Need to understand dry eye cause vs. cornea healing w/serum drops

[Cali]

Hi All - I'm a bit confused as I am new to having dry eye. I am post-LASIK 8 years. I see a new doc on Thursday next week. My question is, I think I need to understand why I have dry eye. I know the LASIK started this, but from what I understand, there are a possible number of things that are causing the dry eye (Lacrimal gland Deficiency, Meibomian gland dysfunction (MGD, blepharitis) Erosions (RCE, ABMD), etc.). I need to know what that is. I also need to know my TBUT (if I have evaporative eye) and Schirmer scores.

I can't tolerate Restasis which targets the inflamation, and I've read a number of people have success with the autologous serum drops. But don't the serum drops just heal the cornea and don't help with the cause of the dry eye?

I'd like to understand how it works. I think the serum drops helps the occular surface heal because it is it's not getting properly lubricated due to MGD, SS, TBUT, etc.? Seems like serum drops alone just treat the symptoms?

Here are the questions I plan to ask my new doctor:

Do I have Aqueous (lacrimal gland Deficiency)
Do I have Meibomian gland dysfunction (MGD, blepharitis) NOTE: Warm compresses really help me so I think this may be an issue.
Do I have Erosions (RCE, ABMD)
Do I have Lagophthalmos (incomplete eyelid closure)
What is my tear break up time (TBUT) or evaporation?
What are my schirmer scores?
Do I have inflamation?
Do I have Sjorgens syndrome
Do I have trigeminal neuralgia/ corneal neuropathy

Thanks in advance for any help or input.

[spmcc]

RE: Questions for ophthalmologist

Rebecca has a list of questions that are good to ask your doctor every visit:

1) How is my tear quantity?
2) Do you see any dry spots?
3) Can you check for staining?
4) Can you press on my meibomian (oil) glands? Are they releasing oil? Is the oil clear and flowing freely? If not, what does it look like?
5) Do you see any signs of allergies?

These are more general questions than yours (e.g., #1 covers your #1 and #6). A couple are re-wordings of your questions and one is new to your list (#5). Your lid closure question is a good one.

For Sjogren's diagnosis, you'll need blood work and/or lip biopsy. As for TN/neuropathy, I know that an MRI can diagnosis TN (or be inconclusive), but neuropathy stumps me. I don't know if there's any test for that.

You can read more on How To Get a Better Diagnosis from the DEZ homepage: http://www.dryeyezone.com/

Good luck.

[Cali]

This is GREAT! Thank you. I didn't know how to phrase the questions.

[farmgirl]

Hi Cali:

I am no expert on autologous eye serum but it is my understanding that it contains nutrients, stem cells etc, which nourish the cornea. Tears normally contain these nutrients so a lack of tears will then starve the cornea of nourishment. Artificial tears provide lubrication but cannot provide the nutrients for the eye itself. So Serum drops don't just treat the symptoms, they help to get at the root cause of the soreness we experience as a result of the dry spots on the cornea. For me the difference was noticeable almost immediately and at my last checkup my corneas were perfect, first time ever since this started. I still have problems related to dry eye but am less symptomatic than before I started the drops. The redness is about 80% better and the burning and grittiness at night (if I don't use makeup) is at least 50% better. I am not cured but for sure it has helped a lot. I highly recommend them...F/G

[Cali]

Thank you farmgirl. Bit by bit I'm gaining a better understanding of this condition. I think that's a big part of getting the help you need - understanding the mechanics. Much appreciation sent your way!

[PotatoCakes]

Farmgirl is correct, serum drops nourish and heal the cornea. They do not cure the cause of dry eye though, if that's what you are looking for. I did ask my doctor, once, what would happen if they injected serum into the tear gland. He didn't know but said it was a good question. Maybe one day there will be a study on it. It's a shot in the dark but serum does have healing properties and it just makes me wonder, if the glands are damaged, would serum help to heal them if it was injected directly into the gland.