Willing to try anything or see any doctor

[fer_ada]

Hi Everyone,

23 years old, been struggling wih DES for 5+ years now. Here's the rundown of remedies I've tried over the years:

- restasis
- xiidra
- lipiflow (total disappointment)
- lacrisert (worked at times but caused severe discomfort in the morning / couldn't read anything in the afternoon due to blurriness)
- warm compresses
- pazeo ( I have dust mite allergies, looking into seeing an allergist about getting regular shots)
- lubricant eye drops
- eye lid scrubs

This condition is starting to affect my work / social relationships as I can't go anywhere without people making comments about my severely bloodshot eyes. The sclera of my left eye is particularly red... from the moment I wake up my eyes are red and burning. Looking for every and and any option to help deal with this.

I travel Monday - Thursday for work every week, including 2 plane trips a week and staying in a hotel every night of my travel days. This obviously does not help with my condition. I've even noticed that the DES has gotten worse since I started this job 1 year ago. Though, I don't think the solution to this issue would come with giving up my career given that my dry eyes have proven to be an issue outside of work (weekends, before I started, etc.)

However, with this job I am realistically able to travel to any city in the country for the weekend. With that, I am open to any suggestions regarding doctors in different cities if there are specific doctors highly regarded by this forum. Additionally, I am looking into the following treatments:

- bio tear tablets
- Doxycycline
- Minocycline
- acular

Thank you in advance to anyone that has doctor referrals or suggestions regarding potential treatments. This community's commitment to helping each other is so awesome

[Hokucat]

Hi. Sorry to hear you've been struggling with this for over five years now, and at a fairly young age.

Sounds like you have at least MGD, but do you also have aqueous tear deficiency? Also, besides allergies, have you been diagnosed/tested for any other possible root cause(s), like vitamin deficiency, autoimmune disease, excessive use of electronic devices, partial blinking, long term contact lens wear, etc.? Knowing this could help identify treatment or combination of treatments most applicable for your condition, and perhaps the best specialists to see. For MGD, besides Lipiflow which you've tried, there are procedures like IPL, gland expression, probing, BlephEx, etc., and only certain doctors have the equipment, tools, and experience for these procedures.

In the meantime, if you are not already using them, goggles/eyeshields may be helpful to shield the air on the airplane, when outside, or even while indoors. Some favorites are WileyX, Ziena, and 7Eye. Also nightwear like EyeSeals 4.0 and TranquilEyes help similarly while sleeping. This forum's Dry Eye Shop stocks these items:

https://www.dryeyeshop.com/mobile/br...wear-c149.aspx

https://www.dryeyeshop.com/mobile/br...ucts-c148.aspx

You may also want to consider scleral lenses at some point, if nothing else works well. If you can tolerate them, they can give you some immediate relief. Sclerals do not solve the underlying condition, but having comfort is just as important. I'm not sure if you would be able to wear them since the lens edges lay on the sclera/white part of the eye, and your sclera is red and inflamed, but you could go for a consult to find out. Sclerals have been used increasingly to treat dry eye symptoms over the last several years. I wear my Boston PROSE sclerals 12+ hours a day and it helps a lot. The Boston PROSE practitioners have extensive training and expertise, so would recommend going to them or another fitter specializing in sclerals like Dr. Gemoules in Texas, as the fitting process is key. Here is some info on PROSE, including their clinic locations:

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome

Dry eyes from allergies alone can be challenging to resolve, based on other patients' postings in this forum, however some did find some relief from allergy shots, so am glad you are already looking into this.

[PhoenixEyes]

Hi,

I second the suggestion to try moisture chamber glasses to reduce exposure to allergy irritants, wind etc. Ziena ones have a transparent silicone shield as opposed to foam which may be more discrete in the workplace if the frames fit comfortably for you. If you also have light sensitivity out in the sun you have the option of light-reactive lenses that are supposed to go clear inside but dim when exposed to heavy sun UV light. There's also the option to get an optician to fit them with special lenses if you suffer from eyestrain at the computer at work that have blue-light blocking, some also have a slight magnification at the bottom like reading glasses.

https://www.zienaeyewear.com/pages/sca-store-locator

About the lens options:
https://www.zienaeyewear.com/pages/how-ziena-works

Screen lenses:
http://www.eyezenpro.com/
http://blutechlenses.com/

If possible it would be great if you could obtain allergy eye drops without preservatives as these can irritate dry eyes. Pazeo I think has Benzalkonium Chloride as a preservative and this is known to be one of the stronger ones. I understand it may be tough to find ones in the US without preservatives though, perhaps that's changed in recent times though as it's just from old threads that I saw that. I remember reading that some managed to get Zaditen or Zaditor preservative free. I've also saw people talk about using Singulair on the dry eye Facebook groups, apparently it works in a different way to antihistamines so dry eye isn't typically a side effect of the medicine.

“It is best to treat allergy locally, but the anti-leukotriene agent, montelukast (Singulair), should be considered instead of an antihistamine for patients needing systemic allergy control,” Dr. Dhaliwal said, to avoid the ocular drying effects of oral antihistamines.

http://ophthalmologytimes.modernmedi...y-eye-symptoms

Hope you find relief soon.

[MGD1701]

Hi
How about Omeg 3, BlephEx, Mibo, probing, IPL, (in office) Expression etc?
Not sure if your causes have been identified, do you have inflammation issues?

[fer_ada]

Hi. Sorry to hear you've been struggling with this for over five years now, and at a fairly young age.

Sounds like you have at least MGD, but do you also have aqueous tear deficiency? Also, besides allergies, have you been diagnosed/tested for any other possible root cause(s), like vitamin deficiency, autoimmune disease, excessive use of electronic devices, partial blinking, long term contact lens wear, etc.? Knowing this could help identify treatment or combination of treatments most applicable for your condition, and perhaps the best specialists to see. For MGD, besides Lipiflow which you've tried, there are procedures like IPL, gland expression, probing, BlephEx, etc., and only certain doctors have the equipment, tools, and experience for these procedures.

In the meantime, if you are not already using them, goggles/eyeshields may be helpful to shield the air on the airplane, when outside, or even while indoors. Some favorites are WileyX, Ziena, and 7Eye. Also nightwear like EyeSeals 4.0 and TranquilEyes help similarly while sleeping. This forum's Dry Eye Shop stocks these items:

https://www.dryeyeshop.com/mobile/br...wear-c149.aspx

https://www.dryeyeshop.com/mobile/br...ucts-c148.aspx

You may also want to consider scleral lenses at some point, if nothing else works well. If you can tolerate them, they can give you some immediate relief. Sclerals do not solve the underlying condition, but having comfort is just as important. I'm not sure if you would be able to wear them since the lens edges lay on the sclera/white part of the eye, and your sclera is red and inflamed, but you could go for a consult to find out. Sclerals have been used increasingly to treat dry eye symptoms over the last several years. I wear my Boston PROSE sclerals 12+ hours a day and it helps a lot. The Boston PROSE practitioners have extensive training and expertise, so would recommend going to them or another fitter specializing in sclerals like Dr. Gemoules in Texas, as the fitting process is key. Here is some info on PROSE, including their clinic locations:

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome

Dry eyes from allergies alone can be challenging to resolve, based on other patients' postings in this forum, however some did find some relief from allergy shots, so am glad you are already looking into this.

Hokucat - Thanks for your response! I have also been diagnosed with partial blinking that is also affecting the dry eye problem. I have no idea how to combat this part of the issue because I don't know how to teach myself to blink better!

Additionally, I'm interested to know whether you think the Boston PROSE would help with the redness? I'm thinking that dry eye relief will ultimately lead to redness reduction, but want to get your perspective as well.

[Hokucat]

Many doctors recommend blinking exercises at least every hour for partial blinkers or those who do not blink enough (often due to use of electronic devices). I find it easiest to put an hourly reminder on my phone. There are different blinking exercises online, this is the one I use:

http://www.skyvisioncenters.com/blog...exercises-app/

You can also put blink reminders like these on your computer:

http://dryeyezone.com/reminders/index.html

I don't know whether sclerals will help with redness reduction on the white sclera part of your eye, as I do not have that issue. I tend to think it may not, because the edges are lying on the sclera, while the dome part is covering the cornea in saline. Sometimes people who wear sclerals also have to use Restasis, doxy or something else to help with inflammation. I think it would be good to go for a consult with the Boston PROSE folks to try on the lenses to see if you are a candidate to wear them, and ask about the redness.

Since you said you have the ability to travel anywhere in the U.S., you could also try contacting Dr. Gemoules' office in Texas with questions. He is also considered one of the top fitters in the scleral world. I've read in this forum that he or his office is good about responding to inquiries about his lenses and the conditions it could help, and he has helped many.

https://laserfitlens.com/

[PhoenixEyes]

I have also been diagnosed with partial blinking that is also affecting the dry eye problem. I have no idea how to combat this part of the issue because I don't know how to teach myself to blink better!

In addition to blinking exercises during the day, you might consider whether the partial lid closure is problematic at night too, if so a sleep mask or cover may help e.g. TranquilEyes, contoured mask (e.g. Dream Essentials), or some simply use saran wrap. You can also couple it with a thicker gel eye drop or ointment.

[Melody_Qi]

In China, people who have dry eye also use artificial tear mytear. They choose to use Kindle to read and use E Ink monitor to work.

[PhoenixEyes]

In China, people who have dry eye also use artificial tear mytear. They choose to use Kindle to read and use E Ink monitor to work.

Make sure you get ones without benzalkonium chloride as a preservative, it seems many mytear products have that, though not all.

http://www.dryeyezone.com/encyclopedia/bchloride.html

[MGD1701]

Hi Melody
Are you from China? If so, could you tell us the in-office treatments doctors/hopitals offer?
Maybe manual expression (how?), accupture maybe?
Thanks!