Less is more ?

[Benjamin193]

Hi guys hope you are all well !
I'm curious if anyone could agree with me here ... During my worse period of dry eyes I was giving everyhing I had read ago to try and get some relief from my dry eyes and I mean they were awful I could hardly keep them open they were swelled up and almost like I had glass in them each time I blinked . I was using the compresses lots of times a day and constantly obsessing over my eyes they were always on my mind and I was that bad I couldn't leave the house because of them . But once I stopped messing around with them
They seemed to get better okay it took a long time and it was agony each day but now I'm at a point where I don't need any drops . My tbut was 2 seconds in both eyes I haven't had them retested but I'm sure they will be a lot better now ! So what I'm getting at is once I stopped messing with my eyes they got better I was doing more damage than good

[dave25]

Yeah, this is a very interesting concept. I recently starting seeing a new doctor and this is basically his approach. However, I stopped using all drops for 1 month and got worse so now I am slowly starting to use them again. (I was using Restasis, Acuvail, and Lastacaft) Now I'm just using Restasis and Acuvail. My question would be is 1 month off all drops a long enough trial period or should I give it more than 1 month?

[Benjamin193]

took me 3 months was the worse pain ever but so worth it in the end

[Scout]

This “less is more” approach worked in my case, but it doesn’t necessarily work for for all types of dry eye or ocular surface inflammation.

After many wrong turns along the way, I did finally decide to stop using allergy eye drops and all wetting drops. This worked for me, over time.

People with mainly ocular surface inflammation (as opposed to evaporative dry eye) do have to be very careful because once the ocular surface is inflamed (and for many, this often will include sinus inflammation) your eyes and sinuses become extremely sensitive and reactive. Substances that were previously neutral (like wetting drops, allergy eye drops, even substances in your environment like fragrances, lotions, shampoo and eye makeup) can suddenly cause severe reactions and pain.

Our eyes feel dry or allergic so we add more medicated drops and more wetting drops, thinking this will help the problem. But adding chemicals and substances onto a very inflamed and sensitive surface can cause a reaction and instead of helping, it can do the opposite.

As an analogy, think about the last time you had severe and painful sunburn. Your skin (similar to the ocular surface in many ways) becomes red, painful, swollen and blisters. Your usual skin lotion stings when you use it, clothing touching the affected area hurts, sleeping on your sheets at night puts painful pressure on the area. Even a shower or bath is painful as the water touches the sensitive skin. The only thing that relieves the pain and reduces the swelling and inflammation is cold packs. And we do know that in time, it will improve.

I don’t fault health care providers when they prescribe all kinds of drops and medications for inflammation. For the most part, they are concerned for our discomfort and do want to find a treatment that works for us. They have a long list of drops and medications at their disposal and prescribe them with the best of intentions. However, for some of us, pouring chemicals onto an already inflamed and highly sensitive ocular surface may not help. And in my case, it made things worse, much worse.

When I realized that the drops I was using, while at first were helping, were now making things worse, I stopped the prescription drops first and the wetting drops about a week later. The first month was really hard, but the improvement was fairly steady after the first month.

During this time I also changed many of my personal care products like shampoo, lotion, etc., and stopped using all eye makeup. I also started using cold compresses on my eyes and sinuses regularly. At first that was at least once a day and as things improved, only when I felt increased inflammation.

I haven’t used any kind of drops for the past 6 years. My LASIK surgery, which caused this problem, was in 1999. (That was almost 10 years with ocular surface and sinus inflammation).

I still watch my environment for offending substances and chemicals and fragrances. And I still cannot wear mascara without suffering for several days after.

And I still use cold compresses when my eyes feel inflamed.

But 6 years of good after 10 years of awful? I call it a success.

Scout

[runnergirl]

Hi Scout,

I had Lasik surgery 9 years ago and this dry eye happened 2.5 years ago. I was wondering, did you use Restasis? I also used every drop made and even the eye pellets. I also got bottom plugs put in. Do you have any plugs in? 2 months ago, I dropped all eye drops and cut the Restasis to one drop in the morning only. I feel no differennce, so I think why take them at all. What kind of shampoo are you using? does it make a difference? Your post gave me hope. Thank you.

[Scout]

Hi runnergirl,

I was wondering, did you use Restasis?

No, I didn’t use Restasis. But interestingly enough, when it first came out, I asked my eye doctor for a prescription. I was willing to try anything at that point. My doctor refused to prescribed it because it wasn’t approved for my type of dry eye. I guess in the beginning, it was only approved for a certain types of dry eye. Now, it is approved for every type of dry eye, and more.

I will never know if it would have helped me or not. But since my eyes are so sensitive and reactive, my guess is that the bad would have outweighed the good. But that is just a guess.

Do you have any plugs in?

I did try plugs temporarily but they did not give me relief. But my problem was never evaporative dry eye. It was always inflammation with poor TBUT (tear breakup time). For a long time, my TBUT was tested at zero in both eyes.

What kind of shampoo are you using?

Currently, I use Dove Shampoo. The cheapest kinds of products usually work best for me.

does it make a difference?

I don’t know if the shampoo change made the difference, but changing to a different body lotion changed things dramatically. I had used Clinique Happy for moisturizing for years and stopping that made a big difference. Stopping eye makeup made a big difference and changing to a very cheap hair spray made a big difference. When I do use hairspra now, I use Tresemme. But what works and doesn’t work for me will not be the same for you. You have to do your own experimentation with the products you use.

With these kinds of products, it is usually the fragrances that causes eye irritation and inflammation. And the most expensive name brands and salon brands have the most fragrances in them.

In eye drops, for me it is not just the chemicals, the preservatives or the types of ingredients in the drops that are a problem. It is also the fact that the drops affect my tears. Adding drops can dilute what tears I do have and affect how long the tears stay on my eyes. I still have low TBUT, but much better than zero.

Your post gave me hope. Thank you.

You’re welcome.

I really don’t know if what worked for me will work for you. But I hope you feel better soon.

Scout

[Scout]

Oops!

Correction: I DO have EVAPORATIVE dry eye, not TEAR DEFICIENCY dry eye. I have an okay amount of tears, they just don't stay on my eyes very long. But at this point (as opposed to the ten years after LASIK) my TBUT is adequate.

I mistakenly reversed the definitions of the two types of dry eye.

Sorry!

[No tears in ATL]

Agree, "less is more" approach works for me, too. I don't use drops anymore. They just make things worse.

Like Scout, paying attention to personal care products is advisable. Hair spray--if you can avoid it, don't use it. Severely limit or eliminate cosmetics around the eyes, and try to use non-irritating moisturizers, and soaps that are not heavily scented. Heavy fragrance, at least for me, will cause tearing up, burning, and on top of everything else, sneezing, for hours afterward.

By the way, the best moisturizer you can buy for face and body is jojoba oil. It is about $8-$12 dollars a bottle, depending on where you purchase it, won't cause breakouts, absorbs quickly (apply after shower is best), and most importantly, has no scent or chemicals. One bottle lasts me an entire year.