Advice

[HeidiPOP]

Hello. I'm a 48 year old woman and I've been suffering from dry eye about a year now.

I'm on my second doctor. The first one just wanted to put me on Restasis within five minutes of meeting me. She got annoyed when I told her I was researching dry eye causes online and told me I should be doing more to help my eyes than reading about it on a computer! My new doctor actually did blood work to look for underlying causes, and dilated my eyes, etc. Everything looks healthy, but she says I have a "tendency" for Rosacea, Blepharitis. I'm not sure what I'm supposed to be seeing in the mirror to indicate this problem.

I'm using a rice baggie before bed, Systane drops all day, a humidifier in my bedroom and Flax seed oil twice a day. I live in western New York so the winter weather and constant furnance output isn't helping much. I also work on a computer all day.

I wear bi-focals and recently tried to get wrap around sun glasses so I could continue to take walks with my dog, however two optical stores told me my prescription is just out of the parameters for a curved lens. This is very depressing to me as walking outside renews my spirit and helps keep the pounds off. Treadmills just don't cut it for me. So I got myself a pair of large sunglasses, sort of "Jackie O" looking, but they don't provide complete protection. Does anyone know if the Pantoptyx or Wiley-X glasses can be made for hard-to-fit cases like mine?

Also, I've had to stop wearing mascara since even the waterproof kind flakes off with all the drops I use during the work day. Has anyone had luck with any brands of mascara? I only wear a little to work and really feel awkward without any on, sort of naked!

I am considering using Restasis, but my health insurance probably won't cover much of the cost. This is really making life a bit miserable right now, but I keep telling myself things could be a lot worse. Thanks for any advice.

[Rojzen]

MEGs; Dwelle; small fitovers in different lens colors

Good news, as many of us can happily confirm that there remain a multitude of options for you to consider, not only for high-Rx protective eyewear, but also for direct treatment.

Please check out updates here on MEGs, which can be made into any Rx that regular glasses can accommodate. These are frames to which may be attached cups that provide moisture chambers that compare well, in function, with most wraparounds. I have a very strong distance and very strong presbyopia prescription in progressive lenses, and my one attempt at getting this Rx into a sport wraparound failed. (RecSpecs, with wrap lenses. Distortion level was unacceptable, and I couldn't see much out of the glasses.) Instead, I have used custom-made moisture chambers, but would now move to OTC MEGs, if I still needed moisture chambers full-time.

Systane is an impressive moisturizing drop, but I do not believe there is any serious science behind its use of guar gum to create a matrix that might stabilize the tear film on any lasting basis. Dr. Holly, who contributes here, has addressed the matrix theory, in at least one of his posts. Dr. Holly's drops, the best known of which is Dwelle, moreover, do not rely on a matrix, and act completely differently from the way that a mere moisturizing drop or artificial tear would.

Systane was my favorite OTC drop, during the years I was on Restasis (to no avail), but Systane never made any difference for me lasting more than about 2 minutes after instilling. Dwelle, in sharp contrast, over a period of 7 months, brought my tear film stability up to the point where I no longer needed moisture chambers.

Years of antibiotics did not normalize my meibomian secretions, moreover.

If you are doing OK without eyewear except for outdoors, have you looked at some of the fitovers available online? There are now dozens of fitover glasses, in both spectacle and goggle style, and these come in many shades of lenses. On a very windy day, just for good measure, I'll wear dark-lens fitovers over my glasses; On a windy night, or on very cloudy days, I wear yellow-lens fitovers over glasses. Even better, I get along AOK without fitovers at all, now, after 16 months on Dwelle (or, occasionally, FreshKote) as my exclusive therapy.

Not all fitovers provide an excellent barrier. The older models that come with a removable rubbery seal for the top of the frames work best for me. Also, it's important to find the smallest pair you can fit over glasses, to ensure best seal on the sides and bottom of the glasses.

[HeidiPOP]

Fitovers

I have not looked into fitovers. I'm still learning what options are available, so thanks for the information. Other than the solar shield glasses I've seen "older" folks wearing, I've never heard of fitovers until your post. This gives me hope!

I found an optical place near my office that supposedly serves hard-to-fit customers wanting wrap around sun glasses. I'm going to start there. If they can't be made to my Rx (which I strongly suspect), I'll look into both the MEGs and the fitovers. I'm at the point where I don't even care if I look funny in them. I just want to be able to take long walks without suffering.

I am confused about the Dwelle drops. It sounds like they work wonders, so why aren't the opthamologists telling their patients to use them? Both the doctors I saw recommended something else.

Heidi

[Rojzen]

Dwelle: Doctors rarely practice EVIDENCE-BASED medicine

Heidi, so glad you have this very upbeat approach to fitovers and MEGs. They can make a WORLD of difference, producing long stretches of time when the pain and rawness of your eyes don't occupy most of your senses and thought processes. Over time, moreover, fitovers have become prettier; and MEGs look just lovely, from the photos I've seen at the SeeFit site.

RE: Dwelle and eye doctors not recommending it. This is a tragic situation, in my view, because what is possible with Dwelle is truly not possible with the almost endless list of OTCs that one finds in the drugstores. Every eye doc I've ever seen has recommended whatever the most recent pharmaceutical rep or company has dropped off. If he/she has samples of Refresh or Optive, the recommendation will be for one of those. For a few years, the Alcon folks flooded doctors' offices with Systane samples, and so my eye docs suddenly became great fans of Systane. Trust me when I report that eye doctors generally have NO idea that there are significant differences among OTC "artificial tears." Some may know that Soothe contains a lipid, and others may know that Systane contains guar gum. Most couldn't care less, however, and most don't even believe that we CAN get well, if I may venture such a sad thought!

I have personally visited doctors to tell them about the real transformation that Dwelle made, in my case, and at best, I've gotten these doctors simply to agree to look into it. I press and press that Dwelle works biophysically, and is based on a tremendous body of science developed by Dr. Frank Holly, in sharp contrast to the many products that are simply moisturizers that aim, in general, to be viscous (which Dr. Holly has proven is hugely counterproductive to tear film stability). The response is usually lukewarm. Doctors seem to be easily bored, even by the very information that could make them real successes!

The bottom line is that doctors are generally NOT scientists, and many are not even oriented to science. This has been well established, for example, in the writings of scholars who study how badly medicine is practiced in the U.S. today. (I heartily recommend "More Harm Than Good," by Dr. Alan P. Zelicoff,on this topic of today's medicine NOT being evidence-based.)

Anyway, if our docs refuse to get educated about dakryology, a field most don't even know exists, then we must pick up the slack. I will continue to try to get my docs to look at Dwelle, and to recommend it, but if they don't, that won't change my direction at all (:^)...

[gary]

Hi Rojzen

The dr holly drops that worked so well for you is that the dwelle drops that has night on the bottle? Do you use them during the day also? I tried them for awhile but they seem so sticky!I can handle it at night,just during the day my eyelids want to stick together when I blink,I have to wash off my eyelids and I didn't know if I was leaving much in my eye to do any good...I also bought nutratear(the red drops) both from the dry eye shop,now were these also developed by Dr. Holly? should I use these during the day and the dwelle drops at nightime?

I have a cataract in my right eye due to the long time use of the prednisolone drops for the zoster virus,and I am scared that when I have the cataract removed it will cause my dry eye situation worse..

Gary