Dry eye sufferer

[orange86]

Hi, im a 33 year old male. I live in Leeds, England.

I am suffering from dry eyes. They are red, sore and burn. The sensation of burning is the overriding factor.

I have a desk based job, im looking at a laptop screen all day with overhead lighting. I believe i'm now photo sensitive. It's really hard to concentrate at work with the pain and discomfort.

I've tried HycoSan Extra, Systane, Carbomer Eye Gel, they all provide very short term relief (say under 30 minutes).I have a microwaveable eye mask, the heat helps but it's just short term relief.

I recently saw a NHS ophthalmologist, she wasn't much help. Said my eyes look ok besides some red blood vessels visible and told me continue with the ointments and gels plus the eye mask !!
I asked her to book me in to get the eye plugs (3 month wait !!!)

I took Hyabak Caps for a month and didnt notice a difference. I've ordered some 'TheraTears Eye Nutrition' - will see if that helps.

I'm now thinking of going to the Dry Eyes Clinic: https://www.dryeyesclinic.co.uk/blepharitistreatment/
It's £200 for a initial consultation which is a lot of money to me, however if they are specialists in dry eye disease and can help i'll pay it. I just need to find out what the consultation will include.

I'm at my wits end here as i'm in discomfort all day and it can get painful.

Can anyone provide some help / advice please?
e.g. diet / supplements or even clinics / eye specialists to see?

[Guest]

Hi, I'm also in England and have been suffering like you for the last 5yrs.my advice would be to try and find a dry eye specialist who should provide a more in depth examination.the £200 pound fee sounds extortionate and so maybe see if there is a normal optician in your area that specializes in dry eye.im in Somerset and mine is alot less at £70 which seems alot fairer.the many drops you have tried will only coat the surface as you have probably found out and only provide relief for a short period.maybe your glands are blocked and so they need to be manually expressed which they can do.stick with the preservative free drops for now but try not to over apply I know it's hard.i feel your pain and frustration so good luck.

[LindaDawn]

I second what the above has posted.

[orange86]

I'm going to a dry eyes clinic in leeds very soon.
initial consultation is free and they offer a thermaflow treatment at circa £100 to warm the glands and move out the oils.

At this stage I will try anything.

[deep_dry_eye]

Thermaflow is typically considered a waste of money, you're better off doing warm compress w/ microwave (its more effective and free!)

[orange86]

Just got back from Optimax (dry eye centre) and the ophmalogist tested my eyes.

Schirmer's test:
Left eye: 4
Right eye: 5

So i have aqueous deficiency.

meibomian gland exam: left and right eye glands are blocked. Left more severe.

She recommended i see the surgeon and go for the MiBo treatment however its on the 13th Jan which is too long to wait as im in pain.

She said it's quite severe dry eye for someone my age.

I've been doing warm compress at home (microwave eye mask) but dont think i'm doing it right as cant see to get the oil out of the glands when i try to press them after.

I'm going to look at other clinics and those that can offer treatment ASAP. I'm back to work on 2nd Jan and will be in agony sat at my computer in a air con office.

[LindaDawn]

Hi. It could be that your glands are too blocked for the oils to be released which is why you can’t see any oils after the warm compress. If it is any consolation I can never feel any oils after my compresses either. Perhaps some other dry eye members can guide us both,

[orange86]

Hi Linda, yes that would be useful if someone with the knowledge on warm compress and gland expression could give some pointers?

Can i go to my GP (in England) and ask for doxy / Restasis / etc or does this have to come from the ophthalmologist ?
The lady said i have aqueous deficiency so will need these to be jump started again if thats possible...

[LindaDawn]

It will need to come from a ophthalmologist. I know you have just said that you are aqueous deficient but I thought you mentioned your glands are blocked. Seems like you also have mgd. You may have kind of autoimmune condition if u r aqueous defficient. .

[Hokucat]

It sounds like you have both MGD and aqueous deficiency. I’ve read often people with MGD get AQD because their lacrimal glands (tear glands) are being overworked trying to make up for the dryness due to reduction in oils from the meibomian glands. I have severe cases of both.

Given warm compress helps you somewhat, albeit only very temporarily, it seems your glands are not totally blocked, which is a good thing. How you are doing the compress and at what temperature can make a difference. As others mentioned above, Miboflo is like a warm compress, so likely will not help you much more (or even less) than the heated mask you’re using. You might benefit from manual gland expression to push out blockage that has built up, and several IPLs to help the oils flow over time. If your glands have very stubborn blockage or scar tissue, you may need probing. But it sounds like you have some oils so would only do probing (it’s a very invasive process and the process itself can cause scar tissue and all the long term effects are not yet known), if nothing else works and your doctors suspect extreme blockage or scar tissue. Some in this forum have found combinations of treatments helpful, like doing an initial probing and then maintenance with IPLs, regular gland expressions and IPLs or Lipiflows, etc. Everyone’s condition can be different.

Once you unblock your glands, they can quickly get blocked up again. With your desk job requiring a lot of computer use, you’re likely not blinking as often or incompletely blinking, which limits the natural secretion of oils from your meibomian glands. So take regular breaks from the computer and do regular blinking exercises to keep those oils flowing.

https://www.skyvisioncenters.com/201...exercises-app/

Also if your oils are not optimal, you may need to change your diet and/or take meds like doxycycline to try to help improve your oils and reduce inflammation. Especially after unblocking your glands you might notice the difference. Did your doctor comment on the quality of your oils when examining your glands? If the oil is thick and/or not clear, usually that’s one indication of poor quality.

I personally had to get probing because I had several glands that had scar tissue. But after each of the probings my glands got blocked up again and reverted to severe dryness until I found the right diet changes for me to help my oil quality. I still have severe dry eyes but the probing plus right diet changes gave me a thin tear film that allows me to wear sclerals to help me with daily functioning. I also limit my use of electronic screens and do blinking exercises.

[orange86]

Hi Hocukat, the ophmalogist at Optimax said i have both MGD and AQD.
I have a heated eye mask, heat to 45 degrees and spray with water and wear the mask. Keep on for 10 minutes, then manually try to express the glands by moving my finger down my top eye lids and moving finger up the bottom eyelids. Not sure i'm im doing it right as not much comes out

I'm off to get the ThermaFlow eye lid heating treatment at Optimax Leeds in a weeks time.

I'm waiting for a referral letter to come through to see a specialist on the NHS, however got told this could take up to 3 months which is too long for me to bear with this suffering.

I'm now considering seeing BBR in Hereford or Peter Irvins clinic in Glasgow. Peter Irvins seems very comprehensive in diagnosis of dry eyes, however BBR seems to offer more treatments:

http://www.bbroptometry.co.uk/eyecare/tear-clinic.aspx
https://www.peterivins.co.uk/dry-eye-clinic/

Let me know what you think to these sites?

[Hokucat]

Sorry for the delay, I’ve been on vacation with limited instances to be active in the forum. Given I am in the US, I was going to recommend you reach out to quattroboy in the UK about doctors and treatment available there, but looks like he already responded and you are interacting on your other thread. He and others in the UK can likely advise you on good eye doctors/clinics there better than I can...looks like excellent advice from what i saw.

I did want to mention getting moisture goggles to wear during the day, and night protection (like EyeSeals 4.0 goggles or bubble bandages) to protect your eyes from the elements, if you do not already use these. You may also want to look into getting a Scleral lens consult at some point, as these lenses are increasingly used to treat dry eyes because they are dome-shaped so vault over the cornea, bathing the eye in saline. Not everyone can tolerate sclerals but if you can, it can give you some immediate relief. These things only treat the symptoms, not the underlying cause, but is just as important and may help with daily functioning.

[Guest]

Hi.
I went to a dry eyes clinic in London and I'm glad I did.

They did all the tests that everyone mentions on this forum and the consultant talked through all the test and stated what he saw and showed me as well.

I also felt he listened more to my concern rather than just sit there, nod his head and say I understand


I reckon you should go and try it.

[gilles]

Don't forget to try to find the root cause simmultaneously while trying out treatments. Try to test your eye vision, maybe glasses might help with screen use (for me it does). For the screen use I would recommend the following programs: f.lux ("adjusts a display's color temperature according to location and time of day, offering functional respite for the eyes.") and EyeLeo (reminder to blink and look outside through a window/take a pause from time to time).

Eyedrops for MGD (here you need lipids): e.g. Systance balance, EvoTears, Optive Plus.
But as for you I would recommend Systane complete (aqueous deficiency + lipids)
If warmth compresses don't help, you could hint your doctor for minocycline or azythromicin (oral use). Cyclosporine eye drops might also help.

[holly123]

If you ring Grafton Optical Company Ltd they will tell you which clinics offer e eye laser treatment. I'm pretty sure there is one in Leeds. It didn't help me really but my eyes are pretty far gone. Some people find Optimel drops with manuka honey helpful though they do sting. I quite like Hylo Dual drops.