Meibomiam gland dysfunction/bleptheritis

Hello

I am desperate for help. I have had this condition for 7 months now, my eyes are red and burning/stinging all the time. I have seen an eye specialist here in the uk but he says there are no more options. I do warm compresses and eyelid massage everyday, lid cleaning too. I use hylo forte eye drops and a gel at night. Have had steroid drops tried doxycycline tablets but they made me sick. Tbis is so very painful and has made me depressed.  Any advice would be greatly received, thank you.

Original Post

Kippy, have you had refractive surgery that caused this problem, or is it something that just sort of showed up 7 months ago? There are a variety of conditions that can cause the kind of problems you describe.

Poor tear film composition, even if you make tears, may cause redness and pain. There are also autoimmune diseases that may present with these symptoms. Have you been tested for anything?

Hello

Thank you for your reply. I had lazer eye surgery in 2001 and haven’t had a problem until now. I have been tested for sjordens disease but blood test was negative. Some meibomian glands have atrophied, doc said about a third on each eye.  I do not know anyone else with this condition and am scared what the future may hold, I would like to hear some success stories.

kind regards

Kippy

Did the doctor you saw have any sort of diagnosis for you? Did they indicate that you have dry eye? Have you been tested for allergies? Do you use drops, and if so, what kind? Has your doctor tried punctal plugs, or mentioned Lipiflow (a treatment to clear the meibomian glands, done in office?

To say there is nothing to more to do would indicate more a lack of knowledge than a lack of treatment options. You may need to find another doctor.

Thank you for  your reply. Yes he says I have Mgd, Blepheritis dry eye. I have had steoid drops, tried loads of lubricating drops and am now using hylo forte in daytime and an eye ointment at night. I have punctual plugs. Couldn’t take Dixycycline as it made me sick. Another doctor said there isn’t any mites so haven’t had an allergy test. The burning and stinging is unbearable 😔

 

(1) Did your doctor recommend the number one treatment for MGD, namely hot compresses?

(2) Did your doctor recommend lid scrubs?

Punctal plugs are for aqueous deficiency and won't help MGD although they might help secondarily if your aqueous levels are reduced.

Doxycycline is usually tolerated but if you were prescribed 100 mg daily and it upset your GI system then possible a 50 mg dose would work.

Hi

Thank you for your reply. I do the hot compresses and lid massage but pressing on the lid against my eyeball irritates my eyeball and makes it hurt

Doc said just clean eyelid margin with baby shampoo/water which I do

Doxyclycline 100mg twice a day, on day 3 I was being sick so couldnt take anymore. How does Doxy work?

I have punctual plugs in the lower ducts as I do have dry eyes too

I was told this is a common problem but I do not know anyone else with it and feel so alone. 

I am back on steroid drops for 6 weeks now.

Doing the warm compress and massage, how long should it take to get some relief?

Thank you

Kippy

Doxy works secondarily as an anti-inflammatory and seems effective for MGD. 100 mg twice a day is double what I prescribe. Better to have used 100 mg once a day, or 50 mg twice a day or 50 mg once a day to start.

MGD is a chronic condition, not really curable. It requires management. You may need to compresses and scrubs intermittently once it is under control but there are times you will need to do both more often.

Thank you Doctor. What can I do about the eyeball being painfull when I massage, is this commonplace or am I pressing too hard, because I can’t see the oil coming out it’s fifficult to tell if I’m pussing to hard or not enough. Your thoughts please.

Kind regards

Kippy

Tenderness is due to the inflammation of the glands. That's not a bad thing because it means the congestion is acute and resolvable. (Cold, hard, non-tender lumps take much longer to go away or may have to be removed surgically.)

Gentle pressure applied below the area (lower lid) or above the area (upper lid) can help move things along but avoid squeezing the actual lump. Be patient and let the hot compresses do the bulk of the work. Expect this to take several days. In the future, at the first awareness of any new tenderness in you lid, get back on the compresses. The sooner you apply the compresses, the quicker it can be resolved.

The actual term for this is "internal hordeolum" and is not to be confused with s a stye which is a tender bump right along the lid margin. Those usually come to a head that can be expressed more easily since it is usually just one pouch, similar to a pimple. Styes can be brought to a head with hot compresses as well. Internal hordeolums take longer to go away.

Hi thank you, but I have been doing hot compressess and massaging lids for 6 months, twice a day, the pain, stinging burning doesn’t go away. Had to give up my well paid job as vouldn’t bear to look at a computer screen, as the pain was worse. Anything else I can do?

Kind regards

Kippy

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