Bryan Johnson@bryan_johnson
I started milking my eyelids.
Here's the situation.
My eyes have been dry/irritated/red for the past year or so. I started using eye drops to moisten and it didn't make a difference. So I went to see an eye doctor.
The source of the problem is that my meibomian glands, the tiny oil glands lining the eyelids, were clogged up. Without the meibum they secrete, the tear film on my eye evaporates in seconds which is bad for eye health.
We're not sure of the cause of the dysregulation. We have few theories that we're looking into.
Taking a closer look with infrared meibography, the imagery showed that my meibomian glands were congested, distorted, and partially dropped out. This is bad news because atrophied glands don't regrow!
It's situations like this that makes me wonder why we do not have a better operating manual for the human body. How could I have prevented this from happening and why didn't I catch this sooner!?
I did additional tests to assess the damage and my situation now.
The Schirmer test (paper strip measuring tear wetting over 5 minutes) came back at 6 and 6.5 mm. A borderline reading consistent with mild dry eye. A healthy reading is typically 15 mm or above.
Here's what I'm doing now to try and nurture my remaining glands back to good health:
1) Forma RF, Radiofrequency (microwave) heat applied from outside the lid, melting the obstruction.
2) LipiFlow, a device that sandwiches each eyelid: heat from the inside, pulsed pressure from the outside, squeezing the obstruction out. 12 minutes, both eyes.
3) Both capped at 41°C, not the standard 42°C, to spare eyelid collagen and elastin. No thinning skin, no premature sagging.
4) IPL around the eyes that shut down the abnormal blood vessels feeding chronic lid inflammation, the engine of MGD.
5) Manual gland milking, the doctor squeezes the lid margin between two instruments, forcing the plugs out. Hard, pasty secretions came out initially. The second and third mechanical milking the glands are returning to a normal, expected oily state.
6) Daily upkeep includes warm compresses, lid hygiene, omega-3 to keep secretions thin and glands moving.
My next check in is 3 weeks form now.
My doctor mentioned that meibomian gland dysfunction in her patients has increased since Covid, likely driven by the rise in screen time. When staring at screens for long stretches, people blink less frequently and less completely. Normal blink rate is roughly 15-20 times per minute but drops significantly during screen use. Incomplete blinks mean the meibomian glands don't get fully expressed, which over time contributes to gland dysfunction and evaporative dry eye.
It's worth you getting checked for this and a good practice generally to make sure your eyes are in good health.
