What is best with ocular rosacea/posterior blepharitis?

[insidious988]

Hey,

I'm a 29 year male from Germany and I suffer from ocular rosacea for many years now.
It all started in 2011 when I first got some Symptoms in my face which doctors first diagnosed as acne.
I never had any acne in my youth though so this was a bit unusual starting in my early 20s.
However, shortly afterards I also got my first chalazion and also my second chalazion.

I soon got diagnosed with rosacea.
Got metronidazol for the face and skinoren. Both helped with the face Symptoms.
But since 2011, my eyes got worse and worse.
I am at a pont where I get up in the morning, feel my eyes burning, and it lasts all day long until I go to bed in the evening. EVERY SINGLE DAY.
2017 I also got 2 new chalazion which had been cut out from the Lids again.

It is unbearable.

I also work in an Office 8-9 hours a day in front of a PC. I am still going to work, even though I have pain.

My lid margins look okay, only when I pull them back I see that it is all red and inflammed I guess. It's all a posterior thing with me.

What is my current regime:

I tried nearly 30 eye drops. With None of them I really feel relieve. None.
I tried nearly every single drop which si available here.
I have MGD so I of Course also tried the lipds one (Systane Balance, Evotears, Optive Plus, Remogen Omega, Cationorm...)
I have a Feeling tha the Lipids one burn even more, even though theoretically they should be best for me.

I do blepahsteam twice a day for 15 minutes each. Doesn't help much.
I do lid Expression with a q-tip after and also lid scrubs with blephasol.
I don't see oil flowing, maybe doing it wrong? How is Expression done right at home?
Doesn't help with the burning.

Since march 24th I'm on Ikervis. Take it every single day before sleep. Burns like hell and doesn't help. Take it anyway because it should help?
Take oraycea 40 mg a day since Novembre with only a week without it. No effect on my eyes I guess.

I take topical Ivermectin for Demodex on my face and the lid margins (Soolantra). Since May. No effect as of yet.

Every single day I take Omega 3, I eat flax seed, chia. Healthy diet in General.

Meibography grade 2. Oil Comes out and is clear said my last doc. But he had to press hard for it to come out. When I blink, does oil even come out? If he had to press hard with a q-tip I guess not...

It is all so frustrating. I can't bear it anymore!

I now made an Appointment for IPL, but the date is in October and I am suffering NOW...

What else can I do? What?

[MGD1701]

Important is to tackle root causes -
good to add tea tree oil - only it can kill demodex - Dr Cremers has a great video at YouTube.

When one has demodex, more bacteria present as well.

[Rebecca Petris]

Hi there and welcome!

So sorry to hear what you're going through.

I see you're working full time on a computer. Are you using goggles or moisture chamber glasses at work? That's the fastest, simplest way to get more comfortable on a computer - there are additional strategies for making computer use more workable. I think it's really important to tackle those things at a practical level not just medical, because the medical side takes time to sort out and doesn't always translate quickly into "more comfortable".

[hannsho]

Hi Insiduous988

I’m sorry to hear of the problems you are having with your eyes. I have also got ocular rosacea, chronic blepharitis and dry eye. I notice that you are taking Oraycea 40 mg, which is a low dose version of doxycyline and called ‘Oracea’ in Spain. I have taken Oracea for six months and used Restasis for nearly 9 months. Unfortunately, both Resasis / Ikervis and Oracea can take a long time to take an effect. Often to notice any real improvement with Restasis you have to wait for 3 months and sometime a full 6 months. Finally, Restasis has helped me a lot, but I did not really notice any improvement until I had used it religiously every day for 3 months. Unfortunately, this means you may have to be patient for quite some time to see any effect, but I eventually got substantial relieve from Restasis. I agree with Rebecca Petris, whilst you are waiting for the medicine you are taking to have an effect, you should try practical measures to try to alleviate your discomfort as much as possible.