Forgetting what it was like to have normal eyes.

[Matt0029]

I guess most people on here have forgotten what it was like to have normal eyes and a healthy tear film
. I've struggled for about 2-3 years took a year to figure out my eye pain and huge vision flutations were because of d eye. I was put on a course of steroid drops and after a month of a 2 month course. I had comfortable eyes I have forgotten what it was like to have eyes that you arent aware of. My eyes have gone downhill again due to stopping the steroids. I think this has made my mental state worse though. I now know what I am missing out on
I had forgotten what it felt like to life without dry eye I had got used to it.

[Hokucat]

Since steroid drops worked for you, it does sound like you have chronic inflammation. Steroids seemed to help me somewhat too earlier on. Unfortunately my doctors continued to prescribed steroid drops on and off over the several years I was battling severe dry eyes, and now I have early cataracts. I know cataracts can get worse over time, so I am worried about having to do cataract surgery at some point, because although I’ve been able to manage my condition, I still have dry eyes and that surgery could make things worse again.

After doing probing first to unblock my glands (I had many glands with scar tissue), I’ve found following a diet with anti-inflammatory and antibiotic properties key in helping my glands, both meibomian and lacrimal, function better. Over time, I believe this helped me manage the chronic inflammation from the inside out. Have you looked into this type of diet? There are many recommendations online on what to eat (or avoid), here’s an example:

https://www.google.com/amp/s/www.enh...eases.html/amp

You might need to do LipiFlow and or IPL to help unblock your glands or thin your oils first, for diet changes to be most effective. You may also want to consider going for a scleral consult and try on a sample pair, to see if you can tolerate the lenses and if they make you feel better.

[MGD1701]

Hi Hokuat
Sorry to hear about catarats. my dr said sentative to light is a sign.

Steroid
what % you used? I have read that <5% is pretty safe.
Dr prescribed you steroid due to inflammation or dry eye? Based on what kind of testings, MMP-9 or just from slit lamp?

Thank you!

[Hokucat]

MGD1701 , fortunately right now the cataracts are only slight. I’m hoping it will never get so bad where I can’t see and need to consider surgery.

Yes, I believe my doctors prescribed various steroids over the years assuming inflammation, likely based on my symptoms, low TBUT and Schirmers, and slit lamp exam. But that was several years ago, when very little technology was used to check all this. I don’t remember the % of the various steroid drops/gels I used, as it was over three years ago I last used steroids.

[Guest]

Hi Hokuat
Sorry to hear about catarats. my dr said sentative to light is a sign.

Steroid
what % you used? I have read that <5% is pretty safe.
Dr prescribed you steroid due to inflammation or dry eye? Based on what kind of testings, MMP-9 or just from slit lamp?

Thank you!

It's not just the percentage, it's the type of steroid. For example, lotoprednol is great for ocular surface disease because it doesn't penetrate into the eye very well. So it's less likely to cause increased IOP. I saw a study that had hundreds of people on lotoprednol .5% for 6 years ranging from 300-3500 drops in each eye. Pretty much all the patients had no issues. So yes, I believe lotoprednol can be safe. sane with FML, doesn't penetrate well.

Now something like pred forte 1% or methylprednisolone 1% penetrates the eye very well. So these drugs probably wouldn't be safe long term for most people.

id like to add, to the OP...look into hormonal issues, autoimmune issues, don't give up. I'm a steroid responder...I have a thyroid disease that caused my dry eye. The thing that set it off was a corneal abrasion, then my hashimotos went crazy. I believe the eyes are usually a symptom of a greater problem. When I was in medical school one of my professors told us that internal disease usually manifests first in the skin 80% of the time. Well, there's a lot of skin around your eye, and your eyeball itself is a specialized epithelial (skin) cell. Don't give up...there's hope.

[Matt0029]

Thanks for the replies. I was originally prescribed prednisolone sodium phosphate 0.5%. I was on this for about 2 months one month just on this and then I took it with Ikervis at night when my eyes were at there best I was on both the prednisolone one drop in the morning and Ikervis at night. My eyes were a flood with tears no dryness or eye discomfort what so ever and vision so sharp. I though it was because the Ikervis had kicked it but in fact it looks like it was the steroids or the fact I need both to be affective? Guessing my lacrimal gland is inflamed and it was allowed to work properly on the steroids? I had inflammation of my eye seen on the slit lamp when I was initially seen and prescribed steroids. I don't think they have the MMP-9 were I go for treatment.

[Matt0029]

Since steroid drops worked for you, it does sound like you have chronic inflammation. Steroids seemed to help me somewhat too earlier on. Unfortunately my doctors continued to prescribed steroid drops on and off over the several years I was battling severe dry eyes, and now I have early cataracts. I know cataracts can get worse over time, so I am worried about having to do cataract surgery at some point, because although I’ve been able to manage my condition, I still have dry eyes and that surgery could make things worse again.

After doing probing first to unblock my glands (I had many glands with scar tissue), I’ve found following a diet with anti-inflammatory and antibiotic properties key in helping my glands, both meibomian and lacrimal, function better. Over time, I believe this helped me manage the chronic inflammation from the inside out. Have you looked into this type of diet? There are many recommendations online on what to eat (or avoid), here’s an example:

https://www.google.com/amp/s/www.enh...eases.html/amp

You might need to do LipiFlow and or IPL to help unblock your glands or thin your oils first, for diet changes to be most effective. You may also want to consider going for a scleral consult and try on a sample pair, to see if you can tolerate the lenses and if they make you feel better.

I think my glands and oils are ok from what have been told. So not quiet sure why I have a reduced tbut.

[MGD1701]

Thanks Matt

Steriodprednisolone sodium phosphate 0.5%.
You meant you took above only once a day (& in the morning) for 2 months??

Inflammation
bacteria or demodex? effective lid cleanser should help,
best to add tea tree oil as demodex is hard to detect. Most doctors do not check this anyway.

[Matt0029]

No sorry for one week 4 times a day, the next week 3 times a day, the next week twice and day then the next week once a day.
The second month twice a day for 2 weeks then once a day for a week then every other day for a week then stopped. And continued just on the Ikervis.

[MGD1701]

Thanks Matt.

Allergy: did your dr check IgE and test on osmolarty levels etc.

[Matt0029]

What's ige?

[MGD1701]

IgE is a allergy blood test - more please google.

[Matt0029]

Should I really discuss with my eye doc my slow return of symptoms after finishing the steroid course 4-5 months ago?

[MGD1701]

I would do so as the more dr knows your conditions, the better (s)he should be able to detect the problems & find solutions.

[Matt0029]

Thanks I booked an appointment for a few weeks time. But then my eyes have been pretty good the last couple of days. I never know were I stand with it all.