Absent Meibomian Glands Causing Dry Eyes

[Skylash]

Hello Everyone

Im new to this forum. Thanks for the opportunity!

After 2-3 years of going through severe dry eye and going to different doctors who told me I had eye allergies gave me steroid drops and with no improvement I stopped using them after completing the suggested treatment. I finally found a doctor who did a dry eye test with a machine and concluded that I have absent and a few disoriented Meibomian Glands which are causing extreme dryness. He showed me scans of my upper and lower eyelids to explain. He also mentioned that he usually sees this condition on a patient who is around 70 years old and not my age. (My age is 30).

My symptoms:
Extreme dry eyes and inflamed eyelids every morning as I wake up (I sleep in air-conditioned room at 22 degree Celsius)
Dry eyes when in air conditioned room or facing the blower
Dry and irritated eyes when around smokers
Symptoms are worse when I wear contact lens (daily)

The doctor has put me on a 6 month course of Omega-3 750mg one capsule three times a day for the first month and after which I will consume one capsule twice a day for 5 months. He also told me to do hot compression atleast 3 times a day. Lastly gave me a lubricating natural tear eye drops to be used 3-4 times a day whenever dry.

After the doctors visit I researched on the internet and read people who had consumed Accutane had similar problems. I had taken Accutane under the supervision of a dermatologist about 10-12 years back to clear out my acne.

I wanted to know if I am on the correct treatment plan? Also, Do the meibomian gland ever come back? If this is caused by Accutane can it be reversed?

[xpro]

How long were you on Accutane for?


For your meibomian glands, despite popular belief that once they are gone they can not be regenerated. It has now been proven that meibomian gland can be regenerated if you create the correct environment for them.

http://www.optometry.org.au/blog-new...eneration.aspx

Also you might have Demodex, start treating yourself for demodex.

[waterbee]

How long were you on Accutane for?


For your meibomian glands, despite popular belief that once they are gone they can not be regenerated. It has now been proven that meibomian gland can be regenerated if you create the correct environment for them.

http://www.optometry.org.au/blog-new...eneration.aspx

Also you might have Demodex, start treating yourself for demodex.

Thanks for linking this, very interesting read. Wish he was my optometrist, it's good to see one who doesn't see drops as the answer to everything

[waterbee]

The fish oil will help, it's good to start taking it as helps with a number of dry eye issues. It can take 3-6 months to work, so stick with it. I would continue to take it at its higher dose and not reduce it personally, but that's because until I found a very high dose fish oil brand it didn't work for me, everyone is different though.

[Skylash]

How long were you on Accutane for?


For your meibomian glands, despite popular belief that once they are gone they can not be regenerated. It has now been proven that meibomian gland can be regenerated if you create the correct environment for them.

http://www.optometry.org.au/blog-new...eneration.aspx

Also you might have Demodex, start treating yourself for demodex.

I took Accutane/Isotretinoin about 10-12 years back for a period of 4-6 months as far as I can remember.
What is the correct environment to regenerate the meibomain gland?
What is demodex? How do I find out if I have it or not before I jump into treating it?

[Skylash]

The fish oil will help, it's good to start taking it as helps with a number of dry eye issues. It can take 3-6 months to work, so stick with it. I would continue to take it at its higher dose and not reduce it personally, but that's because until I found a very high dose fish oil brand it didn't work for me, everyone is different though.

waterbee, thanks for suggesting! Will I need to take fish-oil all my life? Since I am 30 years old
There has been a slight improvement with the suggested treatment by my doctor but I hope I don't have to continue hot compressions and fish oil all my life because that could get difficult.

After hot compression I feel slightly blurry until I blink and then its all cleared out.
I can post my eye lid scans on the forum provided someone can understand them and help

[MGD30]

Hello Everyone

My symptoms:
Extreme dry eyes and inflamed eyelids every morning as I wake up (I sleep in air-conditioned room at 22 degree Celsius)
Dry eyes when in air conditioned room or facing the blower
Dry and irritated eyes when around smokers
Symptoms are worse when I wear contact lens (daily)

The doctor has put me on a 6 month course of Omega-3 750mg one capsule three times a day for the first month and after which I will consume one capsule twice a day for 5 months. He also told me to do hot compression atleast 3 times a day. Lastly gave me a lubricating natural tear eye drops to be used 3-4 times a day whenever dry.

After the doctors visit I researched on the internet and read people who had consumed Accutane had similar problems. I had taken Accutane under the supervision of a dermatologist about 10-12 years back to clear out my acne.

I wanted to know if I am on the correct treatment plan? Also, Do the meibomian gland ever come back? If this is caused by Accutane can it be reversed?

Why do you still wear contact lenses and sleep in air an conditioned room if it bothers you? It seems to me that both of those can be avoided. If you have trouble in the morning you might want to consider night goggles such as the silicone onyx goggles. A humidifier also helps me a lot. Although if you have ac going at the same time they are working against each other.

[xpro]

I took Accutane/Isotretinoin about 10-12 years back for a period of 4-6 months as far as I can remember.
What is the correct environment to regenerate the meibomain gland?
What is demodex? How do I find out if I have it or not before I jump into treating it?

You need to treat any allergies, or anything that is causing inflammation for your eyes.

Demodex are mites living in your hair follicles. they are very common. Start using strong tee tree shampoo, wash your face, hair and eyes with it. Let it sit for a minute or so before rinsing.

You could also have infection in your hair follicles.

Do you get styes at the edge of your eyelids?

[Skylash]

Why do you still wear contact lenses and sleep in air an conditioned room if it bothers you? It seems to me that both of those can be avoided. If you have trouble in the morning you might want to consider night goggles such as the silicone onyx goggles. A humidifier also helps me a lot. Although if you have ac going at the same time they are working against each other.

I have stopped wearing contact lenses but it is impossible to sleep without aircon here in India because it very humid and hot. Before sleeping I do put Genteal Gel in my eye but when I wake up my upper eye lids are inflamed and go away after an hour. Is morning inflammation a sign on MGD?

I will order the night goggle you have suggested! Thanks!

[waterbee]

I have stopped wearing contact lenses but it is impossible to sleep without aircon here in India because it very humid and hot. Before sleeping I do put Genteal Gel in my eye but when I wake up my upper eye lids are inflamed and go away after an hour. Is morning inflammation a sign on MGD?

I will order the night goggle you have suggested! Thanks!

Hi again
Air con really is the worst thing for dry eye, it effects your year break up time and tear sufficiency
And must be avoided, try to sleep one night with it not on, or only have it on for half the time, your eyes are getting inflamed due to the lack of tears which your air con is drying out. If you MUST have it on, use an eye mask and night gel for your eyes (Do you have night gel?)
Please don't try and treat Demodex unless you know you have it and have been adviced, tea tree near the eye unless you are experienced and have good reason and caurse lots of irritation.

[cathy8889]

Hello Skylash

Your symptoms and experience sound very similar to mine. I had a meibography done the other month (is this what you have had done) and it revealed that I had the meibomian glands of a much older person because many had atrophied and truncated (i'm 28) The first thing I will say is that you need to try things out to see if they help you and don't go on the advice of anyone who says don't try this because this happened to me.

I think that taking omega 3s is good to do anyway and will take omega three for the rest of my life because my condition is lifelong and they have helped me. Remembering to take a supplement four times a day is a small price. I take about 5 other supplements to, lutein, zeaxanthin, resveratrol, turmeric, nac, vitamin c.

You need to create your own treatment plan, which takes time and you need to be patient, I've had dry eye disease for 8 nearly 9 years and only got diagnosed in my 8the year. I have been treating myself for the last year and things have got better. I was using eye drops four times an hour in June 2014, now I dont use any.

With me something was causing inflammation in my meibomian glands and I really believe that it was bacteria and demodex (i know it was demodex now). Inflammation causes the glands to dysfunction and bacteria in glands turn the quality of the meibum bad.

For me night time goggles made my eyes worse because it created the perfect environment for bacteria and demodex to grow in, warm and dark. Also using nightime ointment made my condition worse, it clogged up my glands and made the problem of bacteria worse.

To find out whether you have demodex you need to find an optometrist or an ophthalmologist who is aware or open to the idea that demodex can cause inflammation which causes your glands to dysfunction. Once you have found one they can check your lashes for white cylindrical dandruff, I only had a few white specs in my lashes and I did not for one minute think they were demodex but they were. I had blephex treatment done in January and have had this done twice since, it reset my lashes and cleaned them down the lash base. This alone wont get rid of demodex, I have to use tea tree face wash, tea tree shampoo, conditioner and body wash, sterilid eye gel by thera tears which contains tea tree (I rub this into my lashes down to the lashes bases and leave on for two mins and wash off thoroughly so that none goes in my eyes), I never dry my face with a towel, I always use kitchen roll, I change my pillow cases every night as demodex come out at night and can get on pillow. Demodex have a three week life cycle which you need to break.) I will always follow this routine because they can come back very easily. A lot people have demodex on their lashes but dont have any symptoms and it does not cause their eyes to react whereas in people like me demodex cause an inflammatory response. You dont have to use pure tea tree oil to treat demodex, I have treated mine using the above.

I also use coconut oil at night (it is naturally antbacterial) (I use this one http://www.hollandandbarrett.com/sho...t-oil-60042903) I have tried another brand of coconut oil and my eyes reacted badly. It may not help you but it could do.

You need to get the meibomian glands producing good quality oil again, an ophthalmologist should be able to tell you what the consistency of yours is like, mine were producing very little and very frothy meibum, this has slowly improved over the year.

Also warm compresses may not be for you, direct heat on my eyes makes mine worse. I use blephasteam goggles once a day now. Steam is much better for my eyes.

I was also on oral doxycycline for 8 months and still take 50mg from time to time if I can feel bacteria coming back. Doxycycline clears the meibum of bacteria and reduces inflammation.

You need to figure out what works for you best. Hope you can figure it out. I am hopeful that my glands will grow back but I know they wont if the cycle of inflammation is not broken.

Cath x

[cathy8889]

Morning inflammation is a sign of MGD, my eyes are at worst in mornings and if I wake in the night, be careful with night goggles, I paid 100 pound for some and they did not help and I firmly believe they made things worse because they created perfect environment for bacteria and demodex to grow (dark and warm), you need to find out what is causing inflammatory cycle and break it, I firmly believe mine was caused initially by taking medication for another illness but then secondarily caused by bacteria and demodex (I believe the medication initially caused damage to glands which meant they didnt work aswell and fight off bacteria etc)

I have stopped wearing contact lenses but it is impossible to sleep without aircon here in India because it very humid and hot. Before sleeping I do put Genteal Gel in my eye but when I wake up my upper eye lids are inflamed and go away after an hour. Is morning inflammation a sign on MGD?

I will order the night goggle you have suggested! Thanks!

[MGD30]

I have stopped wearing contact lenses but it is impossible to sleep without aircon here in India because it very humid and hot. Before sleeping I do put Genteal Gel in my eye but when I wake up my upper eye lids are inflamed and go away after an hour. Is morning inflammation a sign on MGD?

I will order the night goggle you have suggested! Thanks!

Morning pain and inflamation is sign that you dont close your eyes all the way when you are sleeping. This is fairly common, but for people with dry eye its a much bigger inconvenience. If you have glands that atrophied then you definitely have MGD. I understand why would keep the AC on if you live in India, I cant sleep if the temperatur in my room reaches about 84 degrees. Luckily nights here its almost always below 90 so I just oppen my window. The night goggles should negate some of the AC by keeping in moisture in close to your eyes.

Just curious, when did you start wearing contacts? Did you have an event right before you started getting symptoms of dry such as starting a new job with computer use or taking new medication?

[Skylash]

Hi again
If you MUST have it on, use an eye mask and night gel for your eyes (Do you have night gel?)

Hi waterbee, I am using Genteal gel before going to bed but I am not using a mask or goggles.. Any recommendations on mask/goggles? Wont goggle make it more problematic if its due to demodex

With me something was causing inflammation in my meibomian glands and I really believe that it was bacteria and demodex (i know it was demodex now). Inflammation causes the glands to dysfunction and bacteria in glands turn the quality of the meibum bad.

Cathy thanks for writing that up for me! I think I started noticing this problem since I moved to a different apartment. Before treating for demodex I will first need to know if it is Demodex or not. I remember when all the doctors kept telling me I have eye allergies after which I did a allergy test through skin pricking and it said that I was very allergy to D. Farinae which is a species of mite but I am not sure if that has any connection with demodex in my eye. I will probably have to find an ophthalmologist to would know how to check me from demodex.

I am also having a multivitamin called Source Naturals Life Force Multiple

Someone suggested me to go see a Oculoplasty surgeon for meibomian related issues but I'm not sure if that's the correct direction.

Just curious, when did you start wearing contacts? Did you have an event right before you started getting symptoms of dry such as starting a new job with computer use or taking new medication?

Hi MGD30, I started wearing contacts when I was 17 years old so about 13 years back. When I moved into a new apartment after sometime I started facing this issue. And i just found out that my Meibomian glands are shortened and some are absent basically not doing the job. So I really wonders what has caused it!

[MGD30]

Hi MGD30, I started wearing contacts when I was 17 years old so about 13 years back. When I moved into a new apartment after sometime I started facing this issue. And i just found out that my Meibomian glands are shortened and some are absent basically not doing the job. So I really wonders what has caused it!

For me it was the fact that I was only partially blinking(I think this is the most common reason). I took a lipiview exam and one eye had all partial blinks. The glands get expressed when you blink; so if you dont express that oil it slowly drys up and hardens becoming like plugs for your glands. Your glands then slowly start to shrink and atrophy if you dont fix them. Not sure if you have access to a lipiview exam, but you can do blinking exercises.