Asking for dry eye advice

[jaxadorawho]

Hello~ I'm a new member who experiences dry eye(s) on a daily basis. I'm tempted to make yet another eye doctor appointment but the woman who I go to recommended me to my sixth (and last) eye doctor who was incredibly UNhelpful. I feel that she's at a loss of what to suggest and I'm frustrated because I just want relief from my dry eye symptoms!

A little background: I was born with an extremely droopy eye lid (right eye only). I turned into Franken-baby (haha) about a year later when my mom opted to do corrective eye-lid surgery to stitch up my eye. Since then my eye lid has never fully closed (it almost looks I'm watching you in my sleep! haha)

Fast forward 22 years. I didn't really ever have serious dry eye problems for those 22 years aside from sensitivity to light (my friends would make fun of me for always being in dimly-lit rooms while in college). Then I moved from Pennsylvania to Delaware in March 2011. About 6 months later, I was having such dry eye issues that it was affecting my ability to drive. So I went to my first of 6 eye doctors who told me I had an eye ulcer and sent me to a eye specialist.

Now it's six doctors later and I've found one that I really like but doesn't seem to quite know what to do. Currently I use a bandage contact lense for moisturizing (supposedly) on a monthly basis (leave it in for a month and swap it out at the end). I also use nighttime OTC eye ointment (such as Systane) and preservative-free eye drops (also OTC).

Nothing seems to quite help like I want it to because ideally I wouldn't need to squint my eye (straining, I suppose) and I wouldn't need to put in my ointment/drops every 2-3 hours. D: Maybe it's the changing of the seasons but I'm just at a loss for what to do/where to begin with a safe method to help relieve my dry eye symptoms.

I should also note that my eye has been a bit redder than usual (the veins in my eye, that is) -- though I'm not sure if that's of any importance.

Any help would be very, very appreciated.

[Rebecca Petris]

Welcome.

What happened with the ulcer? Is that cleared up? Were you (are you) having recurrent erosions?

This doctor that you have now that you like... has s/he examined your eyelids thoroughly for MGD? If not, push that in your next appointment, find out the state of your meibomian glands. The move might be coincidence or as you say seasonal factors may be kicking in (winter in the north always bad for everyone's dry eyes) BUT I remember once talking with a practitioner somewhere in the NE who had far more blepharitis cases in her current practice than in another practice in a different state a few hundred miles away. It was interesting. Other possibilities, issues with heating/humidification system in new home, allergies, etc. Increased redness? could be more dryness, could be MGD, could be allergy.

For just plain old relief, regardless of causes, nothin' beats moisture chamber glasses. Inelegant but effective. And yes some people use them in addition to bandage contacts.

Another possibility - rather drastic, and only on the table if you have excellent insurance or a lot of cash sitting around, would be PROSE. I'm increasingly hearing of people with chronic exposure issues from lid problems getting relief with PROSE lenses. (see bostonsight.org).

[jaxadorawho]

Thank you so much for your feedback, Rebecca!

I'm fairly certain that the ulcer is cleared up. Any time I go into an appointment, my eye doctor(s) only mention the scarring on my right eye. I'll be sure to ask about the ulcer at my next appointment so that I'm 100% sure though. I will also ask about her checking for MGD.

I did forget to mention that I used a humidifier for a month or so but I determined that it made my dry eyes worse.

I'm not really familiar with chamber glasses, especially since I wear prescription glasses daily. I'll have to check them out though and see if they might be a possibility.

Again, thank you!

[jaxadorawho]

I just wanted to give an update on this post.

Last Thursday morning I was awoken by my eye hurting. So, I called into work sick. I was so sensitive to light that I couldn't even drive myself to my eye doctor appointment. Turns out that, yes, I do have an eye ulcer. A new one. SO! Thanks to a combination of prescription eye drops + ointment as well as OTC drops + ointment, my eye is feeling MUCH better. I won't be putting my mosturizing contact back in until I come home from my trip aborad (leaving Friday). We'll see how I fare!

Thanks for your help.

[farmgirl]

Hi Jackie:

I'll add my 2 bits here. You mentioned in your first post that you had surgery on one eye as a baby which left you with an incomplete blink. I am assuming this is the eye that is getting the ulcers. I suffer from Sjogren's unknown to me at the time but about 4 years ago I had a cosmetic surgery procedure which for a time left me with an incomplete blink. It was explained to me that the eye is like a pump and the action of blinking squeezes out the oils in the meibomium glands. When your blink is incomplete this lack of pumping action prevents the eye from lubricating properly. I am guessing that it was probably your youth that kept you from getting into trouble sooner but age is catching up with you (all 22 years) and the eye is no longer able to compensate for the defect. My blink has been restored but I have never gone back to where I was before the surgery, probably the Sjogren's has worsened and I understand that once the cycle of inflammation starts it is difficult to get off the merry-go-round.

My question to you is, have you consulted with a good facial plastic surgeon about the possibility of having another surgery to extend the reach of the compromised lid? because if you can address the underlying cause you will go a long way to achieving the 'cure'. I have also found, at least with me, that my good eye is sympathetic with my bad eye. If one bothers me the other seems to tag along.

Secondly, given your circumstances, I highly recommend using serum drops on a regular basis. Because serum drops contain stem cells and vital nutrients they go a long way in healing and supporting the health of the cornea. Before I got on serum drops I had dry spots on my corneas every time that my eyes were assessed. Since starting the serum drops over a year ago they are always pronounced healthy. I still have some discomfort but they are ever so much better than before. You might also want to try experimenting with plugs in the punctae of that bad eye to see if that might help.

I also highly recommend moisture chamber glasses and have found the Wiley's to be a good choice. Mine are prescription. They are good for driving but not so great for reading. I have a pair on as I write this but I wouldn't want to have to work in them all day. They are indispensable for me outdoors, driving, malls, hospitals, airports etc though.

You might also want to consider a nightime goggle like the oniyx which will help protect the ocular surface from drying out as you sleep. I will awake with my eyelid deliciously moist. I still have to add drops on occasion when I awake at night due to the Sjogren's but I do know that they retain a lot of moisture.

Those are my thoughts, I hope you find some tools to help you along, you have a lot of years in front of you...cheers...F/G

[Nikki]

Jackie -

Have you considered looking into getting weights implanted into the eyelid that doesn't close - to help it close? I don't know about the safety, effectiveness of them - but, there's probably posts here that discuss it.

Nikki