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I FINALLY (doc #7) have a proper diagnosis!!! This has taken 8 years...
He used the TearLab diagnostic tool (new to their practice) and determined that each eye is a 327 which puts me in the "moderate" dry eye category. I think he said that people who do not have dry eyes are usually under 200.
My aqueous layer & mucus layer are both fine. My lipid layer however is very poor thus making my eyes so dry. I have Posterior Blepharitis/MGD/Meibomianitis. He says it may have been caused by my former accutane use but it's more likely in his mind that is because of my estrogen levels (female in peri-menopause).
This is all so interesting since some of the previous docs I've seen said my glands were "fine", some said "a few are blocked". He asked if I'd ever had a doc express my glands (no) and he did that - finding that the secretion is not at all clear (which we want) but is very thick and contaminated (? can't recall the exact word he used). He said almost ever single gland is blocked on both my bottom lids and all are blocked on the top lid of both eyes.
He wants to see me again in one month (all the others said "see you in a year"). He has me doing warm compresses with a rice baggy at night (morning too if I have time), then expressing my glands, then applying a drop of Azasite to each eye *on* my lashes/lashline (not in my eye). He also has me using Systane Balance first thing in the morning and before bed/at night. For moisture during the day he has me using Systane Gel Drops (new he said) which are supposed to keep the eye comfortable for 4-6 hrs. (I like it so far-feels really comfortable and doesn't gunk up my lashes like Celluvisc does.) He didn't mention a thing about ocular rosacea (I had self-diagnosed this since I have very mild facial R. - still think I could have a touch of it.) He was very confident in his diagnosis which I also found reassuring.
So...I am, for the first time in 8 years, hopeful that at least now I can find some relief!
He said we'll revisit plugs, and doxy if necessary and also said that we will also wait on Restasis (used it for 3 yrs previously) because in his experience it really does not work unless the glands are unblocked and the secretions are clear.
I asked him how long he had been specializing in dry eyes since I had seen other docs in his office years ago who had never referred me to a specialist or knew much about dry eyes at all, and he said only since June. He said he had so many patients with dry eye problems and none of them were getting much better so he wanted to figure out why, and how he could help, so he began doing research.
I am so thankful to have found him.
Thanks go out to Rebecca for mentioning the TearLab diagnostic tool in her newsletter - I used the link she provided to find out if anyone was using it my area and was shocked to see that he did - which is what led me to call and ask for an apointment.
After I see him next month I will post about any improvement.
He used the TearLab diagnostic tool (new to their practice) and determined that each eye is a 327 which puts me in the "moderate" dry eye category. I think he said that people who do not have dry eyes are usually under 200.
My aqueous layer & mucus layer are both fine. My lipid layer however is very poor thus making my eyes so dry. I have Posterior Blepharitis/MGD/Meibomianitis. He says it may have been caused by my former accutane use but it's more likely in his mind that is because of my estrogen levels (female in peri-menopause).
This is all so interesting since some of the previous docs I've seen said my glands were "fine", some said "a few are blocked". He asked if I'd ever had a doc express my glands (no) and he did that - finding that the secretion is not at all clear (which we want) but is very thick and contaminated (? can't recall the exact word he used). He said almost ever single gland is blocked on both my bottom lids and all are blocked on the top lid of both eyes.
He wants to see me again in one month (all the others said "see you in a year"). He has me doing warm compresses with a rice baggy at night (morning too if I have time), then expressing my glands, then applying a drop of Azasite to each eye *on* my lashes/lashline (not in my eye). He also has me using Systane Balance first thing in the morning and before bed/at night. For moisture during the day he has me using Systane Gel Drops (new he said) which are supposed to keep the eye comfortable for 4-6 hrs. (I like it so far-feels really comfortable and doesn't gunk up my lashes like Celluvisc does.) He didn't mention a thing about ocular rosacea (I had self-diagnosed this since I have very mild facial R. - still think I could have a touch of it.) He was very confident in his diagnosis which I also found reassuring.
So...I am, for the first time in 8 years, hopeful that at least now I can find some relief!
He said we'll revisit plugs, and doxy if necessary and also said that we will also wait on Restasis (used it for 3 yrs previously) because in his experience it really does not work unless the glands are unblocked and the secretions are clear.
I asked him how long he had been specializing in dry eyes since I had seen other docs in his office years ago who had never referred me to a specialist or knew much about dry eyes at all, and he said only since June. He said he had so many patients with dry eye problems and none of them were getting much better so he wanted to figure out why, and how he could help, so he began doing research.
I am so thankful to have found him. Thanks go out to Rebecca for mentioning the TearLab diagnostic tool in her newsletter - I used the link she provided to find out if anyone was using it my area and was shocked to see that he did - which is what led me to call and ask for an apointment.
After I see him next month I will post about any improvement.
) maybe the TearLab customer list would be a decent way to single out doctors who actually take an interest in dry eye. Anyway I'm so glad to hear you're getting better more detailed info and hope the new treatment regimen yields good results for you.
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