What is the natural progression for someone with Dry Eye

[jack1988]

I'm the same way, no crust, if you looked maybe just a tad pink on my margins but I would look "normal" also. The bacteria is inside the gland and the lipid byproducts inside the gland causes the oils to thicken. So you use a hot compress, twice a day, then clean the eyelids directly afterward. They should sell Alcon eye scrubs in the U.K. try amazon. Get a good lid cleaner in the meantime, then get a prescription for hypochlorous acid spray. Here in the states we need a script for something like avenova which is a hypochlorous acid spray. It kills the bacteria around the eyelid. It's usually our own staph that's naturally in our skin that tends to over grow inside the meibomium gland. So the idea is if you clear the glands then clean all the bacteria off the lids. You reduce that bacterial lipase avtivity in the gland and the oils should run easier and more clearly. Good thing he put you on the doxy. One of the best treatments for MGD, I just recently started doxy and got a stomach flu so had to stop. But once my gut is good I'm going to give it a try again.

I think youre om a good path, once you get a hypochlorous acid spray and get a good heat mask online that you can toss in the microwave and really massage those lids. You will feel a lot better in a couple months. Let me also suggest you take a high quality omega 3 I use Nordic naturals ultimate omega liquid. But any high quality omega 3 fish oil in triglyceride form would be great. The idea with the fish oil, is that once you clear the garbage out, you want to replace it with good quality oil. So a healthy diet, a good multivitamin and a good fish oil supplement will do wonders to get that oil in good shape again. You could also get a blood panel andcheck your hormones. Hormone replacement would help as well asssuming your androgen deficient.

Good luck!

Thanks

I was worried that FML drops would sting, but they're actually okay. The Doxy is giving me gut ache though :/

I will scrub the lid with bicarbonate Soda, that will do I think.

[Guest]

Thanks

I was worried that FML drops would sting, but they're actually okay. The Doxy is giving me gut ache though :/

I will scrub the lid with bicarbonate Soda, that will do I think.

Don't use baking soda...use baby shampoo if anything but you need a high quality lid scrub. It's essential in my opinion.

[jack1988]

Don't use baking soda...use baby shampoo if anything but you need a high quality lid scrub. It's essential in my opinion.

fair enough, why do you say that?

so, today is the second day of doxy and using FML drops. My eyes feel a bit more sore than usual this afternoon and when i left went and went outside they fel sensitive and they watered. Could that be due to fml drops?

Also, once my inflammation is under control, can I stop with the compress and just clean the eye lids?

[Guest]

I would think something with a PH of 9 like baking soda would irritate you. Baby shampoo was the old school way to clean your eyelids. You dilute baby shampoo in water and clean with that. I know this is hard to wrap your head around, as it was for me, this is forever. There's no stopping the compress, massage and lid scrubs. If you stop, things will continue to get worse. Again, you have to understand what's happening here. You have thick oil in your glands, you have to thin it with the compress, massage that oil out with your fingers and the clean the lids.

i haven't asked but I assume the fml drops are steroid drops correct? Those are just lowering the inflammation until you get the MGD under control. So if you don't get the basics down meaning the lid regimen, then once you stop the steroids you'll be back to a burning mess.

[jack1988]

I would think something with a PH of 9 like baking soda would irritate you. Baby shampoo was the old school way to clean your eyelids. You dilute baby shampoo in water and clean with that. I know this is hard to wrap your head around, as it was for me, this is forever. There's no stopping the compress, massage and lid scrubs. If you stop, things will continue to get worse. Again, you have to understand what's happening here. You have thick oil in your glands, you have to thin it with the compress, massage that oil out with your fingers and the clean the lids.

i haven't asked but I assume the fml drops are steroid drops correct? Those are just lowering the inflammation until you get the MGD under control. So if you don't get the basics down meaning the lid regimen, then once you stop the steroids you'll be back to a burning mess.

Yes, they are steroid drops. Do you know how long steroid drops take to start working? Also, how long does Doxy start to work?

I forgot to mention the doctor who I saw mentioned IPL to me if this current regime does not work!

Oh, btw, I have just ordered this online. it isn't for dry eye but it contain hypochlorous acid - https://www.chemistdirect.co.uk/natr...r-confirmation

[Guest]

Yes, they are steroid drops. Do you know how long steroid drops take to start working? Also, how long does Doxy start to work?

I forgot to mention the doctor who I saw mentioned IPL to me if this current regime does not work!

Oh, btw, I have just ordered this online. it isn't for dry eye but it contain hypochlorous acid - https://www.chemistdirect.co.uk/natr...r-confirmation

The steroids took me a couple weeks to really start noticing the reduction in inflammation. My steroids are also very weak .2% lotoprednol.

the spray you have there worries me because it doesn't have the concentration of hypochlorous acid and it isn't described for eye cleansing. Again, don't half ass this, it's your eyes. Talk to your doctor about a hypochlorous acid spray specifically for the eyes. You may need to have it compounded unless they have it prepared already in the U.K.

[jack1988]

The steroids took me a couple weeks to really start noticing the reduction in inflammation. My steroids are also very weak .2% lotoprednol.

the spray you have there worries me because it doesn't have the concentration of hypochlorous acid and it isn't described for eye cleansing. Again, don't half ass this, it's your eyes. Talk to your doctor about a hypochlorous acid spray specifically for the eyes. You may need to have it compounded unless they have it prepared already in the U.K.

My steroids are 0.1% Fluorometholone.

It says the acid is safe around the eyes and it's 0.2%.

[Guest]

My steroids are 0.1% Fluorometholone.

It says the acid is safe around the eyes and it's 0.2%.

The strongest I've seen for eyes is .015% so maybe it's not going to be harsh, but just be aware, I personally wouldn't recommend it. Good luck.

[jack1988]

The strongest I've seen for eyes is .015% so maybe it's not going to be harsh, but just be aware, I personally wouldn't recommend it. Good luck.

thanks for all the advice

I will give you a run down of my symptoms / routine during the day.

7:00am Put in FML steroid drops - no stinging
7:30am Put hylo-forte drops in both eyes - no stinging (also take omega 3 at this point)

09:00am - take doxy tablet after breakfast

12:00 Put in FML drops - no stinging
12:30 Put in Hylo-Forte drops in my right eye only- rarely this can sting a little

Finish work at 16:00: when i step outside my eyes water/sting for a couple of minutes

16:30 Put in FML drops (can sting my right eye sometimes)
16:45 Put in hylo forte into both eyes (my right eye usually stings a lot at this point)

17:00 clin lids and compress etc...

21:00 Put FML drops in my eyes

22:00 go to bed

Question 1: what do you think it causing my eyes to water when i go outside after work.
Question 2: Why do my eyes sting in the evening when i administer drops?

Thanks

[Guest]

thanks for all the advice

I will give you a run down of my symptoms / routine during the day.

7:00am Put in FML steroid drops - no stinging
7:30am Put hylo-forte drops in both eyes - no stinging (also take omega 3 at this point)

09:00am - take doxy tablet after breakfast

12:00 Put in FML drops - no stinging
12:30 Put in Hylo-Forte drops in my right eye only- rarely this can sting a little

Finish work at 16:00: when i step outside my eyes water/sting for a couple of minutes

16:30 Put in FML drops (can sting my right eye sometimes)
16:45 Put in hylo forte into both eyes (my right eye usually stings a lot at this point)

17:00 clin lids and compress etc...

21:00 Put FML drops in my eyes

22:00 go to bed

Question 1: what do you think it causing my eyes to water when i go outside after work.
Question 2: Why do my eyes sting in the evening when i administer drops?

Thanks

I can't say exactly why, I can make guesses based on my experience with MGD and my research on the subject.

1) you have evaporative dry eye, so when you're exposed to the wind, you're tears are evaporating at an extremely fast rate. That send a signal to your brain, hey, we're dry. So you start what's called reflex tearing to compensate for the evapotation.

2) you probably have some ocular surface inflammation that's causing your drops to sting more. That was the case for me and once the steroids got me under control, my eyes felt way better. Same with the serum drops, that gave me pretttymuch complete comfort.

It could also be that the specific drops your taking just burn as a side effect. My restasis burns for about 30 mins after in put it in. Just the nature of the drug.

[jack1988]

I can't say exactly why, I can make guesses based on my experience with MGD and my research on the subject.

1) you have evaporative dry eye, so when you're exposed to the wind, you're tears are evaporating at an extremely fast rate. That send a signal to your brain, hey, we're dry. So you start what's called reflex tearing to compensate for the evapotation.

2) you probably have some ocular surface inflammation that's causing your drops to sting more. That was the case for me and once the steroids got me under control, my eyes felt way better. Same with the serum drops, that gave me pretttymuch complete comfort.

It could also be that the specific drops your taking just burn as a side effect. My restasis burns for about 30 mins after in put it in. Just the nature of the drug.

Strange that in the morning they don't burn at all, but then around the evening time they do burn. Also, my lubricating drops also burn my eyes in the evening, but do not in the morning.

[Guest]

Strange that in the morning they don't burn at all, but then around the evening time they do burn. Also, my lubricating drops also burn my eyes in the evening, but do not in the morning.

That's just another symptom of your dry eye...your eyes aren't evaporating tears at night, which is good. Probably means you don't sleep with your eyes open. Then you wake up, you feel great and as the day progresses, as your eyes are open and exposed to air, they dry out and get inflamed. So as the day progresses they burn. Then you close them again for 8 hours, they recover, then you start the cycle again.

[Hokucat]

Jack, this may have already been mentioned to you, but some have found wearing moisture chamber goggles at work, in the house, and outside helpful to keep the air out during the day. 7Eye, Wiley and Zienna are some favorites. The goggles can be ordered clear for indoors or shaded for outdoors.

https://dryeyeshop.com/collections/d...ses-sunglasses

I used to wear goggles at work and outside, along with using a thicker longer lasting eye drop to provide an extra barrier from the air. I used Systane Ultra originally, but when I needed a better sealant, I started using Genteal Severe Eye Gel under my goggles. Some people like Refresh Celluvisc. Sometimes even the Genteal was good enough alone, if the air conditioning or fan was not blowing.

https://dryeyeshop.com/collections/s.../systane-ultra

https://dryeyeshop.com/collections/d...ts/genteal-gel

Am assuming you're using your eyes at work on the computer, reviewing documents, focusing on something, etc. so probably blinking less. It may also help to do blinking exercises to keep the oils flowing, especially at work, and also take breaks to rest your eyes.

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

[jack1988]

Jack, this may have already been mentioned to you, but some have found wearing moisture chamber goggles at work, in the house, and outside helpful to keep the air out during the day. 7Eye, Wiley and Zienna are some favorites. The goggles can be ordered clear for indoors or shaded for outdoors.

https://dryeyeshop.com/collections/d...ses-sunglasses

I used to wear goggles at work and outside, along with using a thicker longer lasting eye drop to provide an extra barrier from the air. I used Systane Ultra originally, but when I needed a better sealant, I started using Genteal Severe Eye Gel under my goggles. Some people like Refresh Celluvisc. Sometimes even the Genteal was good enough alone, if the air conditioning or fan was not blowing.

https://dryeyeshop.com/collections/s.../systane-ultra

https://dryeyeshop.com/collections/d...ts/genteal-gel

Am assuming you're using your eyes at work on the computer, reviewing documents, focusing on something, etc. so probably blinking less. It may also help to do blinking exercises to keep the oils flowing, especially at work, and also take breaks to rest your eyes.

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

Thanks for the info.

I used Hylo-Forte drops, aren't they like the gold standard? Are there better drops out there that will help?

[Hokucat]

Different drops work for different people, depending on the severity of the dryness, what is causing their dry eyes (MGD, aqueous deficiency, allergies, etc.), whether they have an intolerance to certain ingredients in the drops, etc. For example, Refresh is a brand many people like, but the main ingredient in most versions of their drops is Carboxymethylcellulose Sodium, which bothers my eyes, so I can't use that brand at all.

If you find Hylo-Forte works well for you, that's good. For future reference, here's a "Drops, Gels and Ointments Ingredients List" Rebecca maintains on the Dry Eye Zone that you may find helpful.

https://dryeyeshop.com/pages/lubrica...reference-list