwent LASIK you should proceed with prokera irrespective of probing.

Hi Milo again,

Have you seen anywhere that Prokera helped someone with Lasik induced dry eye?

I have a hard time convincing my doctor to do Prokera on me.

[Milo007]

Hi Milo again,

Have you seen anywhere that Prokera helped someone with Lasik induced dry eye?

I have a hard time convincing my doctor to do Prokera on me.

Hello ebi,

Firstly I should ask why do you want to try prokera?

Do you have corneal erosions or any other types of ocular surface injuries?

If you are thinking of prokera as a means to heal the corneal nerves then I think you should first try autologous serum drops. LASIK cuts through the corneal nerves and that's what affects the corneal nerve-lacrimal gland feedback loop. So over a period of time the lacrimal gland down regulates its functionality due to decreased response and feed back from the corneal nerves. Only way to restore the system is to help the nerves heal. Autologous serum drops have healing factors that help the nerves regenerate. I think if your doctor is hesitant to prescribe prokera to you, then you should perhaps ask her for a course of autologous serum drops.

Do you have aqueous deficiency in particular?


@Dowork123 is experienced and knowledgeable particularly when it comes to corneal erosions and use of autologous serum drops. You may seek his advice on prokera as well. I guess he's a LASIK candidate himself!