For Justin Bazan. 'my own thoery, ocular rosacea related dry eye'

[sazy123]

Hi Justin Bazan, thank you for sharing your knowledge and expertise on this extremely debilitating condition.

I would like to share with you my theory for ocular rosacea related dry eye and MGD, based on my strange dry eye situation and my own research, you may find it of interest or that i am way off the mark! Would appreciate your comments either way.

My background-
I am 23 and have been suffering with dry eye for 3 1/2 years. I have no other health problems, no hormone deficiency's, no autoimmune diseases (as suggested from the test). So i developed severe dry eye (MGD) with seemingly no cause. Except rosacea. I never had facial rosacea before and still now it remains very mild. I have perfectly functioning lacrimal glands.


A Step by step thoery

1. I have pale skin (type 1) with a vulnerability to rosacea/ocular rosacea

2. Age 14-17, contact lenses started things off, created vascular damage. Started becoming contact lense intolerant.

3. Age 18, anti depressants or a trial of ortho-k further effected the vascular structure, this amount of vascular damage was enough to create an auto immune response, this led to inflamed eyelids/inner eyelids- which in turn caused hypo-secretion of oil from meibomian glands.

4. The autoimmune reaction (to the vascular damage) is what i believe is causing the the dry eye. The reason i came to this conclusion is- in the event of another illness in my body i.e the flu, face pain, tonsilitis anything or like this- an immune shift occurs in which the immune system diverts away from my eyes to the other problem, in turn the auto immune reaction stops.-

After a year of severe dry eye i developed face pain/fibro pain (from the stress i went through), - DURING WHICH MY DRY EYE BECAME 90% NORMAL. My eyes felt completely back to normal. This also happens with any sickness as stated above. When the face pain went away my eyes would return to being horrible again.

The visual observations that occurred with this were:- the inflammation and swelling of my inner eyelids decreased, tear film became ALOT thicker/glossy (less watery). So my conclusion is- the decreased inflammation of inner eyelids stopped the blockage and allowed the M glands to produce normal oil flow.


Ocular rosacea related dry eye is only one possible cause of dry eye which i believe gets no attention and no new treatments. Yet there are many YOUNG people who have dry eye related to rosacea with no other reason and DR latkany states it as one of his biggest patient groups, along with pre/post menopausal women.

No blocked glands or clogging. I.e hot compresses never improves it because my glands are not clogged at all.


Just my own theory, Sorry for the long post, what do you think?

[Justin]

Thanks for thinking. Its great to have patients like your self forcing change.

Rosacea can affect the MG secretion by obstructing the orifices the oil is exuded from. Also, I think that you have an excellent theory about how the vascular damage from Rosacea leads to an inappropriate and further disruptive inflammatory process that induces MGD.

If your ocular health is otherwise within normal limits, and the only issue is the hyposecretion of meibum, you may benefit greatly from an artificial tear that can stabilize the tear film, like Freshkote. To treat the root cause, the rosacea, work closely with a dermatologist who is passionate about rosacea.

You have made a pretty common observation about the effects of sickness on the eye. Many people experience and improvement in their dry eyes when they are sick. The increase in the amount of mucus may be the key. The mucin layer of the tears is probably enhanced, leading to the added comfort.

Please keep the comments coming. You are helping others form their own theories. The more people putting together well constructed thoughts, the better.

[sazy123]

Hi, thank you for your reply. Sorry its taken a while for me to get back to you.

The 'vascular damage- leading to inflammation- auto immune reaction' part is more or less the same reaction which happens in facial rosacea so it makes sense that it also happens in ocular, but is caused by different methods. Unfortunately though while there are treatments for the facial component there isnt for the ocular. Artificial tears really dont do any thing for me, i just find them quite ineffective, ive tried most to stabalise tear film etc. Although not freshkote. Ive kind of given up with artificial tears now ( i use them when i have to).

Thank you for your interesting point about Mucin being increased. Its possible. The only thing is, the fact that the redness of inner eyelids and swelling (inflammation for O rosacea) goes away due to sickness- resulting in my tear film looking alot thicker, as in more oil, does imply that the inflammation is no longer blocking the MG orifices.Also it occurs when im not flu sick- i.e i had face pain symptoms for one year and had no dry eye the whole time. But interesting point, i hadn't thought about that.

Have you heard about are IPL to the face for ocular rosacea? there have been reports that it has helped peoples MGD. Im considering it as ive tried everything else, but my face isnt bad.

Thanks again sx

[Justin]

Although not freshkote.

Try Freshkote, on a schedule that your doctor presribes. If you are using an ineffective AT only after you are symptomatic, you are not optimizing your chances of your eyes feeling normal.

Have you heard about are IPL to the face for ocular rosacea? there have been reports that it has helped peoples MGD. Im considering it as ive tried everything else, but my face isnt bad.

Thanks again sx

You're welcome. I know very little about IPL and how it is used in treating MGD. If you do have the procedure done, please keep us posted of your experience!