Sudden dry eye (mgd?) - my story. is there hope?

[agrlds]

Hello guys. After weeks following the forum i am now sharing my story.

I guess all of us think our story is different and particular but what triggered my eyes present condition is really awkward and i am feeling really lost.

I am 21, male, from Portugal and before 3 months ago i had never had eye symptoms. On February 2nd, 2017 I had shoulder surgery, with regional and general anesthesia (which i guess screwed me?). So, here i go:

6/7 days after the surgery i suddenly felt my Right eye weird - my first symptons felt like some sort of misalignment between the eyes (i could not watch TV, read or write properly) and together wih that came a bit of dryness (woke up 2 or 3 nights with heavy upper eyelid), big sensitivity to day light and an unjustified eye tiredness (an "eye-headache" would start after 5 minutes wathching TV). I basically stopped doing everything at that point and just watched days go by with no improvals - my primary symptom was that kind of "eye-headache" pain located in the Right eye.

After some ophtalmogists and some number of lubricant and cortisone drops, my eye didn't seem to improve much (just reduced a bit of pain). I went back to work a month after and couldn't concentrate or work normally due to eye pain. My Right eye was affecting me so much and i was clueless.

A month and a half since day 1 my Right eye apparently started getting better, but together with that arrived Left eye pain. Well... It was a different sensation. On the Left eye it started as that "menthol-sensation" (which occurs if I'm in a warm room too, i just need to have the eye open) accompanied by irritation and burning sensation (when i work on computer the burning is worse and eyes become red - but i feel like the pain is only on the Left). My eye has to be shut to be freakin normal and i have to suffer so much to keep it open all day.. The thing is i don't need to do specific things in order to feel this eye pain. If i simply wake up and go to the restaurant i will feel this menthol-sensation with burning and pain - with bright light or not, it doesn't matter. As of today, i have the same Left eye symptons and Right eye seems normal...

Other symptoms: when i need to think more at work, the pain worsens; i don't feel sleepy / normal tired and heavy eyes anymore (since beggining of this condition) despite having like 95% of bad sleep nights (very light sleep condition); i can't watch TV / be in the computer / phone without some sort of eye pain.

Ophtalmogists don't seem to have the answers and basic tests came out normal. I really don't know what to think anymore. I swear i am the calmest i can be. It is unbelievable how debilitating this condition can be, how it interferes with our hapiness and how others simply don't understand the symptoms. ( I think it is not acquos production problem because i wake up with 'rheum' in each eye). Maybe MGD what's going on?

Does any of you identfies with my condition? Please guys share your thoughts.
Thanks for reading,

Andre

[PhoenixEyes]

Hi, Sorry to hear you're suffering through this.

When you say "misalignment between the eyes" perhaps you can look into conditions such as astigmatism which revolve around the shape or curve of the eye being skewed. Doing a quick Google turns up a study which also suggests that dry eye can cause increased astigmatism. I'm sure that can lead to eye strain pain and headaches due to your eyes having to work ten fold to try and correct the visual disturbances.

The average amount of astigmatism was also significantly increased in dry eye compared to that in normal eyes. The dry eye has an irregular corneal surface and the indices of TMS-1 corneal topography system, surface regularity index and surface asymmetry index can be used to objectively diagnose this disorder, evaluate the severity of the dry eye and the effect of artificial tears on it.

https://www.ncbi.nlm.nih.gov/pubmed/11853602

The "rhuem" in your eyes, is that perhaps an excess of dried meibomian gland oil deposits? If you suspect MGD then try to have an ophthalmologist take a close look at your glands, they can try to squeeze the oil out and check the consistency (thick or free-flowing) and whether they are completely clogged / blocked.

First treatment for MGD is usually warm compresses though which are easy to try at home to see if you get relief. Also look into eyelid wipes like OccuSoft Plus, Cliradex etc.

It's been said on the forum that for MGD eye drops containing oil may be beneficial to replace the missing lipid / oil layer the meibomian glands aren't providing. Systane Balance is one such eye drop but there are others.

At work, see if you can improve your environment with a desktop humidifier if allowed. Try increasing font size, the f.lux software to soften things, browser addons that add a "dark mode" to browsing (e.g. black pages with white text) etc. There's also moisture chamber glasses to protect against drafts at work, you can try cheaper wraparound glasses as a starting point.

Hope you find relief soon.

[agrlds]

Thank you so much for you time and attention PhoenixEyes.

I have minor astigmatism, very low. I tried to use glasses sometimes but didn't help.. In terms of vision i'm great now. My current symptoms are burning, eyestrain and an irritating discomfort that stays in my eye a since i wake up.

A few days ago i went to another ophthalmologist and he did the Schirmer and TBUT tests to me. Schirmer was below 5 in both eyes. The TBUT he said it was neither good or bad. He also said he thinks the problem is not with the glands but yes with the acqueous production.

The "rhuem", which i always had a lot, i guess it means proper function of the glands at night, that keep secreting oil and then the cold at night solidifies it...?

I have no trouble to fall asleep but when i wake up i can't go back to sleep because the discomfort seems to be always there - i have trouble staying asleep...

So, i have proven dry eye but i don't feel dryness... I just wanted tu understand better the perspectives at this point. Does it only gets worse? I'm a 21 years old...
thanks for the advices and good luck on this journey for you too

[MGD1701]

Hi, did doctors 'press' your glands with finger/q-tip or a small tool to check

if (clear) oil comes out, if oil is clear orthick etc.? how many glands are functional?

These are most critical but most doctors do NOT check.

morning/mid-night pain - I had this very ofen now I do not have it. I think over use of ointment is the cause.
I wash eyes with warm water for about 10 times in the morning and before bed - to get ride of bacteria etc.
Before bedtime: wear swimming goggle + oil based drop

You need to find out root causes so you can treat them effectively otherwise only get worse.

[PhoenixEyes]

That's great that you finally got a diagnosis. Dry eye is so variable that it can be tough to pickup on tests I think. Hopefully your ophthalmologist is now working with you regarding the aqueous issue.

For night time, Xailin Night and VitA-Pos are options if you haven't yet tried them amongst the lubricants you mentioned. I also find sodium hyaluronate drops like Hyloforte and Clinitas useful for when I wake up.

Everyone is different as far as dry eye goes, but there are many who have moved on from this forum after finding relief or a sense of regaining their life. The key is finding the root cause and what works for your individual needs, which is very much trial and error unfortunately. Keep trying different things and re-visiting your ophthalmologist to track progress.

[agrlds]

MGD1701 thanks,

I think he did press the glands but it was a quick exercise... I honestly know nothing about my oil quality / flowing and how many glands are working - i think i need to get these figured out in order to treat me effectively.

Regarding over using of ointment, that's something i've been trying to avoid since beggining.. I will follow your tips on bed time and wakening. (2 days ago i had warm water from tap on my eyes for 10 minutes and the morning after i was full of the yellowish "rheum" on both eyes - i don't know if this indicates what my problem is... But would almost bet my glands are not good too..)

[agrlds]

PhoenixEyes thanks for replying and for the words. I can tell i'm far from being optimistic on this one. My eyes were perfect but from night to day they stayed like this. But i guess many of the forum participants may relate to this.. It's almost 24/7 of no relief and i didn't think it was possible to live with pain every.single.day..

Thanks for the tips, i will browse the treatments you referred

[PhoenixEyes]

My eyes were perfect but from night to day they stayed like this. But i guess many of the forum participants may relate to this..

I can relate. Before the necrolysis I had perfect vision and no issues regardless of what I did (e.g. could stick my head out the car window to enjoy the wind).

Hope you find something that works, lots to read about and trial on this forum.

[MGD1701]

Hi agrids

If you have MGD - make sure you do warm compress, if you dont have oil feeling, likel your oil is thick.
The heat over 40C is bad for cornea, I have read.

Morning pain
if your eyes are red, pain, sticky together when wake up, most likley inflammation which can affect glands if untreated.
You need to do lid scrubs - very important, twice a day.
I use soap-free tea tree oil shampoo, do NOT use baby-shampoo as soaps are bad for eyes.
If you have to use ointment before bedtime, it is ok for the short-term
just make sure wash eyes, do warm compress etc. next morning.

My steps: wash eyes with warm water, 5-10 times, warm compress/Blephasteam 42.5C, 10-15 min., massage, lid scrubs.

You wrote: ''yellowish "rheum" on both eyes''. I dont know what you meant.
It is normal to have clear/creamy dischrages (= dirts etc) after warm water - it is the purpose.
But when you do it, make sure water quality in your country is clean.

Find out causes otherwise get nowhere and might do more harm to your eyes.

[agrlds]

Thank you very much for the advices MGD1701. I will start today using them. I tried warm compress like 2 times, and it didn't help me (no oil feeling, irritation after taking off the compress - i think i maybe put it too hot)

In the morning my eyes are redish and i feel pain (90% of the times in the left one) but not sticky.
Regarding lid scrubs, i have to buy something and start doing it, just have to find something in Portugal or order it.
Yes, but my discharges are more yellow than clean and i often wake up with it, it doesn't appear right after the warm water.

Just 2 more questions if you let me:

- most of the time, when my eyes are burning (mostly the left), i close them and i have no relief (the burning continues) - do you know why?

- i feel my eyes are inflamed (mostly left) like you said. How do i don't let it untreated? Just cyclosporine (restasis) can help me? Or the things above help with that?

Thanks so much for your time and hoping the best for you

[MGD1701]

If yellow discharge - likely infection/inflamed. Should visit dr

night Pain: could be too dry?? try to wear swimming goggle.

Burning - I dont know.

Inflammion: if untreated, you will develop MGD as
glands will be blocked and disappear/die one day for good (like me and many others).
As to what drops to use - consult dr. Most importantly is to keep lid margin clean - like teethcare.
Tea tree oil (shampoo) can kill demodex.

If eyes are inflammed, not sure if heat is good for you.
Please go to see doctor before getting worse. It would be good to get 2nd opinions.

Dry eye is complicated and often untreated (by doctors).
So do your home work, you need to learn a lot and try new things.