My Plan of Attack...Let Me Know What You Think of it!

[kandykane1544]

Hey everybody,

Tomorrow I have my first ever appointment with an allergist. Then, the second week of October I am going home for the weekend (I'm at college) for my school's Fall Break. That Friday, I am going to a rheumatologist to (hopefully) rule out a autoimmune disorder via blood work. Then, right afterward I am going to a local Opth who will evaluate me, and then potentially give me the lipiflow procedure. Based on my current diagnosis, which is MGD/posterior blepharitis, I am hopeful that I will be posting in the triumphs section in a month or so (hey a little hope never hurt anybody).
However, I am doubtful that M gland obstruction is the root of my problem/pathogenesis. To me, after my countless hours of research, I cannot help but feel I have ocular rosacea. Here's my story/symptoms:
My eye problems started overnight. I woke up one morning, my left eye felt dry and gritty, and I had increased vascularization (new veins) on the conjuctiva to go along with it..happened exactly together. On top of it, it always appeared like my lids and inner corner of my left eye were red. Last year I lived in California hence I got a ton of sunlight, especially in comparison to what I had gotten growing up in Illinois my whole life. I feel that the vascularization coinciding with dryness, redness of lids. my european heritage, and my young age make Ocular Rosacea a decent culprit.
If lipiflow isn't my savior, then I plan on visiting a corneal disease specialist in my local area who has worked with ocular rosacea patients. What do you guys think based on my symptoms? Allergy testing is still a good idea right?

[hankm9]

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[Tankie]

Hey there. I love your attitude! Great to see someone with such a positive outlook =) It sounds to me like you've done your homework; you use the technical terms beautifully like "posterior blepharitis", "conjunctiva", etc.

If I were you, I would go with my gut at first. You've obviously looked into things, you've made a few informed choices, so I would just roll with it and see how it turns out. If things don't turn out the way you want, at that stage it would probably be a good idea to talk to some of the "dry eye veterans" on the forum here for advice on what to do next.

I wish you all the best, let us know how it turns out =)

[Katewest]

Have you looked into IPL or restasis?

[kandykane1544]

Thanks everybody. But yes Katewest I am currently on restasis. As of now I only use it once in the morning and twice if I am going out or doing anything outside the house. As for IPL, that is definitely something I will look into. My diagnosis of ocular rosacea is self made at the moment though, hopefully over these next few months I will talk to some people that can "narrow down" my diagnosis. Some of you probably know how it is... At first you get DES diagnosis, then you push a little harder and you get posterior bleph, meibominitis, etc. and now I am trying to go from there.

[Tankie]

A word of advice when seeking a diagnosis: always refrain from telling the doctor what other doctors have claimed, or what you personally believe it is. The reason is because you want their diagnosis to be 100% impartial and original.


In lots of occasions, people can go to a doctor, and he'll tell you that the patient has ocular rosacea and mgd. The next doctor will say you have ocular rosacea, mgd, blepharitis, and lagophthalmos. The next will say you only have mgd. And so on and so on. I'm sure you understand what I'm trying to say. It's also a good way of testing how well the doctor knows his stuff.


Once you've given the doctor a chance to examine you and make her diagnosis, then and only then is it a good time to start asking questions like "do you think I also have lagophthalmos?" And then she'll take another look and give you her opinion.

[eye_allergy-kids]

In lots of occasions, people can go to a doctor, and he'll tell you that the patient has ocular rosacea and mgd. The next doctor will say you have ocular rosacea, mgd, blepharitis, and lagophthalmos. The next will say you only have mgd. And so on and so on. I'm sure you understand what I'm trying to say. It's also a good way of testing how well the doctor knows his stuff..

Fantastic Tankie
your description about doctors and tests are superb. I add one more... many research reports also the same.

[littlemermaid]

http://rosaceagroup.org/new/
Kandykane, If you think it's ocular rosacea, and jury's out on what that might be in its various forms, then don't think it's not fixable. Lots of people manage or fix it fine.

They're all discovering their triggers so an allergist is a good plan - take your bathroom products, eyedrops (we are pretty much down to saline), talk about your routine. Make a diet diary now before you go, see if you can correlate with eye flares. MG inflammation could be allergic.

Try blepharitis warm compress or eyerub in shower for mgd but watch out your eyes/skin aren't sensitive to whatever you're doing or using. Eliminate junk fats and sugars and supplement with fish/flax oil to change the meibom. Consider there might be residual infection in the MGs if you have a sebaceous skin type.

Ask the allergist what type of hypersensitivities there are in the immune system. Become sensitive to what makes things better/worse. Mostly the allergy triggers are a complete surprise to people, as in 'wow I feel so much better now I've cut gluten/dairy/nickel/moisturiser/perfume/preservatives/aspartame/whatever'. Blitz the house for common allergens. Allergy reaction can be immediate or chronic grumbling days later (type IV hypersensitivity).

Imho, your plan is good. Maybe I would see the corneal disorder specialist ophth before Lipiflow unless you're sure you've got obstructed MGD that isn't resolved the normal ways because of $. Maybe because it started in one eye, it may be either the eye you sleep on and it's allergy, or unresolved infected MGs. The ophth should give a course of topical antibac but make sure they are preservative free.

Post up how you get on

[Katewest]

How long have you been on restasis? I just started this weekend 2x a day.

[kandykane1544]

Thank you everybody for the advice. Tankie that is a good point I will try and keep that in mind. And Littlemermaid, can i just hire you to be my doctor? Haha thanks a lot for your advice, I'm probably just gonna print out your post and bring it with me next time. And Kate, unfortunately I didn't "stick with it" because about 30 days in I started psyching myself out about unnatural products and switched to Manuka Honey...haha sounds kind of crazy but it actually helps alot with inflammation (and I 've read honey has great healing/antimicrobial properties). I basically just put a little dab of honey in some warm water (obviously needs to be thoroughly diluted) and then gently apply it to my lids.That being said, I know that restasis helps maintain a more healthy goblet density so I have started to take it again this week, but I still do manuka honey once a day.
Good news though! Allergy tests all came back negative. Ha I guess I didn't need this air filter after all...I'm a bit of a compulsive buyer what can I say. I mentioned TRUE testing to the allergist and he said that I could do that as well, you guys think it's worth it? I feel good though, if I do have ocular rosacea hopefully I can discover my triggers and I can start improving. Like you said Littlemermaid, a food diary is probably a good idea. My eyes first started bothering me after a 2 week trip to the Caribbean last december, and since UV light is a supposed trigger for some rosacea patients, I feel this might be one for me as well. Again thanks for all your help, this website is the bomb.

[kandykane1544]

Oh and yes I think seeing the corneal specialist before lipiflow might be a good idea too. That's what I was going to do, but I'm only home from school for a weekend and unfortunately the doctor is in surgery on Friday's so I can't see him. I actually heard about the corneal specialist on this website...someone mentioned he has experience with ocular rosacea patients as well so hopefully he can provide me with some answers. Maybe I'll just rush home and try to see him late Thursday if he's available