looking for inspiration!

[david2404]

Could anyone help me out with a couple of questions. I’m trying diagnose myself after becoming very confused by multiple opinions from various ophthalmologists.

I’ll give a bit of background below but essentially knowing the answer to the following might help me out.

1. What can I learn about my eye condition from the fact that my eyes are fine in the morning. They only get worse in the evening – burning/dry/acidic. Symptoms are usually (but not always) triggered by computers/lights.

2. Could my eyes still be suffering from allergies (to external factors, eg pollution) even if anti histamines have no effect.

I went to Brazil recently and since they have such great dentists I thought I’d see an ophthalmologist. He came highly recommended but I was a bit disappointed that there was no discussion, just the usual one way dialogue. He said outright that I have MGD. I’ve read that MGD sufferers often suffer overnight and in the morning but when I mentioned that I have no problems when my eyes are closed and my eyes feel normal when I wake up in the morning, he said that it affects people in different ways - does this make sense.

He prescribed Ciloxan which is an antibiotic/antibacterial ointment. It’s usually prescribed for Blepharitis (although I haven’t had any signs of Bleph for a long time – my eyelids look fairly healthy). Anyway, I’ve taken it for 15 nights and it seems to have had a positive effect but by no means has it been a cure all.

My doc in London (Michel Guillon) found a lot of staining on the cornea after applying Rose Bengal, indicating scarring/scratching. But he said my MGD was not significant and suspected the problem was mucin deficiency. I also did some ‘evaporation testing’ and was told that I would not benefit from MEGs.

I also don’t feel like I have much inflammation in my eye lids although I could be wrong (I’m sure it’s obvious to people who do!?). Cold ice packs and progesterone cream (15%) did noting for me. For me the most significant pain is in the eyes and that ‘staring at the sun’ burning when I’m looking at a computer too long or bright lights. A cool dark room makes the pain go away but I want to know the underlying problem causing the sensitivity to light.

Lid scrubs help, as does Dwelle and staying off sugar helps with the acidity. I also do warm compresses but not sure these make a difference. I haven’t been tested but I don’t think I have Rosecea or Sjorgens. I have no skin rashes etc or dry mouth.

My shirmers have come up mixed but I’m pretty sure I have significant tears and the problem is quality not quantity of tears. I have no problem with wind outside as I get reflexive tears. Heat is terrible for me.

Thx for your help. This site is a God sent!

david

[pete0085]

There are quite a few good resources on this site that has helped me and many others. I've had problems for years and years and never was given a condition. I've been told I have allergy and dry eyes. Used plugs and allergy meds, etc for years without much help.

After going around to this site and asking questions, discovered I have a condition known as MGD for short (not the beer). I only wish a doctor would have told me.

It at least helped me putting terms to my condition. It allowed me to do some research and understand what I need to do to get better. Before I was only using artifical tears when my eyes got really red and dry, but now I have a list of things to do each night and more or less have a purpose and understand why I need to do it.

Overall I notice improvement here and there. It varies on the day and week, but before I had no help and just was miserable and lived with it.

[david2404]

Hey pete, was also diagnosed with allergies on a couple of occasions but had no relief from my dry eye by taking antihistamines - but does this mean that i don't actually have allergies???

For sure i've discovered a bunch of great advice on this site but it takes time since i have about half an hour on a computer each day before my eyes go crazy!

anyway, thx for the reply.

[browneyes]

Hey, have you already tried moisture chamber goggles? They are the only thing that has helped me so far (out of the 15+ treatments I have tried).

[david2404]

I havent tried moisture chambers glasses as such but i have tried using various googles that provide the same effect with no success. I've also had 'evaporation testing' done which indicated i wouldn't benefit from MEGs.

Can anyone shed some light on the significance of the fact that my eyes are fine in the mornings but terrible in the evenings. I'm supposed to have MGD (according to docs) but isn't are MGD sufferers usually bad at night?

[autumnn]

I supposedly have MGD too but am the same painwise in the morning as I am at night (for the most part). I'd like to hear other's answers to your question as it is a good one. What evaporation test did you have done- was it a TBUT? And, what were your numbers- this may help others understand a bit more.

[david2404]

Hi Autumnn. So assuming we both have MGD, but I have ok eyes during morning and bad in evening and you have consistently bad eyes (even when eyes closed asleep?), then surely there is a fundamental difference in our dry eyes and the way in which we should be treating them.

Do you also have an aqueous deficiency Autumnn? I don’t think I do and perhaps this is the difference. I have a tear quality problem so my eyes get worse throughout the day as my eyes become drier whereas you wake up with dry eyes since you’re not producing tears at night?

The evaporation testing i had done was by a group called Optometric Technology Group in London. They put me in front of a computer wearing goggles with 20% humidity for half an hour and then measured the evaporation rate from my eyes by sticking a couple of funnels on my eyes which were connected to a machine which took the readings (sorry I know none of the technical names for the equipment involved!). They then did the same with goggles with 80% humidity and again took readings. I have the figures but they’re difficult to interpret.

I’ve had docs tell me my tear break up time is short but they didn’t give me numbers.

[autumnn]

Hi David- I think because your tear break up time is short they are telling you that you have MGD. That is a classic symptom. My TBUT is not too bad but it a little bit less than normal (8 and 10)- thus my diagnosis of MGD. I am not aqueous defficient. I have one sore eye and one that is pretty normal most of the time- yet- clinically they are almost the same on the tests-but with the TBUT time- the left is a little quicker (8)- that is why I am confident that MGD is causing that eye pain- thus treating MGD is essential.
In the morning? Well, I think because MGD involves the lids it can make the eyes more uncomfortable when you sleep. My eyes (mainly the left) burn a little when they are closed but I think it is the inflammation from dry eyes. I have no problem sleeping though and the uncomfortableness is definitely worse when awake.
BTW, I do TERRIBLE with drops and do not use anything on my eyes during the day.
Those tests you had run sound pretty intense- seems like you have some good doctors involved. Work hard on the MGD (compresses and lid hygine)and SLOWLY it does get better. Remember it took some time to get where you are at now (maybe years?) so it can take time to get back to comfortable.
Have you tried plugs? This morning I am getting an upper plug in my left eye (I currently have no plugs)...I'll let you know if it helps. But, if you are aqueous defficient then maybe plugs would be a godsend for you!
Good luck

[pete0085]

Hey pete, was also diagnosed with allergies on a couple of occasions but had no relief from my dry eye by taking antihistamines - but does this mean that i don't actually have allergies???

For sure i've discovered a bunch of great advice on this site but it takes time since i have about half an hour on a computer each day before my eyes go crazy!

anyway, thx for the reply.

No, not at all. I have both *allergy and dry eye) and they both work against me. Seems like the allergies can dry my eyes out.

What have you tried taking? I would try a couple different things for a few weeks and see what works better. I have been taking allergra for many years. In the past year I've been on an allergy drop called pataday. It usually works really good.

[david2404]

I have only taken antihistamine tablets, on a few occasions but never for more than a week at a time. I assumed they worked really fast so when my eyes felt no change i figured i didn't have allergies. But i guess that's not necessarily the case. Perhaps i should try some allergy drops, but how long does it take for allergy drops to work? Some people on this site have mentioned months.

Autumnn, good luck with the plugs, i hope they make a difference. I tried them a couple of years ago but my problem is more quality of tears than quantity so they didn't work for me. But then my plugs were 'invisible' so they could have fallen out the next day and i'd be none the wiser, since the docs can't see them to let me know whether they're still there!

I'd be curious to hear from more people whose eyes, like mine, are fine in the mornings but progressively worse throughout the day.

cheers

david

[autumnn]

Hi David- I think that something like Pataday is pretty harmless and worth a shot. In people with allergies it is able to increase their TBUT- at least that is what I have read. I have used it with decent success. Steroids are also good for allergies though of course not good in the long run.
Yep, I had the 2-3 month temp plugs put in on Thurs and I saw one lingering in the corner of my right eye yesterday and fished it out. I am glad- I want them out. I hope I lose the other one as well (or that I already lost it- who knows!). I am trying lasicerts and think that they are helpful and I wish I didnt insist on plugs too- I'd rather try one new thing at a time. But, I didnt have a lot of confidence when the doctor suggested lacriserts yet now I am more convinced that they can help me.....they help with tear film- maybe you can give these a trial? I wish that multiple companies made something in this format with different formulas so that more people could benefit from them- do a search if you want to learn more about them- for many on this site they have been a godsend-yet, many others cant tolerate them.....