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Schirmer Test and glands are fine but lipid layer thin

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  • TARYN
    replied
    I don't know what my TBUT was. I think I was trying to say there are other options out there if your doctor can not help you. If the dryness bothers you and you are not getting any relief from the therapies that your doctors has recommended, then maybe another dry eye specialist can offer you another therapy. I think the Amniotic membrane has so many healing properties. You don't have to have a loose conjunctiva. You can have the symptoms of dryness or burning or inflammation and be helped by having amniotic membrane transplantion. It can be put on the area that is dry or inflamed with fibrin glue or in can be placed in the form of Prokera. I think if I didn't have the amniotic membrane placed on the area of the conjunctiva where he did the surgery, I would not have had such a good result.

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Hi Jack, My main problems were burning and redness and inflammation and yes I did have a foreign body sensation. Dr Tseng said because of the folds or loose conjunctiva my eyelids were not spreading my tears evenly over the ocular surface and I had discomfort most of the time. I think when the eyelid drags over the ocular surface and doesn't have the proper lubrication it gives that constant discomfort. My eyes immediately felt comfortable after the surgery.
    my eye doctor said no conjuctival chalasis. i never had foreign body sensation or burning tbh, but I did have dryness. Also, I don't have tearing, and apparently that is quite common with Chalasis.

    What was our TBUT and Lipiview scores when you had chalasis?

    Leave a comment:


  • TARYN
    replied
    Hi Jack, My main problems were burning and redness and inflammation and yes I did have a foreign body sensation. Dr Tseng said because of the folds or loose conjunctiva my eyelids were not spreading my tears evenly over the ocular surface and I had discomfort most of the time. I think when the eyelid drags over the ocular surface and doesn't have the proper lubrication it gives that constant discomfort. My eyes immediately felt comfortable after the surgery.

    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
    In regards to your chalasis Did you have foreign body sensation in your eye and also sometimes you can feel some discomfort when you blink or close lids

    Leave a comment:


  • jack1988
    replied
    Originally posted by deep_dry_eye View Post
    Schirmer is a test that has high variance, and should have very small clinical significance. A negatve Schirmer test does not imply one does not have dry eyes/MGD.

    Yes, your glands can be intact, but produce little oil. You need to find the root cause of the disease, it is most likely inflammation. Good starting points is to do IPL (which can help promote secretions), Xiidra and Reatasis (which can help reduce/control inflammation).
    I have IPL on the 10th June!

    I hope it helps. I don't have any crusting or anything though, so don't think I have MGD/Blepharitis. I guess we will see.

    Leave a comment:


  • TARYN
    replied
    I felt the steam was a more gentle heat. Maybe it was more diffuse. When it was suggested to me that I use the facial steamer to open up my blocked glands, it made sense because I always felt better after a shower. Meaning If you have allergies or MGB or a stuffy nose....a shower or steam opens everything up. It works for me without the irritation of a warm compress on my skin.

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  • jack1988
    replied
    Originally posted by TARYN View Post
    Since my eyes and eyelids are good right now I am not on a strict routine, but when I wanted to keep the glands from clogging up, I would use the facial steamer in the morning for as little as 10 minutes or as much as 20 minutes. After that I would put a drop of Patanol followed by a cold compress for 15 minutes. I don't do it everyday, but it is a treat when I do it because it is like an at home facial.
    I bought my facial steamer several years ago so they may have better ones now. The one I have is by Conair and the reason I like it is that it heats up to a temperature that gets the job done but doesn't burn my face or eyes. Check out Amazon and if you read the reviews make sure people aren't complaining that the product doesn't get too hot.
    This is the one I have and it still works well.
    Click image for larger version

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    Probably a stupid question but why would the heat from the not also cause irritation?

    Leave a comment:


  • TARYN
    replied
    Since my eyes and eyelids are good right now I am not on a strict routine, but when I wanted to keep the glands from clogging up, I would use the facial steamer in the morning for as little as 10 minutes or as much as 20 minutes. After that I would put a drop of Patanol followed by a cold compress for 15 minutes. I don't do it everyday, but it is a treat when I do it because it is like an at home facial.
    I bought my facial steamer several years ago so they may have better ones now. The one I have is by Conair and the reason I like it is that it heats up to a temperature that gets the job done but doesn't burn my face or eyes. Check out Amazon and if you read the reviews make sure people aren't complaining that the product doesn't get too hot.
    This is the one I have and it still works well.
    Click image for larger version

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ID:	234047 Click image for larger version

Name:	81OqQeSH-3L._SL1500_.jpg
Views:	289
Size:	183.6 KB
ID:	234048

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Sorry the previous reply posted again.
    Hi Jack, My eyes are in pretty good shape now. When I first started having problems with my eyes, I was told to do warm compresses to help loosen and liquify the oils. Unfortunately that irritated both my eyelids and eyes by creating inflammation. Then I was told to use a facial steamer. That worked very well. It loosened the oils without giving me inflammation. I also found that I had an allergic component and started using Patanol followed by a cold compress. That gave me temporary relief. I still had redness and burning in my eyes. I then tried IPL which made my eyes worse. I then found out I had irregularities and pingueculas in my conjunctiva which was preventing my tears from spreading evenly over my ocular surface. The AMT surgery got rid of the redness and burning and has given me the reilef I was looking for.
    And to answer your question, my glands are ok now because I use the facial steamer on a regular basis.
    Thanks. Can you link me to a facial steamer? Do you steam and then cold compress?

    Leave a comment:


  • TARYN
    replied
    Sorry the previous reply posted again.
    Hi Jack, My eyes are in pretty good shape now. When I first started having problems with my eyes, I was told to do warm compresses to help loosen and liquify the oils. Unfortunately that irritated both my eyelids and eyes by creating inflammation. Then I was told to use a facial steamer. That worked very well. It loosened the oils without giving me inflammation. I also found that I had an allergic component and started using Patanol followed by a cold compress. That gave me temporary relief. I still had redness and burning in my eyes. I then tried IPL which made my eyes worse. I then found out I had irregularities and pingueculas in my conjunctiva which was preventing my tears from spreading evenly over my ocular surface. The AMT surgery got rid of the redness and burning and has given me the reilef I was looking for.
    And to answer your question, my glands are ok now because I use the facial steamer on a regular basis.

    Leave a comment:


  • TARYN
    replied
    Warm compresses and steaming the lids will open up the glands so that is helpful if you have blocked glands/MGD. I have allergies so Patanol followed by a cold compress is very soothing.
    If you have both MGD and allergies then possibly a combination of warm compresses to open up the glands and if the warm compresses cause inflammation, then following it with a cold compress will calm things down. Everyone is so different. You just need to find something that works.

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Warm compresses and steaming the lids will open up the glands so that is helpful if you have blocked glands/MGD. I have allergies so Patanol followed by a cold compress is very soothing.
    If you have both MGD and allergies then possibly a combination of warm compresses to open up the glands and if the warm compresses cause inflammation, then following it with a cold compress will calm things down. Everyone is so different. You just need to find something that works.
    I use Cromoglycate. I guess that is similar to Patanol.

    do your glands never get blocked?

    Leave a comment:


  • TARYN
    replied
    Warm compresses and steaming the lids will open up the glands so that is helpful if you have blocked glands/MGD. I have allergies so Patanol followed by a cold compress is very soothing.
    If you have both MGD and allergies then possibly a combination of warm compresses to open up the glands and if the warm compresses cause inflammation, then following it with a cold compress will calm things down. Everyone is so different. You just need to find something that works.

    Leave a comment:


  • jack1988
    replied
    Originally posted by TARYN View Post
    Hi Jack, Good news everything healed well. Hopefully you will find ways to make your symptoms better. I tried compresses, probing, IPL and eyedrops. None of those things worked. Cold compresses and Patanol and cleaning my lids with Theralid did help but it only gave temporary relief from burning and redness. For me the conjunctivoplasty with amniotic membrane transplantation really helped me.
    Good luck with the compresses and lid hygiene. Hopefully things will get better.
    Cold compress?? how does that melt the oils? do they not clog up if you cold compress?

    Leave a comment:


  • TARYN
    replied
    Hi Jack, Good news everything healed well. Hopefully you will find ways to make your symptoms better. I tried compresses, probing, IPL and eyedrops. None of those things worked. Cold compresses and Patanol and cleaning my lids with Theralid did help but it only gave temporary relief from burning and redness. For me the conjunctivoplasty with amniotic membrane transplantation really helped me.
    Good luck with the compresses and lid hygiene. Hopefully things will get better.

    Leave a comment:

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