Fish Oil and Doxy

[romeodakins]

I had dry eyes last year on January so it's been a little more than a year. I have MGD and somewhere near the end of 2013 my doctor prescribed my doxycycline and recommended fish oil. I've eaten about more than 60 capsules of doxy and fish oil(so about 2 months) and I'm seeing no results. I still feel the same. My doctor only gave me 100 capsules of doxy to test out. So when the 100 capsules are done and I don't feel better, should I stop taking doxy and fish oil? And what else is there to try after? I've been doing compresses for 10-15 minutes every morning on the weekend but weekdays I do it less than 5 minutes because I'm in a hurry. It's really the only thing that's helping me now. Also throughout the day I yawn very very frequently because the tears help reduce the dryness.

[Santaklauzz]

Hi romeodakins.

There are several other therapies for MGD other than doxy and fish oil.

You could try topical azithromycin for instance, which restores the quality of the meibum toward normal, making it easier to express the glands.
Or diquafosol, which increases the meibomian gland area according to a Japanese study. (This is only available in Asia atm)
Some studies even show that cyclosporine can be useful to treat MGD by reducing overall inflammation.
I'm currently on azithromycin. The other two I haven't tried yet.

Then there are the more advanced experimental treatments like Lipiflow, IPL and probing.
I have had probing and Lipiflow. It has helped some people really well, but it did nothing for me.
However, if your glands are clogged, probing is imho a necessary step regardless of the outcome, especially if your glands are shut off by fibrous tissue.
This was the case with most of my glands and I'm having it done again soon just to make sure they keep open, even though I had no immediate symptom relief.

You could also try other supplements like sea buckthorn oil, flaxseed oil, astaxanthin, N-acetylcysteine (NAC), multivitamin, vitamin D, C, E...
I've tried all of the above except for NAC without result. But there are people on this forum who have had tremendous relief, even from one of these alone.
Imho, these can be useful to tip the balance in mild forms of MGD in some people, but it is rarely a cure in severe cases.
That said, it won't hurt to try of course (apart from your wallet). I'm still taking fish oil, astaxanthin, sea buckthorn oil, vitamin D, a multivitamin and I'm adding NAC to the list soon too.
If I see no results soon, I'll probalby cut it down to only fish oil, the multivitamin and perhaps NAC.

I do warm compresses twice a day. My eyedoc stressed that it is a vital technique to control MGD and to prevent already truncated glands from dying out.
You should try to do it more than 5 minutes though, at a constant temperature of about 40-42 degrees C.
If you do it less than 5 minuts, the oil doesn't reach it's melting point and then it's quite pointless.
I was also instructed to do gentle to firm lid massage/expression with a q-tip afterwards.

You might want to hold on to the doxy for a few more weeks/months. It tends to work very slowly and it's possible that the effects are only beginning to show after 3 months or more.
I've been taking doxy for about two to three months now and the effect still hasn't kicked in, although my acne has improved a bit.

So there's a lot you can try if you find the right doctor.
Dry eye is a terrible condition but just hang in there.

[romeodakins]

Hi romeodakins.

There are several other therapies for MGD other than doxy and fish oil.

You could try topical azithromycin for instance, which restores the quality of the meibum toward normal, making it easier to express the glands.
Or diquafosol, which increases the meibomian gland area according to a Japanese study. (This is only available in Asia atm)
Some studies even show that cyclosporine can be useful to treat MGD by reducing overall inflammation.
I'm currently on azithromycin. The other two I haven't tried yet.

Then there are the more advanced experimental treatments like Lipiflow, IPL and probing.
I have had probing and Lipiflow. It has helped some people really well, but it did nothing for me.
However, if your glands are clogged, probing is imho a necessary step regardless of the outcome, especially if your glands are shut off by fibrous tissue.
This was the case with most of my glands and I'm having it done again soon just to make sure they keep open, even though I had no immediate symptom relief.

You could also try other supplements like sea buckthorn oil, flaxseed oil, astaxanthin, N-acetylcysteine (NAC), multivitamin, vitamin D, C, E...
I've tried all of the above except for NAC without result. But there are people on this forum who have had tremendous relief, even from one of these alone.
Imho, these can be useful to tip the balance in mild forms of MGD in some people, but it is rarely a cure in severe cases.
That said, it won't hurt to try of course (apart from your wallet). I'm still taking fish oil, astaxanthin, sea buckthorn oil, vitamin D, a multivitamin and I'm adding NAC to the list soon too.
If I see no results soon, I'll probalby cut it down to only fish oil, the multivitamin and perhaps NAC.

I do warm compresses twice a day. My eyedoc stressed that it is a vital technique to control MGD and to prevent already truncated glands from dying out.
You should try to do it more than 5 minutes though, at a constant temperature of about 40-42 degrees C.
If you do it less than 5 minuts, the oil doesn't reach it's melting point and then it's quite pointless.
I was also instructed to do gentle to firm lid massage/expression with a q-tip afterwards.

You might want to hold on to the doxy for a few more weeks/months. It tends to work very slowly and it's possible that the effects are only beginning to show after 3 months or more.
I've been taking doxy for about two to three months now and the effect still hasn't kicked in, although my acne has improved a bit.

So there's a lot you can try if you find the right doctor.
Dry eye is a terrible condition but just hang in there.

Thanks, that's very helpful. Is the topical azithromycin otc or does it need to be prescribed or recommended by a doctor? And how is the topical azithromycin working for you? Also what do you use to do warm compressess? I use my thermalon pad i got from amazon and usually I only do it for 5 minutes because I don't want to get up and reheat it in the microwave but when i do I do it 3 times for a total of 10-15 minutes. After the compress I just rub my eyelids with my knuckles. Sometimes I use a q tip and it works much better but I rarely have time to use a q tip and press every single area on my eyelid. My doc only prescribed me 100 capsules of doxy. Would that be enough for the effect to kick in? I've used more than half of it already. The doc only gave me 100 to test out.

Also about the compresses, is there a better product for it? Maybe something where you don't have to reheat it in the microwave or even better, something where you can plug into a wall outlet and it heats by itself at a constant temperature. That would be amazing. Also does putting too much heat on your eyelids damage your eyelid skin? I'm always too afraid to leave it on my eyes too hot for too long after my last incident where i got a small burn on my eyelids.

[Santaklauzz]

It's too soon to tell whether the azithromycin works for me and if it will be sufficient to control my MGD long term.
That said, a few days ago, I noticed that clear, but still rather viscous oil is coming out of one gland of my right lower eyelid right after doing warm compresses.
Now I check very diligently every time and I think I saw a few more glands working, but I can't be sure. And it's only on my right lower eyelid.
But before I started with azithromycin, it happened once or twice that I could express a gland on my left lower eyelid, but only yellowy acne-like pus was coming out.
So I think the azithromycin could be helping.

Azithromycin is available in the USA as Azasite and in most of the EU as Azyter. It's always on prescription and use for MGD is off-label.
It was designed to treat bacterial infections over a course of 3 days. I'm using it once a day for a month.

Replacing the compresses every time they've cooled is imho not the most efficient way to do it.
To melt the oil in your glands, a steady 40-45 degrees centigrade is required for at least 5-10 minutes.
I use Tranquileyes. It's a foam mask with chemical heating pads inside that you can put on your eyes.
If you preheat it with hot running water, it will stay at about 40 degrees (or more depending on how hot the water was), for 5 to 10 minutes.
I was able to order Tranquileyes at my local pharmacy but I don't know where you live of course.
The only disadvantage imho is that you have to boil the pads for five minutes each time they're used.
I've bought about 8 pairs of them so I can do them all together after three or four days.
Afterwards I use q-tips to express my glands (most of the time I can't see anything coming out, but since I use Azyter, this has improved a bit as I said earlier).

You should be careful with rubbing your eyes. The friction may inflame your eyes even more or inflict other damage.
And all kinds of dirt and bacteria can get into your eyes that way.
I tend to rub my eyes too during the day, but it's a really bad habit and I'm trying to avoid it.

If you use too much heat, any inflammation that is already on your eyes and eyelids flares up of course.
And if you really overdo it, you could burn your skin and eyelids as you already experienced.
I think the golden rule with this is, as with everything, to be careful and to listen to your body.
The eye is made to work at 37 degrees as is all the rest.
Increasing that to 45 degrees or more could inflict all kinds of damage. But you should ask that to an ophtalmologist really.

Doxy is a bit tricky. I've been taking it for three months but I haven't noticed any symptom relief.
But it could be that it will kick in next week, or next month. Or maybe it's already working, but it's just not sufficient.
I don't know. If you're on doxy for more than half a year to no avail, I would probably stop.
If I were you, I would ask my doctor to prescribe me some more and see if it works after 4 or 5 months.
It has helped lots of people and it could always be your magic bullet, but you can only be sure if you try it long enough.

[littlemermaid]

Romeodakins ~ You are still busy studying? I was wondering if you had got more comfortable using the computer, like using eye protection glasses and a humidifier. Is the air conditioning still on full at home in your room? Do your eyes feel better when you are outside? Have you got any allergies to anything in your room? And also, have you had blood tests for nutrition like iron or vitamin A? Are you still eating healthy and drinking lots of water?

Maybe you and your father could have a look through this http://one.aao.org/preferred-practic...rome-ppp--2013 and see if anything has been missed by your Ophthalmologists? Are you still seeing a doc for eye checks?

Do your eyes feel worse in the morning, or at the end of the day?

[romeodakins]

Romeodakins ~ You are still busy studying? I was wondering if you had got more comfortable using the computer, like using eye protection glasses and a humidifier. Is the air conditioning still on full at home in your room? Do your eyes feel better when you are outside? Have you got any allergies to anything in your room? And also, have you had blood tests for nutrition like iron or vitamin A? Are you still eating healthy and drinking lots of water?

Maybe you and your father could have a look through this http://one.aao.org/preferred-practic...rome-ppp--2013 and see if anything has been missed by your Ophthalmologists? Are you still seeing a doc for eye checks?

Do your eyes feel worse in the morning, or at the end of the day?

My eyes don't get as worse as I felt before when using the computer. My eyes felt terrible last year in the beginnings of my dry eye but for the past few months it's been feeling not-that-bad using the computer but I can still feel the dryness and it's still annoying. I don't use a humidifier or special eye protection glasses. It's winter for me now but the heater doesn't make my eyes worse. I think my eyes were worse in the summer with the cold air conditioner and fans on. My eyes do feel better when I'm outside. Sometimes when I'm in a classroom and it's stuffy my eyes feel bad but right when I can get up and go outside it feels better almost instantly. I don't think I have allergies in my room or any allergies at all. I haven't got any blood tests for nutrition and I guess I do eat healthy. I definitely drink enough water; I drink at least a liter per day. When I wake up in the morning my eyes are really dry but I think that's normal; it's always been like that even when I didn't have dry eyes but with dry eyes they're just drier than usual right when I wake up. I just do a quick 5 minute compress and it gets rid of this dryness and I'm off to school.

[glimmer-of-hope]

Maybe something where you don't have to reheat it in the microwave or even better, something where you can plug into a wall outlet and it heats by itself at a constant temperature. That would be amazing.

I read about this device called Blephasteam, but don't have any experience with that Does anyone use Blephasteam?

More info here:

http://www.blephasteam.com

http://www.spectrum-thea.co.uk/Apps/...nt.aspx?fid=31

[sunshinelover]

I use it every day and I love it!

I read about this device called Blephasteam, but don't have any experience with that Does anyone use Blephasteam?

More info here:

http://www.blephasteam.com

http://www.spectrum-thea.co.uk/Apps/...nt.aspx?fid=31

[romeodakins]

I use it every day and I love it!

What does the blephasteam do? Is it like a mechanized compress that you don't need to manually heat up?