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Over the last several months, it's been very encouraging to get emails and posts from you about my LASIK dry eye blog. Initially, it's purpose was to vent my frustration and help someone else that might be traveling the same road (that seems endless without end at times). I had no idea if anyone would read it. Imagine my surprise when people started writing and asking if there would be another blog when there weren't any posts for a month. Thank you for writing... all of you. There isn't always time for me to respond to everyone, but I'll write when time allows.
Today, I'd like to share an email a reader sent me about suffering with MGD or
Meibomian Gland Dysfunction. He's asked some very good questions and it seems that everyone would benefit from reading my answers. I've removed his name and other identifying information.
His Letter (some sections removed to conserve space):
The reason why I am contacting you is because you're the only person that really 'gets me'. A month ago I was diagnosed with 'mild mgd', however, it certainly doesn't feel mild. The pain, the daily struggles is honestly debilitating and only you would know that, but then .. 'it's only a bit of dry eye, you'll get over it'. That's all I used to get told.
4 months ago the pain was unbearable to the point where I would go home from work, after weeks of waiting I finally got told I had MGD. Of course, due to me being obsessive on the web, I knew it wasn't good.
Sometimes I'm okay, but the majority of the time my eye's aren't 'dry', however, have ever so slight pain in the side of my eye that doesn't disappear. Whilst my eye's are open, this slight pain remains. Do you get this? Even whilst using eye drops, it's still there. Like right now, whilst typing this after being on the computer at work for 5 hours, my eye's don't feel DRY, they feel tired and fatigued. Do you get this? Oh by the way, if it makes you feel better, I have this and I'm 22.
I sometimes this is my anxiety/depression (if I have any? - I don't know! I just think about it all the time and go on the DryEyezone.com). makes it worse. I was looking through pictures the other day from 5 months back, I was so happy, getting on with life. It makes me think if I had MGD then aswell, but I just didn't know about it. Knowing I have it has definitely made it worse, before I was diagnosed, I would be in slight pain at work (some days) and then go home and I was fine. Now it's everywhere.
1. How long should I give drops a chance? I have only used three drops, do you recommend I keep trying more to see what suits? Do I use them for a day, a week, a month to trial? If I had a drop that genuinely provided relief and abolished all symptoms for a while, I could live with this.
First off. It sounds like your doctor may not be diagnosing/treating you improperly. This is very common. My LASIK doctor never diagnosed my MGD; he kept blaming it on medications I was taking. Imagine my frustration when it was diagnosed over a year later by another doctor. Your glands are dying. This is the symptom of MGD. The glands secrete oil into your tears to keep them from evaporating. Please get help immediately. Once your glands atrophy, that's it... they are gone. I only have four on each eye lid that express oil.
There is no drop that cures this. I've found preservative free Systane drops and Serum drops (made with my blood serum) most effective. You can also try organic Castor Oil. Unfortunately, you will likely be using drops for the rest of your life. There are only two prescriptions in the market for dry eye and they don't treat MGD (Xiidra and Restasis). I did not find either helpful.
If you aren't satisfied with your doctor look again. I tried 7 doctors until I found the right one.
2. Moisture chambers, do they really work? It's on my list to try in the years to come if everything else fails. Sounds sad, but I don't want to try absolutely everything in 1 month and then be screwed, I like to have some hope and keep things for the future.
YES. Annoying to wear, but I use them. Especially important to wear them at night. See my earlier post on EyeSeals 4.0.
3. I have only seen 1 ophthalmologist. She basically said I have to get used to it as it's a chronic thing, but I can try plugs if I like. I hear MGD gets worse with plugs - I hear it helps - I hear that they're great and that people with MGD have seen great improvements.
Plugs can help. I have them. I don't know if it makes MGD worse. I've never heard that. It helps with tear evaporation. You should be doing hot compresses daily to get the oil to express through your glands. See my earlier blog on this. ...Followed by eyelid massage. Since your in the UK, the EyePeace Eye lid massage tool can help with this as well (I have done posts on hot compresses, eye lid massage, and the Eye Peace).
4. Should I be taking drops more often? On a bad day, every hour, today at work I have only taken 2 drops and it's 2:30pm. My eye's are fatigued! I don't know if they're 'dry'. Should I still use?
Take lots of breaks when you are staring at a computer. Watch my video on blink exercises. One of the causes of MGD is not blinking enough or partial blinking. Keep your eyes lubricated as much as you can. When the cornea gets dry it can cause damage. Always use preservative free drops. Hyco San has a nice product that is in Europe that lasts 6 months per bottle. I did a video on these too. I buy them on ebay.
5. I've gone all in and booked myself into the Dry Eye Center in London, they do an examination, all that stuff up to expression and IPL.
Great! IPL and Lipiflow are the two best options to treat MGD. They are not permanent however. My doctor said I will need Lipiflow every 6 months. I've not tried IPL yet. Apparently, it helps remove rosacea around the eyes and heats the glands so they express more oil.
6. You did lipiflow and you said that you experienced relief for months - what was this relief? Symptoms abolished? Felt normal? Or to the point where you could deal with it and you felt comfortable.
Lipiflow is the best treatment for MGD that I tried. It doesn't cure it, but it makes life more manageable. There are some days where I can go for hours without drops. It just depends on what kind of day I'm having and the weather conditions. Getting a full night of sleep really impacts this as well. Wetter climates and wetter times of the year help. Winter time and dry climates are the worse for my eyes.
I so hope to hear back from you dude,
You did! Stay strong dude. I hope this helps. Matthew
Disclaimer: I am not a medical professional. I take no responsibility or accept any liability for the advice or opinions expressed in this blog (this is a fancy way of saying you can sue me if my advice doesn't work for you). Always check with your doctor before trying anything recommended on this site. Everyone's journey is different and what might work for me, may not work for you.
Bluesifyin' LASIK Dry Eye sufferer. Read my blog to get tips, struggles, blues, reviews, whatever on this journey through hell.