Dry Eye Drop That Has Done Amazing Things For Me

[Tankie]

I'm afraid I have some bad news

I tried taking my goggles off today for the first time in a while. However, they hurt a lot within just 20 minutes of having them off. I continued to keep them off for about 2 hours, but in the end I couldn't stand it any more, so I hit the shower, and then put them back on.

The good news is that there were lots and lots of tears coming from my eyes when I did this... this makes me think that I might be close to or completely heal with respect to my aqueous deficiency!

The bad news is that my Meibomian Gland Dysfunction (MGD) has not improved at all. This worries me, because if I ever want to recover some day I have to be using a treatment that is improving my MGD.

I'm going to see the ophthalmologist again in late October, so hopefully he has some other tricks up his sleeve.

If you have any suggestions for how I can cure MGD (besides hot compresses) please let me know!

[Tankie]

Hey guys!
So some interesting news... I got punctual plugs in my lower tear ducts. It was a completely painless procedure that took about 2 minutes to perform and I don't feel any negative consequences at all! The only part that hurts is the fact it cost me $200 And I live in Canada! I guess medical isn't as free as we would have you believe haha. Luckily I can claim some of it back on my tax form.

Anyway I haven't stopped wearing the goggles yet, but I went to the cinema last night for the first time in forever and watched "The Social Network" without any goggles. My left eye was fine, and my right eye was also fine but was a little bit sore. So ya, I don't think I have a cure yet, but I think I can tolerate no goggles now if I want to.

Having said all that, I'll update you all again soon, because it's a little early to be singing the praises of punctual plugs and claiming they're the greatest thing ever when I haven't even had them for even 2 days yet. So ya, that's what's up, and I'll let you all know in a while how things are going.
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By the way... for anyone who doesn't know, the idea for punctual plugs is that they're supposed to prevent my tears from draining, and so hopefully that will protect my eyes a little better. My tears can still drain through my upper tear ducts (they're not plugged... yet), so the drainage system is still intact, but something like 90% drains through the lower ducts (which is now blocked, so 0% for me), and 10% drains through the upper ducts (which is still intact). I will now lose most of my tears due to evaporation rather than drainage I think! ... correct me if I'm wrong on that.

Also, if punctual plugs don't work, the next step my ophthalmologist is going to take is going to be something called "tetracycline". Here's what it is:

Tetracycline analogues, such as doxycycline and minocycline, have been shown to be effective on meibomian gland dysfunction. The effects of these antibiotics occur via 4 ways: (1) Antibacterial effects by causing a reduction in the bacterial load on the eyelid; (2) antiangiogenic effects; (3) anti-inflammatory effects resulting from a decrease in activity of collagenase, phospholipase A2, and several matrix metalloproteinases, and from a decrease in the production of IL-1 and TNF-alpha; and (4) inhibition of lipase production, which decreases production of diglycerides and free fatty acid (FFA) in meibomian secretions. (FFA can destabilize the tear film and can cause inflammation.)

Example 1:
Doxycycline (Bio-Tab, Doryx, Vibramycin). Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.
Example 2:
Minocycline (Dynacin, Minocin). Treats infections caused by susceptible gram-negative and gram-positive organisms, in addition to infections caused by susceptible Chlamydia, Rickettsia, and Mycoplasma.



Not exactly sure if this will help, but that's what he said he's going to do next if punctual plugs fail. My next appointment is in one month! Bye bye

[Tankie]

Ladies and gentlemen, I have a twist in my story.

I've had the punctual plugs in for 1 week now but they haven't solved my problems. They seem to help a bit, but they are definitely not a cure. I can tolerate short periods without the goggles on, but that's about it. For example, I went out for dinner on Sunday without my goggles on, and my eyes hurt a fair bit, but it was tolerable. However, if I had been out for much longer, I'd eventually have to put the goggles on.

So I called my ophthalmologist expecting him to put me on tetracycline... but this didn't happen. Instead he's put me on FML, a steroid eye drop. I am to take 1 drop in eye each 4 times per day from November 2 until November 23.

From what I can gather about FML, it's not an eye drop you should take for too long because you can get addicted to it! Also, it's not an eye drop you should quit cold turkey, but rather gradually. For example, you should take it 4x per day, then 3x per day, then 2x per day, then 1x per day, then stop.

However, my ophthalmologist hasn't said any of this to me! All I was told was by the pharmacist was to take it 4x per day (1 drop per eye x4).

My ophthalmologist isn't at work again until Monday, so I'll have to wait until then before I call him and ask him two questions:
1. Did he intend to give me FML, because I thought I was supposed to get tetracycline?
2. Should I really take this stuff 4x per day and then stop cold turkey?

I don't know, it just seems weird to me. This is what happens when your doctor gives you a prescription over the phone! haha.

Any advice is appreciated!

[Tankie]

Hi everyone! I have some interesting news.

I used the FML for about 2 weeks and I took my goggles off on 3 occations... 2 30 minute runs, and 1 45 minute walk.

During these periods I was fine! My eyes didn't hurt at all Also, I took my goggles off occasionally for 10 minutes here and there over the 2 weeks, and still the eyes didn't hurt at all. However, I kept wearing my goggles for the most part simply as a precaution.

However, there's also bad news. I ran out of the FML on Saturday, and I tried taking my goggles off when I went out for dinner with some people on Sunday and my eyes hurt throughout the dinner and it took me a while to get things under control when I got back home.

So ya, it seems that with FML I'm fine, without it though, I'm no better than I ever was

By the way, for anyone who doesn't know, FML is a steroid eye drop.







So today (Monday) I went to see my ophthalmologist and he gave me something new to try. His logic was as follows:
- Your eyes don't hurt when you wear goggles.
- Therefore it must be an evaporation problem that's causing you all this grief.
- Therefore we need to thicken up the oilly layers in your tears to make them more resilient to evaporation.

And so he's given me something called "Doxycycline Hyclate 100mg"

I am to take one of these tablets once per day for the next month, and then half a tablet once per day for yet another month. They're supposed to make the oilly layers in my eyes thicker, and thus make my tears less susceptible to evaporation.

I hope it works! I'll give you guys another update sometime over the next 2 weeks to a month to let you know how thing are going!

By the way, I'd love to hear from someone because I feel like I'm just talking to a brick wall these days by posting here haha.

[tearless2]

goggles only help people with evaporation problem?

I am puzzled by your opthamologist's logic that you have an evaporation problem (oily layers) because your eye don;t hurt when you wear goggles.

I think many people here who are acqueous deficient have been helped by goggles. People who have sjogren's have written in that they are helped by goggles. I may be wrong but it was my understanding the goggles help people who have an evaporation issue (less oil) as well as those who are acqueous deficient.

[fundryeyes]

Goggles help everyone because it creates an essentially humid micro environment. I just read your posts Tankie and noticed one glaring thing. You're taking excellent steps to improve, but not giving them enough time to work. The inflammation that caused symptoms probably took months to years to get you where you are. The treatments will take similar time. I'm also skeptical of any artificial tear because it merely temporarily bandaids a much broader and serious problem. The cure for this disorder will be found when the inflammation is resolved, and Theratears or anything similar is not going to do it. I believe you can lump DES into three categories. Inflammatory , neurological (lasik), and hormonal. I feel for the lasik people and I tell anyone I know considering it to not do it. I don't care what odds there are, to me its not worth the risk of developing this affliction.

[Tankie]

Hey guys!

It's been forever since I last posted here. Here's an update on my situation.

FML
- These days I'm totally off the FML.
- FML definitely had an affect on me that reduced the inflammation in my eyes (made them a lot more white), but I couldn't stay on it forever, and after a while the pain started to come back anyway, even when I was still on the FML.
- Overall, it worked for a while, but it didn't turn out to be a cure for me. I'd recommend that people try FML if they have an inflammation problem because it will likely bring you some relief, but it won't end up curing you completely.
- Note that there are some potential risks using FML which you should discuss with your doctor before using.

Doxycycline Hyclate
- The Doxycycline Hyclate never worked for me at all.
- This is not to say it can't work for some people, but for me it did nothing.
- I am no longer using Doxycycline

Goggles
- There is absolutely positively no doubt about this one... the goggles help!
- However, I still experience symptoms when wearing the goggles, it's just they are a lot less severe than with them off.
- Even today I can be wearing my goggles, take them off for just a few minutes, and experience a very noticeable burning sensation until I put them back on. In addition to putting them back on, I usually have to put in some eye drops, blink a lot, or close the eyes for several minutes.
- Long story short, I still strongly recommend wearing goggles. They help me a lot! The only down side is I have to wear them (i.e. I have to go around in public wearing goggles )

What's going on with me today
- Today my doctors have diagnosed me with a lid closer problem on both my eyes
- They say too much sclera is showing (the white part of the eye) and so they want to lift the lower eye lids up
- They also say that when I blink/close my eyes, they don't close completely
- On April 5 my oculoplastic surgeon put a sclera graft into my lower eye lid on my right eye, and by doing so, he has built up my eyelid so that it covers up a lot of the white part (the sclera).
- I'm going to be getting this done to my left eye on April 26.
- As far as physical appearance goes, I don't look quite as good as before, but it's not a huge deal. I'm fairly happy with the way it looks, but I have to admit, in a perfect world, I would prefer to look the way I did before the surgery. Maybe I'll get used to it, or maybe once I get both eyes done I'll change my mind, we'll see.
- I am still symptomatic in my right eye (the eye that has had the surgery), however, I would say there is at least some improvement. I would say that if my pain was a 10/10 before, maybe it's an 8 or 9 out of 10 now. So not a huge difference, but I would say there is a small improvement.
- After I get the surgery on my left eye done on April 26, I will be getting two permanent lateral tarsorrhaphies done on my eyes.

Permanent Lateral Tarsorrhaphies
- The scary part about the tarsorrhaphies is that they might really mess with my physical appearance, and they might take away some of my peripheral vision.
- My oculoplastic surgeon said that he wants to do tarsorrhaphies of 2mm on each eye (which hopefully won't change my appearance much)
- Back in February I had my oculoplastic surgeon perform a temporary lateral tarsorrhaphy on my right eye, and it helped a lot. Since then it has been reserved, but it's given me the confidence to go ahead with the permanent one, despite the fact that the physical appearance and peripheral vision may suffer to some degree.

Current treatments I'm using
- Goggles (during the day)
- Tranquil eyes (at night)
- Theratears preservative free eye drops (used anywhere from 4-10 times per day)
- Tobradex ointment x4 per day (an anti-biotic ointment I was given after the surgeries)
- Steaming the eyes (boiling a kettle, pouring the water into a large bowl, putting a towel over my head and looking into the water for a few minutes, especially first thing in the morning. Don't get too close to the water or it'll burn you! Also, the steam can get very hot, so stay at a comfortable distance above the bowl if you try this).

[emmamounteet]

Hi

I'm Dianne

I use Thera Tears. Just found out about them lately, and they really are great!

Just wanted you to know that my vials of Thera Tears DO SEAL. Maybe if you try again, you will see that.

Also, at night I use GenTeal and wake up with little-to-no dry eyes! Use as directed. I think it will help you.

[emmamounteet]

Be careful of the punctual plugs. I had them put in several years ago. They can work their way out a little (mine did) and you won't know it. If that is not caught in time they can rub against your eye and cause damage (I hear). Mine did no damage, but they all got badly infected, and I didn't know it.

[alisonW]

Just wanted to mention that last week I bought Thera Tears in the vials to try again (expiration date May 2013) and they do not close now which I hate - the old ones did. I also feel no difference using them compared to other drops I've used. If they were amazing for me I'd ignore the fact that they aren't reclosable but since they aren't I won't repurchase.

[Tankie]

Hi everyone!

Below you will find a picture of my problem. I have eyelid closure problems! If you wish to discuss my problem, please visit this link:

http://www.dryeyezone.com/talk/showthread.php?14155-

Tankie