New to Meibomian Gland Dysfunction

[London19]

About 6 months ago my left eye started bothering me (foreign body sensation, irritation etc), and I saw a series of doctors who kept telling me it was either an inflammation of some sort or dry eye, and they gave me a variety of steroids, none of which really helped. (it helped often when I was on the steroid, but would resume as soon as I was off it).

I eventually saw a doctor who said it was Meibomian Gland Dysfunction, and put me on Azasite for a few weeks, which I did together with lid cleaning (using Ocusoft), which seemed to help. For about a month the pain largely went away - only hurting a bit in the morning and in the evening (when I wasn't wearing contact lenses). (The strange thing is that my discomfort has also been at the lowest levels when I am wearing contact lenses.)

The doctor told me to do Azasite for a week every month to keep it in balance, but when I restarted ocusoft the symptoms seem to have got worse, and a week of ocusoft didn't help. For 3 weeks I did nothing - I was traveling - and the symptoms were low.

When I returned home and started doing lid hygience - using ocusoft again - symptoms have flared up, and now for the first time my right eye is bothering me. I don't whether it's because of the exteme heat and air-conditioning, or just a coincidence.

I never did lid massages before, so I'm starting that now. And my doctor suggested Ocean as well.

Any thoughts on my experience, and specifically: tips for lid massages, why pain would be less when contact lenses are in, and any thoughts on my experience and what I should be doing ...

Thanks!

[Melissa W]

Hi London,
Lid massages are critical for MGD. Have you seen our info on MGD here?
http://www.dryeyezone.com/encyclopedia/mgd.html

http://www.dryeyezone.com/encyclopedia/lidtherapy.html

Hopefully, once you are regularly doing lid massages and warm compresses in addition to the meds you will getting relief. Not sure about why they feel better with the contact lenses in your eyes...could be that the contact lenses are helping retain moisture- what lenses are you wearing? Anyway, make sure to keep the contact lenses clean (I prefer daily disposables if possible) and never sleep in them. It could also be that the cl's are desensitizing your eyes allowing them not to feel discomfort and that would be a bad thing. Make sure you replace them as necessary as a coated lens doesn't allow enough O2 through to the eye.

Hope the info in the links help and feel free to ask any questions.
Welcome to the RF!

Best,
Melissa

ps I moved your thread to the Ocular Rosacea section

[London19]

Thanks Melissa, I did see those posts, and they were useful. (I use bausch and lomb soflens 38).
There are just a few things that confuse me:
1) Why Azasite would seem to work first time round, but a couple of weeks later when I tried it it didn't help?
2) Is it usual for it to also start to bother me in my right eye, when for the last 6 months it was only my left eye?
3) Does extremely hot weather / air conditioning effect the symptoms?
4) I'm a bit confused as to how best do the lid massages (and what exactly to do), and whether I'm doing the lid cleansing well enough? (I'm using ocusoft and just wiping the lense from side to side).
5) Whether there are any other tricks/hygiene tips to reduce the discomfort?
and lastly
6) why in the first place MGB would start seemingly out the blue?
Thanks!

[Melissa W]

Thanks Melissa, I did see those posts, and they were useful. (I use bausch and lomb soflens 38).
There are just a few things that confuse me:
1) Why Azasite would seem to work first time round, but a couple of weeks later when I tried it it didn't help?
2) Is it usual for it to also start to bother me in my right eye, when for the last 6 months it was only my left eye?
3) Does extremely hot weather / air conditioning effect the symptoms?
4) I'm a bit confused as to how best do the lid massages (and what exactly to do), and whether I'm doing the lid cleansing well enough? (I'm using ocusoft and just wiping the lense from side to side).
5) Whether there are any other tricks/hygiene tips to reduce the discomfort?
and lastly
6) why in the first place MGB would start seemingly out the blue?
Thanks!

1. It may take time to start working again. Most treatments I find do not work immediately even if they seem like they do at first you may have a bit of a setback until the treatment truly takes hold.

2. Yes, because these conditions tend to be bilateral if not symmetrical and may not affect you at the same time initially but may eventually affect both eyes if not properly treated.

3. Absolutely. The air conditioning takes out the moisture from your tear film drying out your eyes and making everything more uncomfortable. Hot weather depending on humidity level can absolutely affect your eye comfort as well. Some people do better with moist warm air but you need to watch out for the cold dry a/c when you go inside!

4. I really like the description of lid massages in the link I provided for you:

Example #1: The index finger is rolled up the lower lid to the lid margin. Pressure is applied inwards as the finger is rolled up to express the secretion from the gland. Lid massage should be done 20 to 30 times on each eye. There are 23 glands in each eye, running upwards to the lid margin, behind the eyelashes. Ensure that you do 3 rolls to cover the entire lower lid and all of the glands. Research has shown that as few as 2 glands blocked can have a detrimental effect on tear film performance. Think of your finger being like a steam roller. Pressure must be kept in against the eyeball to keep the gland blocked as your finger rolls up the lid and the fluid inside is pushed out.
Example #2: Pinch the lower eyelids between thumb and forefinger to express the meibomian glands and bathe the eyes with saline solution to remove excess material. Squeezing the upper lids is not advised
Example #3: Take a Q-tip and gently but firmly roll it from a position about 1/4 inch below the eyelid upwards until you reach the lash line. Repeat this for different positions on the lower lid.

As far as lid scrubs make sure you are being gentle gentle gentle. Gently cleanse where your lashes meet your lids so your lid margin is free of debris and then thoroughly rinse with water.

5. I love cool compresses for comfort. Some people swear by tea compresses etc but I just like anything cool over my eyes when they feel irritated. You can buy those eye gel masks at the drugstore and keep it in the fridge for quick and cool relief.

6. It probably did *not* start out of the blue but as with many conditions just seems as if it did. For example, I am now dealing with a knee injury that seemed to just happen one minute but probably all the trauma from running, cycling etc weakened my meniscus etc and then one minute it just gave out.

Good luck and let us know how you are doing!

Melissa

[London19]

Thanks Melissa. Will give it time and see what happens. I've bought a rice bag from the store and will try that.

Can I do all the heating with my contact lenses in?

[Melissa W]

Hey London,
You should remove your contact lenses before using warm compresses or even cool compresses or lid massages.

Good luck.

Melissa