Seeing another doc for an opinion

[Matt0029]

Has anyone seen another eye doc/ dry eye optican. I'm thinking of getting an opinion of someone else how may specialise in mebuim glands more.
Thank you

[Hokucat]

Definitely good to see another doctor. Especially one with expertise treating meibomian glands, if your current doctor said you have MGD or you suspect that’s the issue. I’ve read ~85% of dry eye sufferers have MGD.

If your glands are severely blocked, including with scar tissue, other treatments, diet changes, etc. will not help much or not at all, until glands are opened.

When I suspected my glands were significantly blocked, after trying absolutely everything with no luck, I sought out a doctor who knew more about meibomian glands. This was a major step in the right direction for me. He was the first eye doctor who thoroughly examined and pressed on my glands, told me little or no oil came out, and the small amount that did was like toothpaste. When he did probing, he said many of my glands had scar tissue, so only probing could unblock them.

The new doctor you get might use meibography (meibomian gland imaging) which is more readily available now, to see the size/length of the glands and any abnormalities with the structure. This may help better determine what treatment is needed. It may be something like IPL or manual gland expression if they think it’s just stubborn blockage, probing if it looks like scar tissue, etc.

FYI, probing is very invasive and uncomfortable. So unless the doctor thinks that’s needed, other less invasive treatments that may help perhaps try first. At the same time, probing can physically check if your glands are blocked, especially with scar tissue.

Assuming MGD is your main issue, once that is reduced or your glands are open with whatever treatment it takes, other treatments, diet, etc. that didn’t work before may now help improve your quality/quantity/flow oil, reduce inflammation, provide comfort, etc. In my case, things like diet changes, blinking exercises, and Ocusoft Lid Scrub Plus Foam have improved my oil quality/quantity/flow and kept my glands unblocked, when those things didn’t work before probing. As all this helped me get a thin tear film back over time, I was able to wear sclerals again and not need my heavy, strong prescription glasses. It takes time to find what works, and is a continuing process. As I continued to get better, I no longer needed sclerals, and last year my eyes had improved to the point I could have successful cataract surgery, and no longer need glasses.

If I didn’t take that step to see a doctor who had more expertise in treating meibomian glands, I don’t know where I would be right now. So I think you are absolutely right on getting an opinion of a doctor who does this.