Something my optometrist told me about my eyes

[Roderick]

I saw her about 18 days ago, and she called to inquire as to how her suggested treatment went. She suggested to regularly instill lubricant drops, to do some eyelid massages with hot compresses in the day, and she gave me a prescription of Tobradex (steroids + antibiotics), to apply on my eyelids for a week.

Unfortunately the Tobradex wasn't of any help so I just dropped it. Didn't want to use steroids over any long term basis anyway.

She seems to be fairly knowledgeable as far as dry eyes go, at least a lot more than the average optometrist. She was even ranting against BAK to me, saying that I should avoid drops containing it at all costs. It sure made me smile.

I asked her what the problem was exactly with my eyes, and what was happening as far as my meibomian glands go. She said that my glands were not obstructed and that they produced oil, but that this oil simply didn't spread over the tear film, instead they simply end up building up in spots. The goal of eyelid massages with hot compresses according to her was to relax my eyelids so that they could spread more.

Does someone know more about that particular type of dry eye symptom?

She told me that she'd make sure to refer me to an ophtalmologist, one who she told me is a lid specialist. Alas, the wait will be long. It could even go to the end of the summer. I suppose that all the people with glaucoma and corneal erosion take priority over me.

[wantsim]

that sounds like a type of meibomian gland dysfunction where the oil produced by the lids becomes thick and viscous like toothpaste, instead of being smooth and free flowing like oil. Thick eyelid secretions are not able to spread and smooth over the eyeball like oil can. So the warm compresses and eyelid massage help to melt this thick toothpaste like eyelid secretion and help it coat the eyeball better.

there is a bacteria component too. bacteria on the eyelid margin can interact with the natural oils being produced from the lid margin causing the thickened secretion. the reaction between the bacteria and oil is called sapponification and thus a thickened secretion similar to soap is produced and this can certain cause burning (imaging getting soap ino your eyes). and since what is produced is thick and can't smooth over the eyeball your natural tears will evaporate quicker.

try azasite drop smoothed over your eyelid margins daily. your optometrist should be able to prescribe it if you haven't seen the ophthalmologist yet