I think the glands are the yellowish stripey lines passing down through the eyelids, quite long, which you can see inside your lower lid. It's worth realising that there are loads of other useful glands around the eye, some exiting around the eyelash follicles. And very important lacrimal glands. So maybe a gentle rub after warm compress is all that's needed if you're trying to get MGs moving without damaging other functions.
I still can't see my glands(various optoms have been able to see they are blocked without using any magnification
To me, excellent daylight is more important than magnification and if you stand right up to a wall mirror it's the best. I've got twins, one MGD, one not. I press gently with 2 fingers slightly upwards under the lower eyelash line and look closely along the eyelid edge, which, this way, is now slightly off the eye surface. In a good eye it hardly takes any pressure to see a tiny row of clear dots of expressed oil (looks like baby oil). With clogged glands there is a slight release of more whitish substance.
Now sometimes, in the good-eye twin, I can't see clear meibom - in fact I'm more likely to actually see it on a good meibom day in the dry-eye twin who's used to all this. However, even without seeing dots of oil on the eyelid margin, the good-eye twin will have blurry vision from expressed oil in the tear film.
To reduce the daily pressures on the glands and keep things moving, and contact around the eyes, we are using Blephasteam goggles every day. She still gets occasional chalazia from acne rosacea but all this helps. So we don't need to use antibacterial eyedrops unless infection's bad.
With us, if the glands are not infected and inflammation around the eye is well controlled, getting clear meibom then depends on making the good stuff in the first place by using good diet with oils and eliminating the cloggers in food.
It seems any inflammation, including allergy, prevents glands doing their thing. So we need to think about whether treatment or products eg detergent or eyedrop formulations are making things better or worse. We don't use warm compress in flareup because Job 1 is bringing down the inflammation either with cool compress, tear substitute drops from the fridge, or if unavoidable, meds. We are finding the MGs are not restoring till the eyes have weeks of 'quiet'.
Without regular warm compress, and on good days without any other problems it doesn't need more than an eye rub in a warm shower as Dr L says, we get chalazia then eye surface damage. For comparison, this MGD is caused by LM's rosacea-type skin which has sebaceous and vascular inflammation then infection but is also hypersensitive.
As Dr L tells us, if you've just rubbed your eyes or done expression there won't be any more for a while. He has posted that he is wondering why some of us are so keen to express the good stuff that's needed. For LM, it's about keeping things moving gently.
The ophth are telling me if we don't see oil dots, see if we get blurry vision, as you say, Robster.
It's also about doing the other things at home that help and allow a cycle of healing of all the functions - protecting the eye surface, increasing humidity, reducing allergens, blinking.
Last edited by littlemermaid; 09-Jun-2012 at 17:32.
Paediatric ocular rosacea ~ primum non nocere