After seeing 10+ doctors, I decided to spend the money on Dr. Latkany (I don't have health insurance). It was expensive but I don't regret it. First of all his staff is very nice. One girl in particular named Desiree who asks the pre consultation questions, made a very nervous me feel very at ease. Dr. Latkany was VERY warm and knew right away (I wear my heart on my sleeve) that I was upset about what is going on with me. He asked me what I have been experiencing and then examined me. He also told me that he could see that my eyelids are swollen from 4 ft away and I thought, FINALLY, a doctor who agrees with me! Upon examining me, he told me that he could tell that my MGD is caused by the skin problems that I've had for 14 years. He says that my oily skin and eyelid problem is one in the same. He said that the level of swelling I am experiencing is a little curious to him, and that he believes there is a component of allergies involved, whether it is food or environmental. He examined my meibomian glands and told me that none of them were closed which is a very good thing, he expressed them and said he had no trouble and it is mainly the quality of oil that is problematic. It's white and clumpy. We discussed my use of Accutane and he said that he sees TONS of Accutane users who have atrophied glands and that I am lucky to not be at that stage.
As for improving my condition, he told me that I must find out what is triggering the swelling because in his opinion there is no doubt an underlying cause. He told me to discontinue any warm compresses and lid scrubs because that will only do more harm than good while the swelling is this extreme. Instead, I am to use cold compresses for 1 minute, 5 times per day. Medicines I should continue are doxycycline 100mg, though he thinks I should stop in a week, pataday eye drops (for the possible presence of allergies), and to restart FML ointment. I asked him if I should continue using Fish Oil and he told me that while it is very good for people with dry eyes, it will probably not help me, especially with my skin already being very oily. He suggested using tumeric as it may be helpful with the inflammation.
The thing that kind of scares me is that in the beginning of all of this which started at the end of February, I'd only had eyelash loss and was using the FML ointment for 10 days before I woke up with swollen eyelid margins. It's since gotten MUCH worse so I am nervous about using the FML but I'm of course going to follow his advice. He gave me a card for the allergist he would like me to see, but I have no idea how I am going to afford this without insurance. He told me I could tell him (the allergist) that I am a good friend of his and maybe he'd give me a good discount. That was very nice of him to offer!
Anyway to be 100% honest I am still not feeling much better, because I feel that I am still at square one. He, like 10 other doctors, thinks that there is an underlying cause and I don't have the insurance or money to continue seeing different specialists until I figure out what that cause is. My eyelids look so bad...the skin is thick and swollen and has folds that make my eyes look droopy. As far as how they feel, they are heavy and a struggle to keep open..it makes me feel constantly tired and I feel sick looking at myself, it's like looking at a stranger. Also, I feel that the longer the swelling persists, the less likely it is that my eyes will ever look somewhat normal again. Not only that, but if I don't get my glands in check I will likely develop dry eyes, which I fortunately don't have yet. Key word ladies and gents, YET. My eyes are a mess.
If anyone is actually reading this, do you have any advice for a case of MGD like mine where it is mainly related to skin (acne, rosacea, seb derm)? I have stopped use of all products apart from Head N Shoulders shampoo and I use Occusoft lid scrubs. Also, I know that allergies can cause eye swelling and discharge, but I wonder if it can cause oily skin? If I do have allergies, I'm leaning toward it being from food..because I have always had gastro issues. I got diagnosed with gastritis a few years ago but the doc wanted to do a colonoscopy for further investigation and that's when I stopped seeing him lol. Not sure that would have showed allergies anyway?
I guess my first step will have to be process of elimination. My absolute favorite things to ingest are cheese and pasta, so knowing my luck...if I had food allergies it would be to something that I love. I will start with dairy and see if I notice any differences.
I'm feeling really sad =(
I guess I drifted away from the point of this post which was to say that Dr. Latkany is a really nice doctor lol. He spent a LOT of time with me and when I walked out he had a full room full of patients. I also shouted out DRYEYEZONE Basically he confirmed everything I already knew, but it was good to discuss it with a doctor who is specialized in this particular condition. I will definitely stick with him as a doctor and see him whenever I can afford to. I recommend him to anyone that is in or around the New York area.
Thanks for listening!