Newbie Here with Question about Lipiflow

[Guest]

I will ask about this coincidence at my Lipiflow follow-up this week. I do know that the eyelid being open creates the dryness within the EBMD, which causes the erosions, but do not know if the dryness could create the inability of the epithelial to anchor to basement membrane.

Well, I don’t think it’s just dryness that caused this, maybe I wasn’t clear. Any damage caused by an erosion can also effect the basement memnbrane. If you then sleep eyes open after the injury, it won’t heal properly. Then you have a faux EBMD. I guess it doesnt matter much why it’s happening. Although that can sometimes help you choose better treatment. Maybe not in this case.

[Rebecca Petris]

Thank you for answer, Rebecca (I'm still not getting notifications).

Have you hit the Subscribe button (top right)? If so and you're not getting notifications, spam folder and typo in the email are the only things I can think of but Brent may be able to help further

I am severe enough to get erosions continually, and have seen two different specialists for either SK or PTK, the latter of which is the most likely. In the last 2 months, I haven't been as desperate for solution because I've sleeping with damp foam inserts (from TE) in the Onyx goggles. My eyes are actually soothed when I awake!
I'm wondering if you have anything to say about PTK, knowing how invasive it is?

Know lots of people who have done PTK... people with very sharp vision tend to shy away from it *if* they can because of potential for impact on vision... I would say, if you're not way off the charts severity-wise (epi falling apart) then often you can just baby things back to health without ever taking off the epi. Goggles, right lubricants, tape at night if having erosions more than once a week... extreme care opening lids in morning or middle of night, etc... Immobilizing the lids, in my opinion is a key part in preventing erosions.

[EyesOpen]

Know lots of people who have done PTK... people with very sharp vision tend to shy away from it *if* they can because of potential for impact on vision... I would say, if you're not way off the charts severity-wise (epi falling apart) then often you can just baby things back to health without ever taking off the epi. Goggles, right lubricants, tape at night if having erosions more than once a week... extreme care opening lids in morning or middle of night, etc... Immobilizing the lids, in my opinion is a key part in preventing erosions.

This has been my thought--to baby corneas back to health after being untreated and then operated on. I don't know if my epi is "falling apart," but I know that at my 6-week Lipiflow check, Dr. Williams noted that the the tears/oils were running over the ridges of the EBMD.
I would like to know the condition of my epi, while understanding that EBMD in itself reveals some unhealth in the epi--with not anchoring as it should--I wonder if you know what specific exam would determine that, in order to monitor healing progress?

[EyesOpen]

Have you hit the Subscribe button (top right)? If so and you're not getting notifications, spam folder and typo in the email are the only things I can think of but Brent may be able to help further

All is in order, Brent found (and I just rechecked). Unknown why I'm not getting notifications, and I check my spam folder before deleting.

[EyesOpen]

You may not have a true basement membrane dystrophy, it may just be induced by the damage of sleeping with your eyes open. It’s a what came first scenario, the chicken or the egg. Do you have EBMD and that’s causing the erosions, or did sleeping eyes open cause erosions and subsequently, a basement membrane “problem due to inadequate healing.

I do have EBMD, but just around the peripheral of my corneas, and the right, problematic eye (that gets the most erosions) is right along the lid line--so opening my eye, or not closing it all the way when sleeping, causes the erosion.