Tear Oil Deficiency-I don't understand

[Cali]

I found a really fantastic doctor this Thursday - hope restored. My physician said my eyes were "salty." She said there was "no oil." She drew pictures of my eyes and then put a bunch of small dots all over the corneas with her ball point pen, saying they looked "pitted."

What does that mean? My body is not producing the "oily lipid layer" and that my meibomian glands which are responsible for producing this layer, are not functioning correctly?

Please note, I had LASIK 8 years ago and this all started then. I didn't ask the right questions during my appointment even though I came prepared with questions. I've learned sometimes I just kinda sit there shocked and try to take everything in. Now that I am calm, I'm trying to understand what this diagnosis means. My TearLab and Schirmer scores were "0." The lab tech could not get a reading. She paused and was surprised during the TearLab test that it registered NOTHING.

Oh, and for awhile I've been taking 5,000 fish oil and flax oil daily. My hair and skin are greasy and shiny after about 8 hours yet no oil on my corneas?

I guess the glands are like muscles and are either scarred or atrophied and are not secreting? I don't know how you get around this problem since clearly taking vast quantities of oil doesn't make it's way to the glands (or at least my glands).

Hoping someone can provide some input to help me better understand.

[Tankie]

Perhaps watching this video will help: http://www.dryeyezone.com/talk/showt...EE!&highlight=

LipiFlow costs approximately $1400-$1700 to get done depending on where you live.

[Guest]

Oh, and for awhile I've been taking 5,000 fish oil and flax oil daily. My hair and skin are greasy and shiny after about 8 hours yet no oil on my corneas?

I guess the glands are like muscles and are either scarred or atrophied and are not secreting? I don't know how you get around this problem since clearly taking vast quantities of oil doesn't make it's way to the glands (or at least my glands).

Hoping someone can provide some input to help me better understand.

We are taking the fish oil for the anti-inflammatory properties of the omega-3 fatty acids that are IN the fish oil (ie. not because of the oily properties of the fish oil)... the anti-inflammatory effect of the omega-3's can hopefully reduce inflammation that is contributing to our dry eye symptoms.

Not all fish oils are created equal - check the label of the one you are taking to see how much omega-3 you are getting. The brand I use is Ascenta NutraSea - I take 4 capsules per day, which totals 4.792 grams of actual fish oil, and THAT gives me 2.3 grams of omega-3 fatty acids per day (1.5g EPA, 0.5g DHA and 0.3g misc. omega-3's)

If you scan the various brands available, you'll see a huge range in the amount of omega-3 per gram of fish oil - some fish oils supplements are more potent than others in terms of how much omega-3 you get. You can think of the omega-3 fatty acids as the "medicinal ingredient" in the fish oil.

Also, there are different ways of manufacturing the fish oil supplements - that's one reason why you may tolerate some brands better than others in terms of side effects ("fish burps", nausea etc.)

[Cali]

OK. I get it. I'm trying to reduce my inflamation with the fish oil. But why am I inflamed? A result of the LASIK 8 years ago? Per Tankie, I'm become aware of how my MG's might be an issues (blocked/scarred/gooped up like toothpaste). This is so hard. I just want to understand what my issue is. What I now know is that I have virtuallly no tears. My eye's are salty. I'm producing no oil. But why? What do I need to know? If I'm inflamed and what is causing the inflamation and why I'm not producing tears or no oil? I don't know what questions to next ask. Also, my serum drops that I get soon will help heal my ocular surface, but will I still hurt because I have no tear flow, no oil? Do I need to learn how to express my glands? NOTE: Hot/warm compresses help a lot so maybe I have oil in m glands but it's just not making it to the surface of my eyes.

I wish I asked these questions to my doctor. I was just so relieved to find someone compassionate, engaged, educated and well, good, that I just sat there feeling hopeful but still not understanding what is happening to me and why.

[unicorn]

I wish I asked these questions to my doctor. I was just so relieved to find someone compassionate, engaged, educated and well, good, that I just sat there feeling hopeful but still not understanding what is happening to me and why.

You're in the right place, Cali, to try to start understanding these things. It's great that you've found such a good doctor. You will no doubt be going back for follow-up appointments so these will be your chance to ask the right questions. Start writing things down as they occur to you. These questions are important! Understanding your condition is really key to working out the best treatment, I feel.

It's great that warm compresses are working for you. These should help to loosen any blocked oil you have in your glands. Have you tried lid massage? Dr Latkany's book 'The Dry Eye Remedy' explains clearly how to do them.

[Guest]

OK. I get it. I'm trying to reduce my inflamation with the fish oil. But why am I inflamed?

Could be LASIK decreased your tear production and until now it wasn't an issue... maybe as you got older, your tear production decreased naturally with time, but when you add that on to the decrease from LASIK, it finally pushed your eyes over the edge to a stage where you are now having a lot of symptoms.

As for why you are inflamed, it's a vicious circle with dry eye - your eyes can be inflamed because there is something wrong with the tear film (maybe not enough tears, maybe MG dysfunction etc.... ) then THAT problem leads to inflammation which worsens the original dry eye cause, which then causes more dryness and more inflammation, which then causes more dryness or MG dysfunction, which then causes more inflammation etc.

The trick is to break the cycle somehow - if you can reduce your MG dysfunction, you'll have less inflammation and less dry eye - if you can take fish oil, you'll hopefully have less inflammation and less dry eye, plus various other ways etc.

I highly recommend Dr. Latkany's book that was just mentioned - it does a great job of explaining what's going on.

Also, google the "DEWS report" - it will also tell you everything you ever wanted to know about dry eye.