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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11267
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have something wrong w my eyes. My eye dr has diagnosed it

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I have something wrong w my eyes. My eye dr has diagnosed it - unfortunately, i forget what it's called. Oil glands(?) plugged up- I'm on doxycycline 20mg 2x/day and hot compress on eyes for 10 min at night which is supposed to soften the oil so it will come out and normal(?) oil will flow.

When I go to dr, he expresses out lots of this solidified oil. Yuk! it kind of stings when he does it, but my eyes feel sooo much better after. And no extra tears in the morning. Then after a couple weeks, I can tell the ducts are clogged up again b/c I'm all teary again in the morning.

I'm sure it's not working b/c my left eye in particular is teary in the morning for about three hours, including after I put in my contacts.

What is this problem called? And- what else can I do to make it go away? And-- can I learn to express out the solidified oil myself?

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

You most likely have blepharitis. There are some home treatments you can do to help control this problem.

Dr. Rick :

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.


The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


Dr. Rick :

you could also express the glands yourself by closing your eyes and pressing with the pad of your index finger along the margin of your eyelids, right below the eyelash line. This should help to get the "gunk" out.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick :

I see that you are offline. We can use the Q&A system to 'text message' each other. An email will be sent to each of us every time something is posted to this thread.


Let me know if there are there any other concerns or issues you would like to discuss on this topic.
Customer: replied 5 years ago.
Sorry, Dr. Rick, I went to bed.

OK-- what you are saying is the same as what my eye doctor told me to do, so I guess what he siad is not as odd as I thought. -- I forgot to tell you I do the eyelid scrubs- I have a bottle of Steri-Lid scrub. But- I scrub for barely a minute- wow-- 3-5 minutes is a loooong time. I'll have to get used to it b/c I really want to get rid of this. I guess the scrubbing I've been doing hasn't been enough.

Am I going to have to do that shower scrub for the rest of my life??

And, you're right, I don't see the gunk myself, but I know my eye doctor does w the lamp. it sounds pretty gross : (

I've tried expressing the gunk out myself, after the hot compresses. I never see anything come out, so I don't think I'm successful. I feel like I would see it since it's as thick as toothpaste.

Thank you so much for your time and your very complete answer. I really appreciate it.

So tired last night, I fogot to sign my name,


You fingers work better then the steri scrub things....and they are Original Factory Equipment that you don't have to keep buying at the store :o)

No, not for the rest of your life, just for a few months and then again, once in while, to keep things under control.

You'd not necessarily see it when you try to express it yourself so.....keep up the good work.

Let me know if there is anything else I can do for you, Holly.
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
Thanks so much! I'm encouraged that I can go to a maintenance plan once I get this cleared up.

And ... I'm glad I don't have to buy those little- and pricey- bottles of Steri- Lid Scrub. Baby shampoo -- much more doable.

I guess I'll have to have faith that I'm getting gunk out even if I can't see it.

Thank you again. Now that we've 'met,' I'll have your name on record in my previous questions and I can go right to you.Best,


My pleasure. I look forward to helping you in the future. Keep on scrubbing lol!
Customer: replied 5 years ago.
Hi Dr. Rick,
Alrighty, I am back ... same darn problem.
Clogged oil glands.
I've used the hot compresses and tried to express the glands myself w index finger pads. I also take doxycycline 20mg 2x/da- actually I just take two at once.
My left eye is worse-- keeps tearing almost all the time. It is beyond annoying. I am sooo tired of this dumb problem. Why isn't there a real solution? I mean, if there is chemotherapy for cancer patients and it is often successful, can't someone invent a successful solution to this simple problem? This has got to be easier than cancer!

You've got an excellent point.....but blepharitis is a tough cookie to crack. The good news? It is not as deadly as cancer....I've never lost a patient to it (yet). :)

If you are going to take doxycycline I would suggest 100 mg tablets, take one a day for 30 days and then re-evaluate. The dose you are on seems too small to me.

Best of luck and thanks for the update.
Customer: replied 5 years ago.
Hi Dr. Rick,
I agree that the dose is too small. I even said that to my eye doctor, but he wouldn't change the strength. The strength I'm on seemed pretty pointless. Somehow, I get the feeling that he just wants to keep me on the hook since I don't have vision insurance now and I pay for each visit. (Tho he is never going to get rich from my visits as they only charge $60, but still...)
Maybe I need a new eye doctor.
How about you? Would you fax me a script? My only allergy is erythromycin.
Or are by some miracle locted near where I live which is Princeton, NJ area?

I'd love to fax you a script but then I would run the risk of loosing my medical license.....the Feds (not to mention JustAnswer) get real uppidy about that sort of thing...something about actually having a physician/patient relationships among other things :)

That being said, doxycycline 20 mg, twice daily is too low. If you are going to do anything at all use 100 mg/day for 30 days and re-evaluate.

Is this eye "doctor" an optometrist? Didn't think they could prescribe oral meds but you never know nowadays what "rights" their licensing board has given them.....

I'm just a short hike down the road from you: Northern Wisconsin -- about 1,300 miles per google maps. But I really don't think you need the services of a retina specialist at this point ;)
Customer: replied 5 years ago.
Hey, c'mon, we have a physician/patient relationship. Besides, I was born and raised in IL and vacationed every summer in northern Wisconsin. Rhinelander, Minoqua, muskie fishing etc, just so you know I'm credible.

Well, I knew you really couldn't give me an Rx. That's too easy.

My dr's degree is called Dr of Optometry. Should I start loking for an opthalmologist?
Or a particular specialty?

Wish I could write myself a script since I know what I want.

I'll bet what I have is what the oldsters have who have those red rimmed eyes that are sort of glistening wet looking! Looking at them always makes my eyes hurt. Yikes! I sure don't want to become those persons!

Soo- my question is ... what kind of eye doctor should I look for?
Holly ophthalmologist would be better; I don't think you need any sub-specialist at this point.... Here is the difference between the two:

An Optometrist is to an Ophthalmologist as an Eagle Scout is to a Sgt. Major of the Marine Corps. They both are experts in their area however one of them has a lot more training, ability and experience.

An ophthalmologist is a full fledged MD who does surgery and has at least 12 years of training post HS; an optometrist does glasses and has some basic knowledge of eye diseases. They are not MDs and do not do surgery.

I've heard that the Woodruff, Rhinelander, Three Lakes area is pretty nice....when it's not sleeting out that is :)

Getting old is not that bad, at least when your think of what the alternative is ;)

Customer: replied 5 years ago.
Thanks for the help. We were only up north in July so pretty much avoided the sleet Cool

Soo- when you have patients w blepharitis, are you able to cure them? Do you prescribe the 100mg doxycycline? Other than that- the shower eye scrubbing, index finger expressing of the glands and hot compresses?

And ... just one last question ... does this problem come from using the dreaded
M word ... mascara? (Evin tho I was it off every night)

Yup. I've got blepharitis patients and yes, the treatments we've discussed work. The doxycycline I only use in selected, difficult cases. Cure? Usually not. Control and make feel back to normal? Yup. Can do that.....

Keep using the really doesn't make a difference.

I bet it has sleeted here in June at least once in Recorded History lol!
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
Thanks so much, Dr. Rick. You've really been helpful!

It has been my pleasure.

I'll be here if you have any questions in the future.