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Schirmer Test and glands are fine but lipid layer thin

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  • jack1988
    replied
    Been to the doctor, he said my scar is flat and have no conjunctival chalasis. The doctor did say my glands aren't blocked but the oil is slightly milky. He has told me to try Doxy, warm compress and eyelid hygiene

    Leave a comment:


  • TARYN
    replied
    I went to the top specialist at Johns Hopkins and other respected corneal/dry eye doctors and no one else mentioned it. Dr Tseng did not think the loose conjunctiva was severe but since it was causing constant burning and redness, I decided to try the surgery. I think the procedure took less than 1/2 hour. No pain at all. It has made such a difference in my quality of life. I used to think about my eyes constantly. Hopefully you can get some answers from your doctor or maybe get in touch with Dr Tseng to see if he can recommend some doctor near you.
    Last year I had the same procedure (conjunctivoplasty and amniotic membrane) to get rid of the pingueculas because they were causing redness. I had the same great result.
    Good luck. Hopefully you can get this resolved. I would assume the doctor that did your strabismus surgery probably had other patients who developed scar tissue and dry eye. Is he being helpful?

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Hi Jack. It is probably better you ask a doctor that question. All I know is that I had burning, redness and inflammation. I went to several dry eye specialists and finally ended up flying to Miami (only a 2 hour flight from Washington DC) Dr Tseng said I had a loose conjunctiva and pingueculas which weren't allowing my tears to spread evenly over my ocular surface. The burning stopped immediately after the surgery. Then I had 3 weeks of healing and my eyes were clear and white. I would guess scar tissue causes all kinds of problems. I know you need a smooth ocular surface.
    did none of the other dry eye doctors notice you had loose conjunctiva?

    Leave a comment:


  • TARYN
    replied
    Hi Jack. It is probably better you ask a doctor that question. All I know is that I had burning, redness and inflammation. I went to several dry eye specialists and finally ended up flying to Miami (only a 2 hour flight from Washington DC) Dr Tseng said I had a loose conjunctiva and pingueculas which weren't allowing my tears to spread evenly over my ocular surface. The burning stopped immediately after the surgery. Then I had 3 weeks of healing and my eyes were clear and white. I would guess scar tissue causes all kinds of problems. I know you need a smooth ocular surface.

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Hi Jack, It is one surgery where they remove the damaged conjunctiva or in your case the scarring and they place the amniotic membrane over the surgical area so it will heal quickly with no scarring. You can get in touch with his office and see if he recommends anyone in the UK. Dr Tseng pioneered the surgery so he may have trained some doctors in the UK. Whenever I have gone to his office there always seems to be patients from other countries so he must have an international reputation. His websites are ocularsurface.com and tissuetech.com and biotissue.com
    can scarred conjunctive cause dry eye/ tear film instability?

    Leave a comment:


  • TARYN
    replied
    Hi Jack, It is one surgery where they remove the damaged conjunctiva or in your case the scarring and they place the amniotic membrane over the surgical area so it will heal quickly with no scarring. You can get in touch with his office and see if he recommends anyone in the UK. Dr Tseng pioneered the surgery so he may have trained some doctors in the UK. Whenever I have gone to his office there always seems to be patients from other countries so he must have an international reputation. His websites are ocularsurface.com and tissuetech.com and biotissue.com

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    The scarring on the conjunctiva might be interfering with the tears not being able to spread evenly over the ocular surface. I also had a few pinguecula on the other eye which was interfering with the tears being able to spread evenly over the ocular surface. The burning and redness bothered me. The AMT surgery gave me immediate relief. The amniotic membrane helped the surgery to heal with no scarring. I had the surgery with Dr Scheffer Tseng in Miami, Florida.
    Thanks for this info. I wonder if there are surgeons in the UK that do AMT surgery or the conjuctivochalasis surgery. Never heard of it before.

    Leave a comment:


  • TARYN
    replied
    The scarring on the conjunctiva might be interfering with the tears not being able to spread evenly over the ocular surface. I also had a few pinguecula on the other eye which was interfering with the tears being able to spread evenly over the ocular surface. The burning and redness bothered me. The AMT surgery gave me immediate relief. The amniotic membrane helped the surgery to heal with no scarring. I had the surgery with Dr Scheffer Tseng in Miami, Florida.

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Hi Jack, It sounds like your strabismus surgery might have caused damage to your conjunctiva which is causing a disruption of the tear flow and tear film instability. I had problems after a blepharoplasty a cosmetic procedure. I developed a loose or wrinkled conjunctiva which is known as conjunctivochalasis. I had burning and redness which eye drops and compresses were not giving me any relief. I had a conjunctivoplasty with amniotic membrane which helped to have no scarring and a quick recovery. I do not have burning or redness any more. My eyes are clear and comfortable. You can ask your doctor if the strabismus surgery could have caused damage to your conjunctiva and if the procedure I had might help you.
    Hi, i do have scarring on the conjuctiva. I don't have any loose or wrinkled conjunctiva though.

    Where did you have your surgery?

    Leave a comment:


  • TARYN
    replied
    Hi Jack, It sounds like your strabismus surgery might have caused damage to your conjunctiva which is causing a disruption of the tear flow and tear film instability. I had problems after a blepharoplasty a cosmetic procedure. I developed a loose or wrinkled conjunctiva which is known as conjunctivochalasis. I had burning and redness which eye drops and compresses were not giving me any relief. I had a conjunctivoplasty with amniotic membrane which helped to have no scarring and a quick recovery. I do not have burning or redness any more. My eyes are clear and comfortable. You can ask your doctor if the strabismus surgery could have caused damage to your conjunctiva and if the procedure I had might help you.

    Leave a comment:


  • jack1988
    replied
    Originally posted by Alix View Post
    If the lipid layer is thin, then surely it means there is not enough oil coming out of the glands. The problem looks like quantity not quality.
    What did he say you should do?
    I can't remember. It was two years ago when i went. My glands are fine with no inflammation. The ocular surgery has destabilised my tear film. He didn't have an issue with my glands. I need to go back to him

    Leave a comment:


  • Alix
    replied
    If the lipid layer is thin, then surely it means there is not enough oil coming out of the glands. The problem looks like quantity not quality.
    What did he say you should do?

    Leave a comment:


  • jack1988
    replied
    Originally posted by Alix View Post
    Do you take omega 3 supplements and eat fish? Not that it’s guaranteed to work but if your lipid layer is thin you need to do something to improve the quality of the oil coming out of your glands. Did the doctor have any suggestions as to what’s causing the thin lipid layer? No amount of eye drops is going to fix this. You have to treat your problem from within.
    Hi,

    I had ocular surgery back in 2010 and I've had bouts of dryness ever since. My glands are all present and correct and the oil is clear according to Mr Tam.

    Leave a comment:


  • Alix
    replied
    Do you take omega 3 supplements and eat fish? Not that it’s guaranteed to work but if your lipid layer is thin you need to do something to improve the quality of the oil coming out of your glands. Did the doctor have any suggestions as to what’s causing the thin lipid layer? No amount of eye drops is going to fix this. You have to treat your problem from within.

    Leave a comment:


  • jack1988
    replied
    Originally posted by deep_dry_eye View Post

    Restasis treats inflammation, if the inflammation causes MGD, Restasis will help the MGD.

    Just because oil is nice and clear does not imply you don't have MGD, e.g., MGD can also cause oil volume issues. The next step for you imo is to give IPL a try, You should also double down w/ Xiidra as well, esp if you find the Restasis ti help.
    Thanks, I will mention IPL. We don't have Xiidra in the UK.

    Leave a comment:

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