Dry eye newbie. Several questions (eye ointments bad? uk shopping questions).

[jswill100]

Hi all,

Happy to find such an active forum for dry eye related problems. I have been struggling for a few years with moderately dry eyes, and only recently went to see an Optometrist. She has put me through a range of things (a variety of drops, as well as sodium chromoglicate drops for allergies).

After doing a bit of research of my own, she clearly isn't as clued up as she might be (giving me lots of products with BAK as a preservative which I haven't got on with well at all).

Anyway, since the anti allergy treatment did not seem to help (although difficult to separate it from the fact that the BAK irritated my eyes), right now I believe I simply suffer with moderate general dry eye, and I am just starting a self-prescribed course of the below:

--Systain preservative free vials in the day.

--Refresh Optive "sensitive" preservative free vials on order which I thought I would also try as a daytime general drop (Systain I am not completely sold on yet).

--Refresh Celluvisc drops morning and night.

--Refresh PM ointment is on order which will become my nightime drop.

--Tranquileyes kit on order (never used any kind of night goggle, but I tend to have my dryest eyes in the morning so thought this would be a good idea to try).

--Dr Hollys dwelle on order to try out. Although I hesitate as it has a preservative - do you think this is worth trying over and above the good preservative free daytime drops I have listed?

I work with computers and have also just bought some "computer" glasses, which basically have anti glare and some UV protection and a slight green tint I believe to help with reading contrast. I also bought an identical pair that have a tiny +0.25 diopters on each eye which I am told helps focusing at the distance of a computer screen. Has anyone any experiences with these kinds of things? I hesitate to put any kind of vision aid on as my vision is more or less perfect.


Anyway, that's my setup right now. I am only just starting off with it so fingers crossed I get some relief. I have read a few things that claim that the heavy eye ointments can actually make problems *worse* over time, weaking the eyes natural resources in some way. I don't have the link now, but I am sure I read something along these lines. Does anyone have any information on what I might be talking about - Refresh PM seems like a good preservative free eye ointment otherwise.

Secondly, as you can see I am using alot of Refresh products. I cannot seem to find them for sale in the UK (with the exception of Celluvisc), and I seem to only be able to source them from the US (even if through a UK site). Does anyone have any thoughts on where I can pick them up in the UK? (or perhaps a good cheap source for it all from the US).

Cheers
John W

[pete0085]

Wow..that's quite the list

First of all - Have you been diagnosed with a specific reason for your dry eye?

For years I was told I have dry eyes, they inserted plugs, told me to take artifical tears during the day and go on my way. It wasn't until 2 years ago I learned about my MGD dry eye condition and was able to start to treat it instead of inserting drops all day long.

If you know the reason for your dry eye, you can better treat and manage it.

Second - that is a long list of artifical tear products. If you take all of them at once, how do you know what is helping? Taking the wrong combination may make your condition worse.

I would start with one thing at a time and go from there. If you can, stay with the preservative free drops.

That is my opinion or suggestion.

[jswill100]

Thanks for the reply.

I was first diagnosed with blepheritis (sp?), but after a vigorous cleaning regime I was told it was not that and simply £dry eyes". After a load of drops failed to help we investigated the allergy side of things, and sodium chromoglicate products didnt seem to help.

How did you eventually learn about your condition? I have seen an Optometrist and found her useless (gave me lots of drops with preservatives that hurt my eyes badly), and now have been refered onto a private specialist opthamologist - is this the right way to go? is there anything you would particularly recommend I ask of them or make sure they check?

So now I am back to thinking it is simply dry eye made worse by working in front of computers for 8+ hours a day, but I suppose it could have its roots in a number of different conditions?

Right now all I am using is celluvisc in the AM once, and systane all day, and it seems to be doing slightly better than my previous drops. When my eye ointment comes I will trade that for celluvisc, so should be able to tell which works best as a night/morning drop.

Thanks
John

[Rebecca Petris]

Hi & welcome.

I was first diagnosed with blepheritis (sp?), but after a vigorous cleaning regime I was told it was not that and simply £dry eyes".

Not so sure about this. Was it the same dr. or someone else, who said it was "not that"? Usually when someone's diagnosed with blepharitis, the dr. isn't making it up - it is much more likely that a dr who doesn't see it is not looking closely enough at the meibomian glands. It is actually fairly common (lots of stories here) for doctors to come out all over the map on the severity of blepha/meibomian gland dysfunction in the same patient but I think a big part of the disparity is whether they think it is serious enough to be causing the symptoms the patient describes.

By the way "simply dry eyes" is a common but seriously inadequate answer... Sounds like you've been doing a lot of reading and you probably know this by now but in case it's helpful here's an article re: dry eye diagnosis.

So now I am back to thinking it is simply dry eye made worse by working in front of computers for 8+ hours a day, but I suppose it could have its roots in a number of different conditions?

Yes re: the latter. Computer use will almost always worsen symptoms of ANY kind of dry eye. The main reason is because you blink far less frequently when reading a screen. Blinking spreads tears and also stimulates tear production.

I have read a few things that claim that the heavy eye ointments can actually make problems *worse* over time, weaking the eyes natural resources in some way. I don't have the link now, but I am sure I read something along these lines. Does anyone have any information on what I might be talking about - Refresh PM seems like a good preservative free eye ointment otherwise.

There are at least two different possible reasons for ointments to cause issues. One issue that was raised fairly recently was the possibility of ointments interfering with the meibomian glands. I haven't seen any scientific work on this at all so it's just a matter of speculation. The other I first heard from Dr. Holly ages ago. I'm sure I'm oversimplifying it but basically when you spread grease on a surface, water can't penetrate it. This means your natural tears cannot reach the ocular surface to do their job of nourishing & protecting the surface for some significant part of the day (well, night) that the surface is coated. That can't be good long term. Anyway, that's my understanding. Can't point you to anything printed though.