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Thread: Eyelid massage for MGD- how gentle/hard it be?

  1. #1
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    Eyelid massage for MGD- how gentle/hard it be?

    Hi,

    Despite doing eyelid massage for 7 months now, I am still feeling unsure about what a good eyelid massage should involve. How gentle or tough should it be? Am I doing enough? It seems in comparison to what some other people on this forum are doing (eyelid pinching, use of q-tips) I am doing a very laid back type of massage.. I hope not too laid back!

    It would be great to hear descriptions of others' eyelid massage routines. Hope to hear from you

    my routine: (3 min, 2x daily)
    1)heat up glands- usually blephasteam or clean towel held under hot water, placed over eyes
    2)with index finger, press each lid individually, from one side to the other, 5 seconds per press
    3)hold upper eyelid skin taught with one index finger, then rub along with the other (i often wet with saline to make it easier to rub across) 4-5 times each eye
    4)look up and press lower eyelid with index finger (same as step two but eyes are open so I can see if oil comes out)

  2. #2
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    Home massage will not provide much improvement if your MGD is chronic. You regular in office expression.

    http://www.drmalcolmmckellar.co.nz/m...pression1.html

    Read last paragraph.

  3. #3
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    I have a couple of things to say to this, but I warn ahead of time that you need to be very careful if you take my advice! Okay here it goes.

    In my opinion there is a much easier way to excrete your glands besides doing all this pushing, pinching, pressing, holding skin taught, etc. I recommend the following method:

    1. Wet a Q-tip (purified saline solution would be ideal, but tap water will do the job if you're confident in the cleanliness of the water in your area)
    2. Place the Q-tip inside your eye just behind the lower eyelid.
    3. Place your index finger below the height of the Q-tip, but on the outside of the eye.
    4. Push the Q-tip (which is behind the eyelid) into your index finger. This will result in you pushing the Q-tip downwards towards your index finger. Doing this will create a "sandwich" composed of Q-tip (on top), eyelid (in the middle), index finger (on bottom). The eyelid should excrete meibum if done properly and if your glands are not 100% blocked.

    Be very careful with the amount of pressure you use! Don't over do it. Be gentle at first until you get the hang of it.

    You can move along the entire lower eyelid and excrete every single meibomian gland you have by repeating this process as you move the position of the Q-tip along the eyelid. When I do this, I can literally see the meibum coming out of my glands. Heating your eyes with any method you like is recommended before doing the excretion since it softens up the meibum (oil) in your glands. I do this twice a day, once in the morning, once right before bed.

    Hope this helps, and if not, I hope someone else gives you some advice that works for you =)
    Last edited by Tankie; 06-Oct-2012 at 19:55.

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    lacrima-you sound like me... i always questioin this too..
    however. to be honest i hvae knocked several plugs out due to massage. so now i ususally apply warm moist heat (wet paper towel over rice baggy) for about 10 minutes-i reheat at 5 min..
    the i gentle push the lower glands back and forth about 3x trying to stay away from my plugs..my uppers i feel i have more control over and use a new qtip again and push against them. i get a blurry sensation which is good
    however,my doc manually expresses them monthly..i think what i do helps a bit but unfortunatley for me they clog up again!
    good luck!!! Ps i cannot put the qtip inside my eye-have tried and ouch that hurts!!! i go BEHIND THE LASHES!
    Jenny

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    Hi to all.

    What I do is firstly, i get an eye lash brush/comb and run it over my lashes up and down, back and forth to remove any dried drops or flakes etc.... and then i use a wet baby sponge from hot water and hold it against my lids for a few minutes e.g. 5-10 mins, then i use latex gloves and pull the upper lids off the cornea/iris so the top whites of the eye is showing and massage my lids near the lash line and sometimes press down or squeeze on them gently to draw out any oil. Repeat this for both eyes then use the small wet baby sponge to wipe the top and bottom lids and massage them and clean the lash lines before rinsing both eyes with cold water. Then lastly use eye drops.
    Last edited by Jenn1; 09-Oct-2012 at 09:27.

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    Thank you for replies.

    Hankm9- the link which you attached is interesting. I hadn't really thought about trying to get a doc to manually express before, but will see if I can have it done at my next appointment.

    Tankie- I read your routine and decided to try it-sounds really good-but unfortunately like Jenny2008 I just couldn't get the q-tip behind my lower eyelid.. if I try to force it, it just scrapes my eyeball, causing redness.. Maybe I can find something smaller/flatter to use instead of the q-tip. What massage do you do for the upper lid?
    By the way since starting this thread, I have stopped pulling my eyelid taught when massaging, because I read that it can cause droopiness of the eyelids..

    Jenny2008- Have you ever done your eyelid heating for longer than 10 minutes? I am considering just extending my heat application time. I figure if I am finding it so hard to do a more rigorous massage, but still want more result, I could just warm compress for longer. Maybe use a hot cloth as well as blephasteam for example.

    Jenn1- do you ever put your fingers under your eyelid, or are you kind of pinching the skin together from the top? I hadn't thought of baby sponge, thank you, I will try this.
    Last edited by Lacrima; 13-Oct-2012 at 08:48.

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    I just thought- theoretically -if you heated your eyelids long enough, shouldn't it be almost effortless to press the oil out? Why not just do a 30 min warm compress for example?

  8. #8
    i've previously been told no harder than you would rub your eye.

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    Lacrima- there is a part called the 'tarsal' plate. It's specific evolutionary purpose in partnership with the eyelid has developed to 'protect' the eye itself.

    The tarsal plate can withstand severe levels of heat. Think of it as insulation for you eye.

    Warm compression does little/nothing to heat meibomian glands, as they are situated behind the tarsal plate, and lie on the inside of the eyelid.

    This is why LipiFlow has been somewhat successful, as it bypasses the tarsal plate.

    Blephasteam goggles may be an adjunct option for you, as it can heat up to 40 degrees and may start to impact the meibomian glands with sustained temperature over 15mins. The problem with warm compress is they lose heat rapidly once applied to the face.

    Ask your doctor about in office expression. The meibomian glands need to be massaged regularly (not too often) to empty out solidified gunk and to encourage production of new oil.

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    Quote Originally Posted by Lacrima View Post
    Thank you for replies.


    Jenn1- do you ever put your fingers under your eyelid, or are you kind of pinching the skin together from the top? I hadn't thought of baby sponge, thank you, I will try this.

    Hi Lacrima,

    Apologies for the late reply, been busy with life. I don't put any fingers under the eyelid, mainly because its tricky, but also because the skin underneath is very soft tissue and can be damaged easily, so i just stick to massaging the skin on top and pressing or squeezing gently near the eyelashes/lashline area. I dont need to express my lower lids, all the inflammation is on the top eyelids near the lashline and although sometimes it can look swollen, no actual lumps or chalazions as yet. I find the baby sponge, and I dont mean regular sponge material, the one i have is kinda like the sponge material you get with makeup sponges, sort of rubbery material, but its great for removing dirt, any skin cells etc... on the lids or eyelashes/eyebrows and also help the blood circulation and oils maybe flow better. I find the sponge better than using a cloth and less messy.

    Like many here, I was told to avoid expressions, but ive been trying it out myself anyway, only twice a week, once a day etc. I did see in one eye a bit of yellow pus type stuff floating about when i first started the expressions, but nothing since. I wonder if my glands are blocked at all or if its more outside lid inflammation and swelling rather than blocked glands and my eyes arent as badly irritated as before, but can still be uncomfortable. I find that warm water is less irritating and drying on the lids than a hot microwaved rice bag compress, but i know the rice bag is handy for really badly blocked glands as it holds more heat in than a sponge with water. However, the sponge can be used after the rice bag compress to remove any dirt or oils etc... afterwards.

    Do many of you have visible eyelid veins? I have quite a few and wonder if the lid inflammation has caused them as they werent present before?

  11. #11
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    Hi all...I have a few questions too. Are you suppose to rub your meibomian glands? Sometimes I can see clogged oil glands b/c there are lumps on my eyelids/underneath my eyelashes. Do you rub them or keep you eyes closed when you are doing lid scrubs?

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    Jenn1- Thanks so much for replying. Really helpful to hear how you do your eyelid massage. Good idea to use make-up sponge cause it's tough but still gentle, can't wait to try this.
    To answer your question about eyelid veins I have a few which I am pretty sure appeared early on before my diagnosis, when I was really inflamed. I keep an eye on them to see if they are getting worse, or increasing in number. They don't seem to be so I suspect they appeared during this early flare-up. My optho said he is watching out for early signs of ocular rosacea but so far I'm ok. Next appointment is in late Jan. I will ask him if he thinks inflammation has caused them- will let you know any info


    Piot0020-Are you doing any type of warm compresses or massage at the moment? Scrubs are different to massage. Massages express meibomian glands. Scrubs refer to eyelid area cleaning and often follow massage.
    You can clean the eyelid area without 'scrubbing'; I clean my eyelids after massage using SteriLid foam or sterile wipes like this: http://www.healthcare4all.co.uk/imag...care-wipes.jpg. I keep eyes closed when cleaning, except sometimes, when using a wipe, will rub along the eyelid margins (as advised by my doc).

    There are many types and brands of eyelid cleaning products available, doesn't have to be SteriLid or lidcare.
    Last edited by Lacrima; 17-Nov-2012 at 06:30.

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    Quote Originally Posted by Lacrima View Post
    My optho said he is watching out for early signs of ocular rosacea but so far I'm ok.
    What did he say were the "early signs of ocular rosacea"?

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    Quote Originally Posted by spmcc View Post
    What did he say were the "early signs of ocular rosacea"?
    Hi spmcc, he didn't say- I wish I had asked. From what I remember he was looking at my eyelids when he mentioned rosacea.

    I made the link between the tiny vessels and rosacea myself, but really don't know if that's what gave him the idea.

    I'll be sure to ask him what early signs are, and write them here, after my appointment.

  15. #15
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    Hi everyone...long time no see!! Great thread BTW!!

    Eyelid massaging for me is now every 4-5 days as i am virtually symptom free of gritty greasy eyes...hoorayyyyyyyyyyy!!

    My technique is done in the shower like this: I actually spend over 30 mins in the shower allowing the steam to melt the meibom oils...the key to success is continued heat over an extended amount of time and thats why showering is so effective at expressing those stubborn oils...i also scrub the lid edges with the edge of a flannel as that rouch textured cotton really grips that greasy mess.After 30 mins in the shower i then massage the lids still in the shower for about 30-60 seconds and also push push on the lid edges and i feel great after.

    Im just slightly concerned at times about rubbing to hard and possibly causing eye floaters
    "Only the body can heal itself, and all healing must come from within your body."

  16. #16
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    My Dr very experienced said massage is useless and max 2 minutes warm compress . I am very compliant and feel so much better. too much too long heat results in red eyes .
    However glands are still blocked after 3months with tbut of 4
    Has anyone found that all this massage/expression actually improves tbut and oil flow in Dr appointments?
    Will the glands just fix themselves one day?

  17. #17
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    Quote Originally Posted by spmcc View Post
    What did he say were the "early signs of ocular rosacea"?
    Hi spmcc,

    I had said I would come back to answer this- sorry for late response. I had a new doc recently, she said redness on the eyelid margins with small veins could suggest ocular rosacea. I am guessing my previous doctor was just watching out to see if my mild redness and veins worsened. Unfortunately I don't think he meant there are any other early signs.
    Last edited by Lacrima; 13-Apr-2013 at 06:45.

  18. #18
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    Thanks, Lacrima. That makes sense... I have TONS of little red veins on my lids esp near the glands/lashes. My diagnosis is ocular rosacea since ~1997.

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