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  • Posterior Blepharitis/Meibomian Gland Dysfunction

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    Old 05-11-2004, 07:04 AM   #1
    calibug
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    Posterior Blepharitis/Meibomian Gland Dysfunction

    Hope we can get a good discussion going on this type of Blepharitis. Anyone out there have Posterior Blepharitis? It is a problem with the oil glands. Mine started about two years ago. I went to different optometrists and also an allergist. Of course wrong direction. I finally figured out I should see an opthalmologist for this.

    I started out having too much oil and now my oil has thickened. What used to be just an occasional nuisance has really begun to be a daily trial. My face blushes from time to time and stings so we believe this to be caused by Rosacea. This only started recently.

    I use only preservative drops now in the vials. I used to think the others were preservative free. That has helped some. I have been on Restasis for almost 6 months now. No real difference. My Schrimer (sp?) test was pretty high (29) which I am told is because of the dry eyes. My tear glands overcompensate because of the lack of good oil. Funny...the time before my Schrimner test was 6 in one eye and 10 in the other.

    Here are a few questions I hope you all can help with:

    Can you actually lose the function of these meibomian glands overtime?

    Can you actually stop producing oil??

    I've seen a few messages about new treatments coming out. Any news on that?

    I, of course, do all the warm compresses, cleaning with Ocusoft, massages, etc.... I do have good days and bad days. I'm just afraid that this might get worse overtime. I've started back on the doxycycline (never used it very long). I am a bit concerned about using all the antibiotics but there doesn't seem to be a simple answer here. It is a condition that should be controlled...how do you know when it is under control? Are your eyes still supposed to be so irritated and burning even while the condition is under control??

    Hope we can put our ideas/tips together in this thread! Look forward to hearing from you...Calibug

     
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    Old 05-11-2004, 02:16 PM   #2
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Sorry you are having problems. I also have the same problem. I do have Rosacea and it travelled into the eyelids. Many will have eye problems and then Rosacea shows up.

    When I quit the Erythromycin ointment at night, my eyes return to being irritated, etc. Using the Erythromycin on regular basis my eyes do not bother me and I fail to recognize need to add eye drops. I use Systane eye drops, hot soaks, eyelid scrubs.

    Used the Occusoft scrub for a while and then eyelids became more irritated. I now use a weaker solution of Johnson's Baby Shampoo, q-tips for cleansing eyelid edges and a cotton cosmetic pad to cleanse outside eyes/lids.

    I have been battling first eye inflammation and then 9 months ago Blepharitis took over and it has been a battle.

    Doctor told me several people are on the Erythromycin ointment for long term. I was not able to continue the Doxycycline, bothered my stomach.

    As you probably know, there is no known cause or cure for Blepharitis. It is a matter of keeping it under control.

     
    Old 05-11-2004, 03:55 PM   #3
    mani81
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    marie,

    how serious is your blepharitis? It's still not under control after nine months?
    I have minor blepharitis (1-1.5 out of 4) I've been told to only do the warm compresess. Do you think mine will take long to control? I've been doing the compresses for almost 2 months and now there swollen and more swollen when I do the compresses. I don't have rosacea, so do you think I should be ok?

    thanks

     
    Old 05-11-2004, 04:12 PM   #4
    calibug
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Thanks for the post. I've tried the ointment and wondered if I had a reaction to it. I only tried it for about 5 days and one night my eyelids really hurt and swelled up. I then had a meibomian gland clog up about a day or two later (that never happened before). I stopped the ointment and I haven't had a clogged gland since nor that pain. Can the ointment actually clog your glands??

    For Mani, what kind of blepharitis do you have?? If it is not getting better, I wouldn't wait too long. I would probably go back to the doc to make sure. If I knew now what I didn't know two years ago, I really don't think I would be in this position. I did not understand how long I had to be on the doxycycline and also with Rosacea, there are triggers. You might try to see if there are things that make your eyes worse. I'm not sure, but I think triggers can irritate the eyes too.

    I can't believe today. My eyes feel almost normal. I am wondering if the doxycycline is finally taking effect. I've been on it for almost 10 days. Who knows. It also rained today....that always seems to help with the dryness.

     
    Old 05-11-2004, 05:04 PM   #5
    mani81
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    hey Calibug,

    I think my bleph is related to seborreich (sp) dermatitis although I have not been diagnosed with it. I have crusting along my lash line and it tends to flake. My doctor who I recently went to said it was very minor and I should not worry too much about it getting worse.It's just that I now have swollen eyes in the morning, when I do the compresses and a little bit as we speak. The doc said that was a good sign cause my oil glands are unclogging (this was three weeks ago). Since It hasn't gone away and am told it takes a long time to get under control. I'm hoping it isn't too much longer! The only thing I don't understand is when it is under control what are the chances of it coming back?
    I'm glad the doxy is working well for you. How long have you been doing the compresses? And how bad is your blepharitis? Do you have alot of crusting?
    Have you been to the dermatologist for your rosacea? Maybe they can subscribe something for your eyes.
    Keep me posted.
    Mani
    P.S. i don't think your eyes should burn or get irritated once the condition is under control. Once under control your eyes should feel normal. Do you find that your eyelids burn a lot. Mine do when I sweat, and I don't know if this is realted to the bleph.

    Last edited by mani81; 05-11-2004 at 05:07 PM.

     
    Old 05-11-2004, 07:06 PM   #6
    calibug
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    No...I don't have flaking. Yours does sound like Seb. Derm. with the flaking. I use creams for the Rosacea. You would never know I have it. My face looks normal. I guess we caught it so early plus I have a very mild case of it. The eyes are the biggest concern.

    I would think that the eyes should be comfortable once this is under control. I'm going to talk to my eye doc about it at the end of the month. I really don't know what normal is anymore. I was told that it comes and goes. I can be fine one minute and then an hour later they burn. It is pretty confusing.

    My lids are sensitive. I've been avoiding makeup. I can't get near eye shadow. One thing is for sure...keep up on the warm compresses and cleaning. From what I can tell, you've really got to keep that up. Massages are good too to keep the oil from clogging.

    Hang in there. Let me know how your progress is going. Hopefully this will be a manageable thing here real soon for you!

    P.S. You asked how long I have been doing the warm compresses....Almost a year.

    Last edited by calibug; 05-11-2004 at 07:14 PM.

     
    Old 06-27-2005, 07:22 PM   #7
    Ladymoon
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hey guys,
    I've heard about this herb combo that can cure the condition. it's called herbchina 2002 or something. just type in "blepharitis" and "herb" and search. do you guys believe it? i've heard that chinese herbs can do wonders, but i dont know about in 2 months. but it claims to be very good. if its worth a try, id do it. i'd do anything...
    btw, calibug, i heard you're doing better. do you have any more symptoms? is your condition under control now?

    Last edited by Ladymoon; 06-27-2005 at 07:23 PM.

     
    Old 06-27-2005, 11:09 PM   #8
    CSLewis
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hi - my bleph/mgd/dry eye problems first appeared in April 2003 (I can't believe it has been over two years!). The symptoms I experienced for the first six months were severe and included burning, swollen eyelids (especially at night), a constant "gritty" sensation, photophobia, redness (my eyelids AND my eyes), and eyes as dry as the desert. I was constantly having to use artificial tears. I must have gone through about a hundred tubes of GenTeal gel that summer! I was hopeless. I didn't think my eyes were ever going to feel "normal" again. It was some time in August of that year that my eyes SLOWLY started to get better. I think my condition started to improve because I became very diligent about doing the warm compresses and lid massages, and I started taking doxycycline (oh, and I started seeing a new, GOOD ophthalmologist). I was off and on the doxycycline for a long time and I kept up with the compresses/massages. Finally, at my most recent visit to my ophthalmologist last April, he couldn't find any signs of inflammation or MGD/bleph. I was so happy to hear that! Now I have been off the doxycycline for about five months and haven't had any recurrence as of yet. My eyes feel just fine (dare I say - normal). I just can't believe what I went through. It has changed my life. There's not a day that goes by that I don't think about has happened to me.

    I don't think doctors have a really good understanding of this disease or the best approach for treating it. A lot of the burden falls on the patient to figure out what works best for him/her. What works for some people doesn't work for others. Some people are more severly afflicted and suffer for long periods of time while others have only minor symptoms and get the disease under control quickly. And as for permanent damage to the meibomian glands caused by this disease - I don't think I've heard or read anything about that. But I guess it's possible? I don't know.

    How do you know when you have the disease under control? I'm not sure about that. For me it was when I could sleep through the whole night without having to use artificial tears (that was a big milestone). And when I felt like I didn't have to do warm compresses or lid massages anymore. When I could make it through the whole day without having to use tears (another big milestone for me). When I could watch TV or stare at a computer screen for hours without my eyes feeling dry. When I could leave the house without bringing a bottle of GenTeal drops with me. When I could wake up in the morning to white eyes instead of blood red eyes (red eyes was the symptom that took the longest for me to get rid of).

    Okay, hope this helps and that I addressed all the questions you asked. And my greatest wish is for everybody here who suffers from this awful disease is to get it under control, whatever that means I understand how frustrating it is. Good luck!

     
    Old 06-28-2005, 01:45 AM   #9
    Ladymoon
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hey Jen!!!
    So glad you checked back. I'm sooo glad to hear that you're still good...really gives me A LOT of hope...and believe me, i really really really need it. anyways, you said that your eyes were most swollen at night. May i ask where it was swollen? that's odd b/c i feel the same way...like when its really dry, but i read that w/ mgd it should be worse in the morning. so im glad im like u. and u also mentioned ur doctor could see inflammation on the lines...what does that mean? i can only see little memoibian cysts. also, my doctor says that its a lifetime thing, so that even after it gets under control i still need to keep up compresses, etc....but did ur doctor say you were COMPLETELY recovered and dont need to do that? did you get it under control so quickly b/c you found out early about it? i hate to think that b/c i started treatment late it cant get to where it could have been, esp since i was only 17 when i first got it.
    anyways, i'm sorry for flooding you w/ questions. but sometimes i feel really really hopeless. if you have time, i would really really appreciate the help. thanks a lot and hope to talk to you soon

     
    Old 06-28-2005, 04:36 PM   #10
    jack94
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    hi ladymoon , are you really sure it's lifetime ??? as i already told u , the eyelid of my left eye is different shaped than my right eye eyelid because of the swellings due to the gland dysfonction
    i've seen the best specialist in france about eyelid , he gave me a warm + massage treatment which i do since 3 weeks now but , unfortunately for me , i see no improvement . As he told me , i'll contact him again for a heavier treatment , but he didn't appear to be very optimistic about the chance it go away so i ask :

    are there people here who have a similary problem ?
    there is really no chance of getting it cure ?

    this problem is really killing me day by day u couldn't understand how it absorbed my life

     
    Old 06-28-2005, 05:47 PM   #11
    Ladymoon
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    hi jack,
    im not sure if u have the same problem....is urs a tender or hard swelling? mine is tender and changes dayly...my doc said its due to the irritation from the oil and bacteria, so as long as my mgd is cured/under control, the swelling should go. but if urs doesnt change and is a hard swelling its not due to mgd. do u know what it is due to? mines is like a reaction to an allergy but constant. urs may be different. do u know what it is?

     
    Old 06-28-2005, 10:52 PM   #12
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Quote:
    Originally Posted by Ladymoon
    hi jack,
    im not sure if u have the same problem....is urs a tender or hard swelling? mine is tender and changes dayly...my doc said its due to the irritation from the oil and bacteria, so as long as my mgd is cured/under control, the swelling should go. but if urs doesnt change and is a hard swelling its not due to mgd. do u know what it is due to? mines is like a reaction to an allergy but constant. urs may be different. do u know what it is?
    Yes mine is pretty constant , as doc told me it's due to clogged duct , something like that

     
    Old 06-28-2005, 11:46 PM   #13
    CSLewis
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hi Ladymoon - no, my doctor didn't pronounce me as "cured". Unfortunately, as you know, there is no cure. He just couldn't see any signs of my ever having had the disease at that point in time. And he said it's possible that the disease could stay "dormant" for the rest of my life, meaning that I'll never experience any symptoms ever again (I hope and pray). But I'll always have the disease, so I just have to make sure I carefully monitor my eye health on a daily basis. He didn't tell me that I could stop doing the massages and compresses. I just decided to do that myself. It seemed to me after a certain point that they were just irritating my eyes more than helping them. But I think that while you're in the stages of trying to get the disease under control, compresses and massages are absolutely essential! Back when I first started to experience symptoms, I used to do them about 6x/day. I gradually dropped that down to 1x/day. And now all I do is rub my eyelids a little when I'm in the shower and have warm water flowing over them. I also keep my lids super clean by soaping them up everyday. This regiment has been just perfect for my eyes. Actually, my eyes seem to be most happy when I just leave them alone and stop fussing over them!

    So your eyes are swollen at night, too? That's when I'd get it really bad. The parts of my eyes that were actually swollen were the lids. And it made my eyes feel like they were on fire!! I couldn't sleep at all. I'd get up at all hours of the night to get fresh ice packs. Can you believe that I used to have to try to sleep with ice packs on my eyes?!!! Yep - that's how bad it was for me. I'd get so frustrated and I'd try to cry, but I couldn't produce any tears because my eyes were so dry. Wow - how sad is that? Do you have that burning sensation as well? I sure hope not. What are your eyes like in the morning? You mentioned that you have a lot of the meibomian cysts. I didn't get those so much. But when I'd pull out my eyelid to check the inside (the part that rests against the eyeball) I could see all the white lines of the inflamed meibomian glands (these are the "lines" I think you were asking me about). Those lines are gone now and I can't see them anymore.

    I actually didn't get a proper diagnosis for a long time. The first ophthalmologist I went to see (in April 2003) didn't know what I had and actually made things worse by having me put all these different kinds of drops in my eyes. This made me really mad! He was just treating the symptoms without trying to figure out what was actually wrong with me. My eyes just kept getting sicker and sicker. I actually ended up in the emergency room at one point. I finally said goodbye to this doctor and went on my own for a while until I found a new ophthalmologist I could trust (this was in August 2003). He properly diagnosed me and gave me HOPE (unlike the other doctor who told me I'd have to live like this for the rest of my life). He was very patient with me and I could tell he cared about making me well. He also made sure that I understood that this is a disease that can take a considerable amount of effort and time to get under control. It's not like a cold or flu that goes away in just a week - this could take months or years and I had to be prepared for this. He assured me, though, that I would in fact get better, but I needed to be patient. This was all I needed to hear. It's amazing what a little hope can do.

    Okay, I've been rambling on and on. I hope I answered all your questions. If you get a chance, let me know more about your history with this disease (i.e. when you first got it, symptoms, medications, etc.) and we can compare notes. I'm just sure you can beat this! Hope to hear from you soon.

    Jen

     
    Old 07-01-2005, 09:12 PM   #14
    Ladymoon
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    Talking Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hi Jen,
    Thanks so much for taking time to talk to me, even after you've gotten over the problem. I really appreciate it. Actually my problem started in March of 2002. At first my main symptom was that my lids were swollen - all day, not just at night or in the morning. it would be worse in the morning but never completely go away. its not a very obvious swelling, more like kind of a tender edema around the eyes, as if I were really really tired, and i'd have undereye bags all the time. at first i thought it was b/c i was so tired, so i didn't pay attention to it. but then it didn't go away, and my eyes began to sting sometimes. but no doctors knew what it was: one said it was allergies. later a few doctors said it was b/c of my contacts and that i'd have to not wear contacts for at least 1 year for it to go away. so i stopped searching for doctors and discontinued my contacts wear. but over two years later it was still there, and it was getting worse...I was experiencing more symptoms, especially the stinging and dryness ( i also took accutane in 2003, which may have brought on the dryness).
    finally in june 2004 i went to an op that told me i had meibomitis and told me the correct treatment. when i first did the compresses, etc, it got really bad for about a week, and then a lot better. so i had a lot of hope. my lids were still swollen, though, and it would get a bit more swollen and my eyes would get red after doing the compresses, but the redness never lasted long. so at this point i was wearing my contacts and treating it, hoping it would clear up soon. for the first 8 months or so i only did compresses twice a day - morning and night - and wore contacts, eye makeup, etc., so i think maybe i didn't implement a good enough treatment. So about 2 or 3 months ago i started doing the warm compresses more often, now at least 4 times a day, and i also try to squeeze out the oil as best I can (do you think forcing too much oil out can be bad for the glands?). i also scrub w/ baby shampoo and use erythromycin at night. i've also been on doxycline for almost a month now (my doc's pretty conservative and didn't really want to give it to me for a while). i actually don't have the stinging feeling much anymore...my main problems now are the swelling (like before, tender, on and around the lids w/ undereye bags - what kind of swelling id u have? I also have burning feeling, esp since im doing an internship in an office w/ heavy a.c. and using a computer. The swelling is worst in the morning and at night, and the burning is worst in the office and at night; eyes are also dry at night and i can't wear my contacts anymore ( i think they also increase the swelling..is that possible?). so i've taken a semester off school to really take care of my problem w/ rigorous treatment b/c i'm afraid the longer it takes to get it under control the worse it may get.
    sometimes i'm really scared that b/c i didnt take care of it for over two years in the beginning, it won't be able to get under control anymore. i hate that no doctors were able to diagnose me properly; i believe that if i got the right treatment in the beginning it would be under control by now. i also wish i did a more rigorous treatment after i found out in the beginning. do you think that if i haven't gotten it under control after a year of treatment, its still possible to do so? also, you said you had inflamed white lines...when i look at the inside part of my lid (the part w/ contact to my eyes), i can only see red lines, which seem to be going to the rim, but nothing white, can you describe it a bit more? Also, when were you finally symptom free? do your eyes look completely normal now? and are you able to wear eye makeup now? honestly, i can deal w/ the burning and the dryness, but i really wish the swelling would go away. i know it sounds vain, but i'm only 20 and it started when i was 17 (what a great way to spend your teen years huh?) and at my age, esp as a girl, its looks are really important to me. i'm actually a very optimistic person and has hope, but sometimes i get so depressed about my problem b/c im so scared that it can never clear up. and i get more depressed thinking about how it probably would be better if i just did the proper treatment earlier. honestly, the only wish i've made to God in the past three years was for this to go away....alright, i'm going to stop the rambling. i'm sorry its so long, but i just really wanted to tell you my feelings. i also want to tell you that in the past year i've read your previous posts over and over and they really give me hope. thank you so much. i would really appreciate your reply when you have the time.
    ting.

    Last edited by Ladymoon; 07-07-2005 at 01:12 PM.

     
    Old 07-29-2005, 02:04 PM   #15
    Ladymoon
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    Re: Posterior Blepharitis/Meibomian Gland Dysfunction

    Hi jen, just writing a new message so that if you came on u might see my last post. i know its long so please feel free to reply when u get the time.

     
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