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If the vision seems to clear up as the day progresses then it could be as a rsult of tear film abnormality.
Is that good or bad. Does that require surgery
No , it does not require any surgery.
The tear film is made of 3 layers out of which the lipid layer is contributed by the meibomian glands(modified sebaceous galnds present in the eyelids).
If this layer is affected ( as can occur with underlying blepharitis or meibomitis), there can be blurring of vision in the early mornings.
Treatment is in the form of-
First, application of heat to warm the eyelid gland secretions and to promote evacuation and cleansing of the secretory passages is essential. Individuals are directed to use soaked warm compresses and to apply them to the lids repeatedly. Warm water in a washcloth, soaked gauze pads, or microwaved, soaked cloths can be used. However extreme heat should be avoided.
•Second, the eyelid margin is scrubbed mechanically to remove adherent material, such as crusting, and to clean the gland orifices. This can be completed with a warm washcloth or with gauze pads. Water often is used, although some clinicians prefer that a few drops of baby shampoo be mixed in one bottle cap full of warm water to form a cleaning solution. Attention must be directed to gentle mechanical jostling or scrubbing of the eyelid margin itself, not the skin of the lids or of the bulbar conjunctival surface. Vigorous scrubbing should be avoided as it may be harmful.
•Third, an antibiotic ointment is applied to the eyelid margin after it has been soaked and scrubbed. Antibiotic-corticosteroid ointment combinations can be used for short courses, although their use is less appropriate for long-term management and should be used strictly on the advise of the ophthalmologist.
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