Inflammation in the skin / underneath the eyelids weeks after meibomian gland probing

[Leah_10]

Hi forum users, I am reaching out to ask if anyone has had issues with persistent inflammation underneath their eyelids that would not settle down after having meibomian gland probing? I had a probing procedure nearly 6 weeks ago now and my lids have been seriously inflamed ever since, they feel swollen and have hardened and are extremely uncomfortable to the point where I cannot sleep.

It would be helpful to know what peoples post procedure approaches were and if there was anything that they were prescribed or tried in this instance that helped them?

[Cissou]

Hi, I did probing 7 weeks ago. Doctor prescribes me steroids during 2 weeks. I have inflammation as usually. Where did you done gland probing ?

[Leah_10]

Hi Cissou, when you say as usual, do you mean that you usually have inflammation or that you usually have inflamation after probing? Is it your first time probing? And how is your inflammation after the steroids - did it come back?

I'd prefer not to say publicly where I had it done but it was with an ophthalmologist and I wasn't prescribed any medications. I am concerned that my glands are closing up again, I was advised to get expression done once a week for 5 weeks after the procedure but have been unable to do so as I was too inflamed. I was reading the M%$&#@ protocol and it says that he dilates the gland after probing (I'm not sure what he means by this and whether this is done with the same probe that is initially inserted) and then in some instances uses a 4-6mm probe to establish gland patency. My ophthalmogist only used the 1-2mm probes and said that the 4-6mm are only used if indicated. I question when it would be indicated as my ophthalmologist also noted that many of my glands made multiple popping sounds (several at 2-3 pops) indicating blockages further inside the gland. 3 pops is a lot withon 1-2mm.

I also read that M%$&#@ applies steriods intraductally, during / after the procedure. My concern is that without being given antibiotics or steroids immediately after the procedure that there could now be bacteria or inflammation trapped within the newly closed glands, this is how it feels to me anyhow. I have alot of swelling (a lot more than usual) especially in the left eyelid and am now about 8 weeks after the procedure.

[Cissou]

Hi, it's my first probing in 2 session. 1 probing with ipl in august and 1 month later another probing with ipl.
it vas done with 1,2 and 4 mm. I bad à lot of fibrosis.
You did probing in USA or in Europe ?
did you done ipl? It's very important.

[Leah_10]

Hi Cissou, I had the probing done in Europe. I'd had IPL 4-5 times prior to the probing and had mixed results perhaps as I was blocked and it was just heating the oils underneath the skin (I was not expressed properly after either). It did reduce the visibility of the blood vessels on my lid line (which was presumably bringing down inflammation) but I had deeper inflammation which the IPL did not reach.

I have not had IPL since probing and I am concerned about increasing scar tissue in my lids.I have scarring under my lids from previously removed chalazions and the scarring increased while I was getting IPL, I am not certain whether there was a link but I was not getting any other treatment at the time and am now concerned about the safety of IPL for people with scarring.

The data I have read on IPL for dry eye is difficult to navigate. I have read that when IPL is used for skin conditions that it is contraindicated with scarring, but conversly when it is used for dry eye the contraindication for scarring is not clearly indicated. Unless there are differences in the IPL wavelengths used for the different applications (dematological vs dryeye) this doesn't make sense to me, I am yet to find anything definitive that says IPL is safe to do when you have scarring in your eyelids and if so whether there are specific wavelengths indicated. If anyone has any data on this I would be keen to read it.

I have been looking into gentler options like LLLT (Low level light therapy) masks and am not sure of the efficacy of the different options for dry eye so I am still looking into this. Reading into the LLLT masks the different colours have different uses.

I understand that if you have MGD this is often linked to skin conditions. Seeing a dermatologist is next on my list (with a view to have allergen testing as well) as it is important to eliminate and address additional factors that may be present. Cleaning and removing things from your environment is also important to eliminate or reduce anything that may be further irritating your symptoms (Known allergens including dietary ones, exposure to certain fabrics, dust, etc).

Properly cleaning your eyelids and eyelashes is a must. I had an optomotrist clean my lid line with a Nulids device and this removed debris that I could not remove with lid wipes. I felt quite good after the Nulids clean and ended up buying my own device, it is agentler option than the blephex as it pulses rather than spins, the pulsing of the device has been speculated (in a Dr's review video I saw online) to help stimulate meibomian activity. I wish I had had the lid cleaning done earlier but had not been aware of it.

Did your opthalmologist (or was it a Dr?) suggest Lipiflow first before getting a 2nd round of probing? It seems very soon after your first probing to have been recommended another probe without them suggesting another (cheaper and less invasive) option to get the oils flowing.

My opthalmologist said that my glands were extremely blocked as well. Noting that the oils were inspissated (meaning thickened or congealed) and stating that after probing it was important to try to keep the flow of oils going (with heating and expression etc). I am amazed that you were able to be probed a month later, I am unfortunately nearly 2 months after my probing and have only in the last couple of weeks been able to have my lids flipped to have them examined. I am obviously not healing as expected and wish the were gentler options that I could tolerate (other than steroids and antibiotics) to bring down post procedural inflammation as I seem to react to everything.