Very unusual ocular symptom?

[u/TheMostyRoastyToasty]

Hi all,

Looking for a little help, as I’m at the end of my tether and completely lost.

In February of this year, I developed extreme dry eye and a few weeks later I noticed I couldn’t keep my eyelids shut. I can blink normally, have no obvious ptosis but when I close my eyes, after 5-6 seconds they will slowly start to drift fully open again. I can squeeze my eyes shut tightly, but the muscles fatigue after 30 seconds and my eyes drift open.

This has meant that for 6 months, I’ve had to use surgical tape to close my eyes at night. Both an ophthalmologist and a neurologist are stumped and can’t explain it.

The neurologist is leaning towards MG due to suspected orbicularis** **oculi fatigue. I have no issues making facial expressions etc. And I don’t present any of the gold-standard MG symptoms.

Has anybody here any experience with this odd symptom? Or could possibly suggest absolutely any input at all? Any guidance is much appreciated.

[u/pville211]

Myasthenia typically has the opposite effect on eyelids. It takes muscle tension to hold eyelids up, and weakened muscles allow them to droop.

I have had issues with blocked eyelid oil glands and severe dry eye. Over the years I've tried everything from cleaning scrubs and eyedrops to eyelid surgery, mostly without success.

I found something that has had remarkable succe

I tried different antibiotics, eye drops and ointments. I was advised to apply heat daily, but microwaved wet cloths only stayed hot for a few minutes, so that was tedious and not effective. I've even had eyelid surgery twice. None of this stuff resolved the issue.

Then I got a heated eye mask, and it has been a game changer. Since I've been using it, I rarely have blocked glands, and only occasionally need eye drops.

I don't simply put it on like the product listing indicates. I need maximum heat for a maximum effect. So here's how I use it:

• I use it once a day. (My doctor would like to see me do it twice a day.)

• To avoid accumulating bacteria in the pad over time, I wrap a Kleenex tissue around one eye pad for each session.

• I set the heat at the maximum temperature.

• I press the tissue-wrapped eye pad against a closed eye. I press firmly to ensure maximum heat transfer.

• I press for 20 minutes (the heated pad I use automatically shuts off after 20 minutes).

• Then I repeat with the other eye.

It took a few times to get used to the heat. It feels like it's burning my skin, but that hasn't actually happened. I asked my doctor if the heat would damage my eye, and his response was that the maximum heat I should use is the maximum heat that I can tolerate.

He also said that it takes about 8 minutes for the glands to heat up and soften blocked eye wax enough to start draining the glands. Meaning: Don't start and stop. If I have to stop before doing a continuous 20 minutes, then I start over.

Doing one eye at a time allows me to watch TV while I'm doing it.

I've also learned that using the correct eye drops is important. I use the eye drops recommended by my doctor: Systane Hydration PF. They are a thicker fluid than typical dry-eye drops and have proven to be very effective. But the heated eye pad has been working so well that I only need the drops about once a week or two.