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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2436
Experience:  MS Ophthalmology with 13 years of surgical experience, well versed with all eye diseases.
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Eye got red, problems since then

Customer Question

(please can only doctors specializing in eye disorders answer this)

, I have inflammation under my top eyelids from slight droopy eyelids, I've been put on prednisolone and hylo-forte. Problem is a month ago I got a cold, and whole day my right eye lower eyelid was dark red. Since then my right eye has been different, lower eyelid is redder than before (not that much though), and after another week or so the lower eyelid was sometimes getting sore and warm/hot. I had to increase my usage of hylo-forte from 4 times a day to 8 to cope. Also my right eye also feels exposed, sometimes cold (inside house), as if it's not lubricated enough now. I've seen my eye specialist since, but he was dismissive there's any problem, he pressed out some of the glands and said thicker than average, flowing, clear, I found it very sticky though. I think there's an improvement where the oil came out. So is something seriously wrong? Do I need to act to preserve my Meibomian glands health? What do I do?

Submitted: 2 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 2 years ago.
Dr. A.S. Desai :

, Welcome to Just Answer

Dr. A.S. Desai :

Thank you question.

JACUSTOMER-ajflou57- :

, what am i doing here?

JACUSTOMER-ajflou57- :

never seen this window before!

JACUSTOMER-ajflou57- :

ok, i get it, well hope you check this window shortly :)

Dr. A.S. Desai :

Looks like you have some amount of meibomitis. Meibomian glands are modified sebaceous glands present in the eyelids.

Dr. A.S. Desai :

, welcome to this live chat session

JACUSTOMER-ajflou57- :

i know what they are, i did som0e basic research hence looking

JACUSTOMER-ajflou57- :

so, what should i do, its a difficult place when you are going against your doctor

Dr. A.S. Desai :

Thank you, ***** ***** the time of the condition.

Dr. A.S. Desai :

Meibomitis can be under diagnosed

JACUSTOMER-ajflou57- :

yes i read that too, thats why im concerned

JACUSTOMER-ajflou57- :

i know my own body, its behaving different

Dr. A.S. Desai :

Nothing wrong if you feel you are going against advice. Thankfully its treatment is very basic and can be easily done at home.

JACUSTOMER-ajflou57- :

thats good news

JACUSTOMER-ajflou57- :

its been 2-3 weeks, i hope thats not significant, what i've read suggests months/years would be unwise time to wait

Dr. A.S. Desai :

The tiny pores or openings of the meibomian ducts open at the lid margin. This causes redness around lids, puffiness , early morning crusts and even watering.

JACUSTOMER-ajflou57- :

i've read up on the basics, i dont get crusts, but it definitely is redder than it used to be, evidently not enough to concern my doc thoguh

Dr. A.S. Desai :

It requires gentle lid scrubs with diluted baby shampoo, warm compresses thrice a day

JACUSTOMER-ajflou57- :

is that safe?

Dr. A.S. Desai :

Once the clogged up pores open ( safe with gentle lid scrubs), the symptoms begin to disappear.

JACUSTOMER-ajflou57- :

is the scrub required, would it be a good idea to try the compress first and see if it improves

Dr. A.S. Desai :

You can add omega 3 fatty acid rich food such as fish in daily diet.

JACUSTOMER-ajflou57- :

i've already added omega 3 week or so ago

JACUSTOMER-ajflou57- :

would saline solution be suitable, using babyshampoo concerns me

Dr. A.S. Desai :

Yes, scrubs are an integral part of treatment which help to open the pores.

JACUSTOMER-ajflou57- :

i have noticed if i blink forcefully sometimes i get some more oil out, it feels a bit sticky, so they are open?

JACUSTOMER-ajflou57- :

(appologies you!)

Dr. A.S. Desai :

Saline solution would not help much. If you don't have crust, just give digital massage and express the sticky fluid out.

JACUSTOMER-ajflou57- :

i tried that yesterday, in 1 spot, and it ached a bit afterwards

JACUSTOMER-ajflou57- :

also my concern is i have droopy eye lid diagnosis, how dangerous is all this putting things on my eyes (since warm compresses rest on eyes), rubbing

Dr. A.S. Desai :

You can gently massage the lid without any worry about droopy lids

JACUSTOMER-ajflou57- :

very little force, barely touching it i assume?

Dr. A.S. Desai :

Warm compresses should be applied on closed lids

JACUSTOMER-ajflou57- :

i know that, that would be dangerous if they were open (and painful)

JACUSTOMER-ajflou57- :

so pretty much any warm compress will do?

Dr. A.S. Desai :

Yes, gentle force such that you do not notice any indentation, blurring

JACUSTOMER-ajflou57- :

and if im doing it right will i notice something come out

JACUSTOMER-ajflou57- :

and, er how do i explain all this to my doctor? :(

Dr. A.S. Desai :

Yes, you might notice cheesy material or toothpaste like material or sticky fluid being expressed out.

JACUSTOMER-ajflou57- :

if i dont notice anything do i apply more pressure, i assume no?

Dr. A.S. Desai :

No, there is no need to use any more force.

JACUSTOMER-ajflou57- :

ok, is there anything else i need to know?

JACUSTOMER-ajflou57- :

one thing when i tried to express a gland yesterday and it ached a bit after, is it likey i did any harm?

Dr. A.S. Desai :

No, unlikely

Dr. A.S. Desai :

Just continue with warm comoresses

JACUSTOMER-ajflou57- :

ok, thanks detailed assistance

JACUSTOMER-ajflou57- :

how do i close this?

Dr. A.S. Desai :

You are most welcome

Dr. A.S. Desai :

You can close it by rating the answer

JACUSTOMER-ajflou57- :

ok thanks

Dr. A.S. Desai :

The entire conversation will be saved refere

Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 2 years ago.

I have a few additional questions (replying by message is fine) :-

I've read warm compress can increase inflammation, is that a concern given I'm on a steroid (currently prednisolone 2 times daily)? Or is it only a problem use of a warm compress by silly people?

Is it really possible to have this condition when my eye specialist expressed some oil? I'm just naturally a bit cautious of advice of the internet.

How long should I continue the treatment you suggest?

Thanks, ***** ***** most helpful. If this works out needless to say I'll add a bonus :).

Expert:  Dr. A.S. Desai replied 2 years ago.

xxxxx, The suggested treatment should be continued 3-4 weeks before you begin to notice improvement. It is normal amount of oily secretion to come out of the meibomian duct orifices since that is the normal secretion. When the secretion accumulates it begins to cause meibomitis. You can can give warm compresses safely without worrying about it causing any increase in inflammation. I hope that answers all queries. However do feel free to ask any more queries if and any , in future too. Thank you and best wishes. Have a good day!

Customer: replied 2 years ago.

> It is normal amount of oily secretion to come out of the meibomian duct orifices since that is the normal secretion.

Is normal discharge supposed to feel very sticky?

> When the secretion accumulates it begins to cause meibomitis.

I gather that, but can I really have this condition when my eye doc expressed some liquid oil that he thought was ok?

> You can can give warm compresses safely without worrying about it causing any increase in inflammation.

A family member has expressed strong concern that heat may help the steroid enter my eyeball, is this a risk?

If I wait a few weeks to see my doc and talk to him will this get much worse? I.e. how urgent is it I act. How can I convince my eye doc there is a problem?

> I hope that answers all queries. However do feel free to ask any more queries if and any , in future too.

Ok, I've not used this site before so I don't know if I'm asking too many questions!

Expert:  Dr. A.S. Desai replied 2 years ago.
You can ask as many questions as you want till you are satisfied with the replies.
The fluid expressed out of the eye is normally a bit hick and sticky. If few of them drain the fluid there are many more which might need to be expressed. There are about 15 to 20 tiny pores whih are visibly seen at the lid margin.
Application of heat will not cause the steroid to do any harm to the eye. Heat would help the thick secreions to liquify and enables better expression of the fluid.
There will be no harm if you delay this treatment by another week or so.
Have a good day!
Customer: replied 2 years ago.

> You can ask as many questions as you want till you are satisfied with the replies.

Ok, I feel like a headless chicken at the moment (you probably get that quite a lot I imagine).

> There will be no harm if you delay this treatment by another week or so.

That'll make the total time since I first notice something was different about 6 weeks, is that long enough to matter?

I was able to get some sticky oil out if I blinked forcefully, but since I tried to express that spot (which ached after), now forceful blinking has no effect, does this suggest I actually have done some damage?

Expert:  Dr. A.S. Desai replied 2 years ago.
6 weeks is long enough to suffer but not long to have done any damage in the eye.
Don't express the fluid so much that it begins to hurt. The idea of warm compresses is to keep the secretions fluid and the massage should gently get it out. It should not hurt after the massage. Avoid using fingers in that case. Yoh can use a Q tip and roll it gently from out to eyelid margin. Too much force can disturb the gland or even infect it or result in chalazion.
If blinking has no effet,, it does not mean that therenis damage.
Customer: replied 2 years ago.

I tried the warm compress yesterday, it appeared to melt the oils and felt better few hours. But after that I've had some sensations in my upper (and lower) eyelid area, hard to describe, like small tingles, some tiny pains, and when I woke up today my eyes were redder than yesterday (and are staying that way ). Should I be concerned about friction having done harm (with my droopy eyelid inflammation problem)?

Expert:  Dr. A.S. Desai replied 2 years ago.
I'm sorry late reply. If you have noticed worsening in redness of the eye then I guess it is better to keep the lid massage and warm compresses at hold. You must let your ophthalmologist know about the incrasee in redness in the eye. If the droopy eyelid is because of narrowed palpebral aperture ( the opening between the two eyelids) it could be due to inflammation inside the eye too. You might have been put on steroid eye drops . At this stage it is better to get eye exam done and let your ophthalmologist have a closer look at the eye.
Regards
Customer: replied 2 years ago.

> If you have noticed worsening in redness of the eye then I guess it is better to keep the lid massage and warm compresses at hold. You must let your ophthalmologist know about the incrasee in redness in the eye.

I've an appointment on Monday. It's not as red now, but today there was brief (30 mins or so) period of soreness under top eyelid, it's never done that before, it stopped once I put next dose of steroid in. Is that a bad sign? how bad do things need to get to need to go to causality?

> You might have been put on steroid eye drops .

I've been on steroids for > 2 months now (I mentioned it above).

Also the steroid seems to upset my stomach, I can barely eat anything without coughing and feeling like I'm going to be sick, is there anything I can do to stop that happening?

Expert:  Dr. A.S. Desai replied 2 years ago.
If the steroid eye drops gave you relief then I suspect that the inflammation it has been given , may not be due to a eyelid problem. It might be due to inflammation of the outer surface of the eye( the white part- episclera) or inside the eye. I just thought that 2 months of steroid eye drops is pretty long time to be used ( unless there is chronic inflammation). It is good that you have an appointment on Monday and can get your eye examined again. However it is not something you need to go to the casualty . Symptoms you would need urgent eye care are severe pain in the eye with intense headache/nausea/vomiting along with redness/watering/photophobia/sudden reduced vision.
Have a good day!