Downright disgusted

[DCRdryeye]

I don't know Indrep, but it's a question I'd like answered. Perhaps a meibography will reveal what's happening. I've had dry eyes for 7 yrs now and thus, whilst only using artificial tears and no anti-inflammatories and MGD treatment, the MG's will get worse to the point of no return - fibrotic. Fibrosis is like a scar, it has no collagen, thus no stretch and pliability. It cannot 'pump' meibum out due to it's rigidity. Thus in theory a fibrosed gland is acting like an atrophied gland.

[indrep]

My understanding from research that Jeffrey Gilbard, MD and others is after as little as 36 months of inflammation and inability to secrete, the lacrimal glands and meibomian glands begin to atrophy and lose the ability to produce aqueous and lipids.

[DryInUpstateNY]

My understanding from research that Jeffrey Gilbard, MD and others is after as little as 36 months of inflammation and inability to secrete, the lacrimal glands and meibomian glands begin to atrophy and lose the ability to produce aqueous and lipids.

does this assume that the patient did nothing for 36 months? as soon as I had the slightest bit of discomfort from dry eye (Aqueous deficiency, no mgd), I was on Restasis. I do feel a lot better. it's gone from intolerable to tolerable.

[indrep]

This is 36 months after inflammation is present. Inflammation becomes present after the osmolarity of the tear film has risen. So the time period is probably somewhere around 40-50 months after elevated osmolarity is present.

The eye care providers that I speak to say just what your experience was. The patient that starts on Restasis as soon as discomfort is noticed has the greatest benefit form the drug. So if the inflammation stays away and the root cause of your issue can be addressed your situation will be very manageable.

[NotADryEye]

NotaDryEye, what are your thoughts on this? Did this happen for you? or anyone else replying to this thread?

No, I did not have red veins from Restasis. For me is was extreme burning and extreme pain. Generally speaking, if there is pain or burning or other discomfort, I discontinue.

[DCRdryeye]

My understanding from research that Jeffrey Gilbard, MD and others is after as little as 36 months of inflammation and inability to secrete, the lacrimal glands and meibomian glands begin to atrophy and lose the ability to produce aqueous and lipids.

My Lacrimal and MG's are atrophied then lol. I hadn't used an anti-inflammatory for the first 6 yrs, just survived on artificial tears. It was only last year I went on Prednisolone (preservative free) and Cyclosporine drops. It further shows that artificial tears provide some comfort, but do nothing to slow the progression of the disease.

I'm definitely getting a meibography asap.