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DocwithDryEye own struggle with dry eye and MGD

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  • DocwithDryEye own struggle with dry eye and MGD

    I'm an OD, and I have been battling dry eye on a personal level for over eight years. It was around my sophomore year of college that I began to notice waking up in the morning with dry, red, eyes. I didn't think too much of it at the time, and thought using one of the over the counter "get the red out" drops would fix the problem, and started using those 4-5 times a day (not a good idea). My eyes soon became even MORE red. After stopping this drop, things got a little better, but every evening around 6:00 pm, my eyes would have a pinkish/red color, and every morning when I woke up, it felt as if someone had rubbed sandpaper across my eyes.

    Over the last few years, I had tried almost every pharmaceutical, natural, or home remedy dry eye treatment I could find online.

    Below is a list of what I had tried
    -Artificial Tears Drops (often 10-12 x day with no relief)
    -Lubricating Gels at bedtime
    -Steroid drops
    -Warm compress with a hot washcloth and the rice-in-the-sock method
    -Lid scrubs
    -Fish Oil (3000 mg of triglyceride form)
    -Castor Oil (this is part of the liquid vehicle in Restasis. Just leaves a sticky mess)
    -Moisture Goggles
    -Taping lids shut while sleeping
    -Punctal Plugs
    -And multiple other things that I am not going to list here, because of how ridiculous they were, and I'm embarrassed to admit I even tried them.

    None of these provided much relief. My eyes still felt and looked horrible after 6:00 PM. I tried not to look people in the eye too long when speaking with them, because I knew they would notice the redness. I was unable to wear contacts any longer then three hours, because they began to feel like hard plastic in my eyes.

    What I have found worked best for me was having the LipiFlow procedure

    To begin, I had my meibomian glands evaluated. The meibomian glands are the glands that create and secrete the oil that mixes with the watery part of tears, creating a healthy tear film of oil and water. Luckily, I still had a few glands that had not atrophied too far, and were still producing some oils.

    The LipiView device, which is a diagnostic tool that helps evaluate the quality and quantity of tears on the front of the eye, showed I had an extremely poor tear film. The tears that I did make evaporated quickly, leaving my eyes dry, raw, and irritated throughout the day. It is scored of 0-100. The higher the number, the better the quality of tears.

    A score of 80 of less often indicates some dryness.

    I scored 43 in both eyes.

    The LipiView device also helped me to see that when I blink, my blink is not "complete", and is in fact a "partial" blink. The instrument found that of eleven blinks I made in 30 seconds, 11/11 were partial blinks. That means that my eyes do not close completely upon blinking. Because of this, the important oils that my eyes do make are not being spread across my eye, resulting in daily dryess and gritty sensations. Due to fact that I did have some good oils being produced, some glands that were still processing oils, and a poor reflex blink, I qualified for the LipiFlow treatment.

    The LipiFlow procedure consisted of two eye lid expression devices being applied to my eyelids, which generated heat to melt the oils clogging my glands. Next, through gentle pressure, squeezed the glands from both the outside and the inside to express oil. The procedure took about twelve minutes, and was not painful in the slightest.

    It is important to note that this procedure is not a "miracle procedure" or "cure-all" for all dry eye patients. I didn't go from having dry eye all the time to suddenly being dryness free and white eyes. I was set up with the realistic expression, that due to my low scores, if we could reduce the dryness to less then 50% of the time (down from 100%), or depending less on artificial tears, then these would indicate a successful treatment. At this point, I was just hoping I achieved SOME relief, having tried everything else on the market with very LITTLE relief.

    The treatment at this point has exceeded my expectations.

    Upon walking out of the LipiFlow procedure, I noticed an IMMEDIATE difference. It was a windy day, and I remember walking outside, and turning to face the wind. Normally, this would cause my eyes to slam shut in agony from the dryness of the wind...but I found I could stare wide-eyed into the wind with no problems. Such a simple thing, but take someone who feels dryness every day, and ask them if they know what I'm talking about, and I bet you they do.

    It's been about seven weeks since the procedure. Again, I haven't experienced a change from 100% dryness to zero, but I have noticed a considerable decrease in dryness feeling. My eyes are no longer pink at the end of the day. I can look at the computer longer without wanting to rub my eyes out of my head. I wake up and the sand-paper feeling is no longer there. My eyes look and feel better, and that's exactly what I was aiming for.

    I am still taking a mild steroid once daily, and fish oil. I make sure I take in plenty of water, and continue to do blink exercises, which I've seen multiple people mention on this forum. I use the Bruder mask warm compress every morning, But I've given up on the almost all artificial tear use, and any grittyness or dryness has decreased by about 90%.

    I had a great experience, and a few of the other doctors in my practice, who all had varying levels of dry eye tried the technology as well. Everyone experienced some sort of relief. We were so impressed that we invested in the technology, and we are now the only OD or MD in our state that has the technology. Because of this, we are seeing patients from all over the state being sent to us by their optometrists for the procedure. Many of these patients have now returned to me for their 3 month and 6 month follow ups, and I'm seeing better oil expression, decreased complaints, and improved speed scores.

    While this technology isn't for everyone (aqueous deficient dry eye, significant gland atrophy, tortouous irritated lid margins), for those who qualify for the procedure and are having it done, things look very promising.

    Thanks for your time

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