Extremely dry eyes!

[premedboy]

I'm new to the forums and I posted pretty much the whole story in the story forum. Anyways, here's a summary of what's been going on. I've been having extremely dry eyes since the end of june, after a bad eye infection that I did not get treated for. Anyways, since then, I've tried tobradex, lotemax, zirgan (an antiviral), besivance (antibiotic), zaditor (used this as just a last resort kinda thing), and nothing has helped. I went to a doctor that said basically the infection might have clogged up the oil glands (meiobemian glands) so she put me on docycycline 100 mg twice a day and azasite to rub on my eye lids every night after the warm compresses/lid scrubs. I also got a pair of tranquileyes since I do have lagophthalmas. I've been on this treatment for 2 weeks now and my eyes have not improved at all. I'm running out of ideas and am EXTREMELY frustrated.

If you guys have any opinions on this please tell me. Oh and btw, I'm only 20 years old and have NEVER had any problems with my eyes prior to this.

[premedboy]

Also, the break up time for my tear film is about a second. My shirmer's test result is 6.

Thanks

[spmcc]

RE: meibomian gland dysfunction (MGD)

I always feel like a donkey (sorry donkeys!) when I answer posts as I'm 15 years with dry eye (DE) and not much improved...

I'll just tell you something my 3rd (or maybe it was 4th?) ophthalmologist told me... he said if your (my) main problem is MGD, then hot compresses and lid expression (getting the oil moving out of the glands) cures approx 80% of people. I don't know if there is any proof for this number, but it's encouraging. I have an uncle who says that as long as he "scrapes" (that's what he calls it) his lids, upper and lower, in the shower every day, then his DE is controlled.

Could you ask a doctor how to perform manual expression of the glands? I think it's easiest if you have someone show you in person. And you should do the expressions after you've loosened the oil with warmth/heat from compresses.

Personally, I can't handle hot compresses and expressions because I have rosacea and any manhandling of my lids causes swelling, redness, heat, and pain. But maybe you could handle more compresses with warmth (don't burn your lids)... up to 4 times a day?

If your problem is mainly MGD, then you're on the right track: oral doxy, azasite, compresses, lid expression, lid scrubs, then perhaps, IPL for dry eye, and maybe Lipiflow thermodynamic device (not FDA approved in the US yet).

If the problem includes aqueous deficiency then treatments include: restasis/cyclosporine A drops, plugs/cautery, oral salagen.

It's also very important to cover your eyes as much as possible. I tell people that air is my enemy. So, not only is there Tranquileyes for sleeping, there are also goggles (see Tankie's posts) and glasses (e.g., 7Eye, Wileys, Seefit MEGs, and custom moisture chambers (see SAAG's posts)) for daytime. For nightime, I not only use Tranquileyes but I cover my eyes first with pieces of Glad Press N Seal. The goal is to make a mini-Costa Rica for your eyes.

Good luck.