MGD and Ocular Rosacea - Rosacea Message Board

missmolly89 · 10-12-2003, 09:54 PM

I have been diagnosed with Meibomian Gland Dysfunction as well as Ocular Rosacea. I was given Minocycline at 100mg daily and Blepharide ointment. I have been on this for a little over a month with no improvement. I know that these things take time to work but I would think that I would at least have slight improvement. I think things have gotten worse. My upper eyelids are both so swollen that it looks like I haven't slept in weeks. I have constant red eyes, especially in the corners and lid margins. Plus I have blood vessels all over my eyeball, but really bad on the top of the eyeball. I constantly have headaches from the swelling in my eyes. I don't know, but I would say that even my eyeballs are swollen.

I just need some support and suggestions. I just don't think that I can spend the rest of my life like this. Surely there has to be something that can be done in order to have normal eyes again.

By the way it has taken me 3 different doctors to get this diagnosis. The last one told me to do the lid scrubs ( never explained how), gave me the meds and out the door he went.

If anyone out there can help, I sure would appreciate it!

Jen2003 · 10-13-2003, 01:00 AM

Hi missmolly - I think I responded to one of your earlier posts about chronic bloodshot eyes. I had this problem too, and I have also been diagnosed with MGD and ocular rosacea. I just wanted you to know that you can and will get your symptoms under control. BUT you have to be very diligent about doing the warm compresses and the lid massages in order to keep the meibomian glands functioning properly. Did your doctor explain this to you? If not, let me know and I'll try to help you with the details.

I think that's good your doctor started you on a cycline derivative. I have been using doxycycline for two months now (100 mg/day) and have experienced dramatic results. It has really helped to reduce the amount of redness I had in my conjunctivae (they're actually starting to look white again!). You just have to be patient for it to kick in and start working (maybe one month?). As for the Blephamide, I would just be extremely careful with this drug - it is a steroid and can affect intraocular pressure. PLEASE stop taking it immediately if you have any pain because it can permanently damage your cornea and/or optic nerve. This is what almost happened to me. Thank goodness I stopped taking it in time!

I think the most important things to do if you have this disease, as I mentioned earlier, are the warm compresses and lid massages (at least 4x/day). You should also drink tons of water throughout the day and maybe try some of those eye nutrition supplements. I take a couple of those TheraTears Nutrition pills every morning and night. But if you decide to use these supplements, DON'T take them within two hours of having taken your minocyclene - I think there may be some absorption issues. Another thing I do is use a prescription medication called MetroCream. My ophthalmologist told me to put it on my nose, cheeks and forehead once a day. This cream is usually for people who have the facial form of rosacea (which I don't have), but my doctor says it is of some benefit to the ocular form because it helps reduce inflammation somehow (not exactly clear on this). And finally, NEVER use any eye drop that has vasoconstrictors (drops that "get the red out") - this will only make your condition much worse!!

Also, are you experiencing any dry eye symptoms? The warm compresses and lid massages should really help with this. And you should use an artificial tear that is preservative-free (you probably already know all of this).

I hope you start to experience some relief soon. If it's any consolation, I've been there and I know what you're going through. It took me months to figure out what was happening to me - the first ophthalmologist I went to could never give me an answer, and I suffered greatly. I am so happy I'm seeing this new doctor now. He has helped me a lot and seems genuinely concerned about seeing me get better. I hope you find a doctor like this, too. Please be patient - there is hope that you will get your symptoms under control.

missmolly89 · 10-13-2003, 09:54 AM

I am going to ask my eye doc about metro cream. How does it work on the eyes, though? Do you think I should switch from Mino to Doxycycline?

Can you tell me how to do lid massages? Also, I do use Visine daily because I would never be able to leave the house with the redness of my eyes.

purple2067 · 10-13-2003, 02:26 PM

The feeling of pressure in your eyes concerns me. You should go back to the doctor and get that checked. Does the ointment you are using have any steroids in it?

Also, I hate to say it but I think the Visine is the problem. It has a rebound affect. It gets rid of the redness for a short time, but then it comes back with avengance. Also, the preservative in it could be irritating your eyes. It's a very harsh drop, and not really good for the eyes no matter what the package says.

Jen2003 · 10-13-2003, 03:57 PM

Hi - I'm not sure if Doxy is any better than Mino in the long run. They may have different side effects - I'm not sure. As far as Doxy and Tetracycline, I know that Tetracycline is supposed to produce results faster initially, but they kind of even out around 6 months. And there are supposed to be less side effects with Doxy. I haven't experienced any side effects on this drug so far and it has the added benefit of making my skin softer and smoother. I think all the cycline-derived drugs work in the same way for blepharitis (meibomitis) - they're not really used for their antibiotic properties, but rather for their anti-inflammatory effects. So I guess if you're not experiencing any side effects from the Mino, maybe you might want to stay on it a little longer(?). If you haven't noticed any improvement at all, though, it may be time to try something else.

I think the absolute key things for you to do right now are the lid massages and warm compresses (I don't do the lid scrubs anymore because they just caused further irritation to my eyes). Doing these two things has helped me 10x more than any drug I've been put on -I'm not kidding you. I got rid of every single symptom of meibomitis, except the red eyes, doing just these two simple things at least 4x/day (my red eyes started to clear up more once I started the Doxycycline). Compresses and massages are absolutely essential for you to get your symptoms under control (have I made my point?). I'll explain how to do these in a little bit.

Another thing that I think would benefit you a lot is to wean yourself off of the Visine - I know it's hard to face the public with red eyes, but these drops are only doing you more harm than good in the long run. You may have noticed that when the Visine wears off, your eyes are redder than they were when you first put them in (this is called the "rebound effect"). Over time, the blood vessels in your eyes become permanently damaged as they lose their elasticity. Then they remain red and engorged with blood because they have completely lost their ability to constrict. As I said, I know how difficult it is to have red, bloodshot eyes - I'm sure people must have thought I was high on pot all the time! But you really don't want your eyes to become dependent on these drops. Just give them some time to clear up on their own, and try not to worry too much about what other people think (I know this is really difficult, though!).

I would definitely ask your ophthalmologist about the MetroCream. You should also ask him if he supects you have the facial form of rosacea, too, and whether or not you should consult a dermatologist. My ophthalmologist doesn't seem to think I have the facial form, though, so I never went to see a dermatologist.

As for the lid massages and warm compresses, try to do these at least 4x/day, definitely in the morning when you wake up and at night right before you go to bed. This will help to unclog the meibomian glands and get them functioning properly. For warm compresses, I would put a couple pieces of those cotton makeup removers under warm water then place them over my eyes. I would leave them on my eyes for about 10 minutes and just rewarm them under the water if they got too cool. While having the cotton on my eyes, I would gently massage the lids by pressing down on them and rubbing them. This helps to push out all of the clogged oil of the meibomian glands that line the inner rim of each eyelid (you can see these glands if you pull your lower eyelid out a little bit). After the compress, I would take my index figure and GENTLY push my eyelid against my eyeball to squeeze out any remaining oil. My ophthalmologist taught me how to do this and it works REALLY well - maybe you can ask your doctor about this next time you see him/her. I hope I explained this oaky - let me know if this explanation was too confusing. I should mention that the warm compresses/lid massages may seem irritating at first, but you will start to notice their benefits within a couple weeks.

Okay, keep in touch and let me know how you're doing. Stay hopeful and patient - this disease is tough to get under control and it takes a long time to get to a point where you're not experiencing any symptoms anymore. Believe me - I know. My doctor told me that the healing process was really slow, but he kept reassuring me that things would eventually get better. It's not like having a sore throat where once you start taking the medicine you feel well again in a couple of days. With this disease it takes weeks to notice just the slightest, tiniest bit of improvement. Honestly, with some extra effort on your part, it will get better. But don't expect the drugs to do it all for you!