At my wit's end with artificial tears. Someone please explain this to me.

[No tears in ATL]

Some of you likely know my history and that I've never had any luck with artificial tears. As a recap, here is what happens when I use drops, OF ANY KIND. I'll get into the brands I've used in a second.

Upon instilling the drops, which are always preservative-free, there is a few minutes where the drops feel nice and there is some relief. However, an hour goes by and my eyes are veiny and the lids are red-rimmed. This cannot be good.

This happens also now with serum tears, 100%.

I've tried dropping once an hour. I've tried the saturation method (emptying half the vial into each eye 4 times a day). I've tried refrigerating the drops. I've tried only using drops when I need them. I've used ice compresses BEFORE instilling drops. SAME result. Every time.

I've tried and have spent a fortune on wasted product:

Thera Tears
Systane
Soothe
Bion
Blink
Genteal gel
Refresh Optive Advanced
Refresh Tears Plus
Refresh Celluvisc
Hylo Tears
Hylo Care
Oasis Tears
100% serum
75% serum
50% serum

In hopes that maybe I was experiencing especially hypertonic tears, I used the saturation method with Theratears today. Same redness and here it is 6:30 and it hurts.

My stats:
Tried quadra plugs--major backup inflammation. Upper plugged currently. Take doxy 20mg. Take enough krill and fish oil to grow fins. AD and MGD. Do not eat gluten, meat, or poultry. On no other medications.

So do drops just wash everything away? That is all I can come up with. I've gotten advice before to just "tough it out" because "your eyes are just really inflamed now," but seriously, when my eyes are on FIRE all day after applying these, how can this be good? The days I don't put anything in my eyes, it is better. Why??

I'm sorry, I'm just so frustrated, and all I get from doctors or otherwise is that I'm just imagining this crazy redness and burning sensation. I really want to be trooper and reduce this osmolarity or whatever so that things don't get worse. But the treatment is worse than the condition, for now.

[dryeyedave]

Some of you likely know my history and that I've never had any luck with artificial tears. As a recap, here is what happens when I use drops, OF ANY KIND. I'll get into the brands I've used in a second.

Upon instilling the drops, which are always preservative-free, there is a few minutes where the drops feel nice and there is some relief. However, an hour goes by and my eyes are veiny and the lids are red-rimmed. This cannot be good.

This happens also now with serum tears, 100%.

I've tried dropping once an hour. I've tried the saturation method (emptying half the vial into each eye 4 times a day). I've tried refrigerating the drops. I've tried only using drops when I need them. I've used ice compresses BEFORE instilling drops. SAME result. Every time.

I've tried and have spent a fortune on wasted product:

Thera Tears
Systane
Soothe
Bion
Blink
Genteal gel
Refresh Optive Advanced
Refresh Tears Plus
Refresh Celluvisc
Hylo Tears
Hylo Care
Oasis Tears
100% serum
75% serum
50% serum

In hopes that maybe I was experiencing especially hypertonic tears, I used the saturation method with Theratears today. Same redness and here it is 6:30 and it hurts.

My stats:
Tried quadra plugs--major backup inflammation. Upper plugged currently. Take doxy 20mg. Take enough krill and fish oil to grow fins. AD and MGD. Do not eat gluten, meat, or poultry. On no other medications.

So do drops just wash everything away? That is all I can come up with. I've gotten advice before to just "tough it out" because "your eyes are just really inflamed now," but seriously, when my eyes are on FIRE all day after applying these, how can this be good? The days I don't put anything in my eyes, it is better. Why??

I'm sorry, I'm just so frustrated, and all I get from doctors or otherwise is that I'm just imagining this crazy redness and burning sensation. I really want to be trooper and reduce this osmolarity or whatever so that things don't get worse. But the treatment is worse than the condition, for now.

I also struggle with lubricating drops. I have just discovered for instance that I have developed an allergic reaction to Oasis Tears Plus. I have tried every drop on the market and currently I can use Refresh classic, sparingly like only once per day in my right eye only(the one that I do not wear a scleral) Celluvisc, and tears natural/bion tears. That saturation method is awful and only washed what little tear film I had away making me worse. Systane was the most irritating of all drops as was Thera tears. Have you tried FreshKote? It can be irritating as well but you might only need it once or twice per day. Also wear your sealed glasses. Have you tried Padada? it really helps me when my eyes are flaring up from allergic reaction. Also the Refresh Classic is a milder form of Freshkote and is preservative free.

[No tears in ATL]

Thank you, dryeyeDave, it is at least good to know this is not just me experiencing this. I have used Pataday during allergy season in the past but it has been awhile. Humidity, a not-freezing room (about 74-76 degrees seems ideal), and moisture chambers seem to be the only thing that works. I really wish this eye drop mystery could be solved for the extra sensitive like us as drops seem to benefit others in their treatment...

[indrep]

I remember reading in the DEWS report where the polarity of the cells of the cornea reversed. Normally water is moved in and out of the cells in a physical way, for people who have suffered ocular inflammation for a long period ( can't remember the time frame) the process becomes "electrical". This is rare and I am not sure what the testing method would be to determine if that was the issue. Perhaps the cornea would be edemic (bloated from too much water)?

I think there was an artificial tear at one time that was hypotonic. I think it was tears naturale. Glycerin can also be used to pull water from the cells if needed.

Cellular death can happen for hyperosmolarity and hypoosmolarity.

[No tears in ATL]

I remember reading in the DEWS report where the polarity of the cells of the cornea reversed. Normally water is moved in and out of the cells in a physical way, for people who have suffered ocular inflammation for a long period ( can't remember the time frame) the process becomes "electrical". This is rare and I am not sure what the testing method would be to determine if that was the issue. Perhaps the cornea would be edemic (bloated from too much water)?

I think there was an artificial tear at one time that was hypotonic. I think it was tears naturale. Glycerin can also be used to pull water from the cells if needed.

Cellular death can happen for hyperosmolarity and hypoosmolarity.

So it would seem that I am doing more harm with drops, if indeed this is my issue. Yikes. It should be noted that when my condition began 6 years ago, drops served no relief even then. And quadra plugging, which I assume just brought more water in, caused more irritation, while plugging uppers seemed just about right.

Dumb question, but would this mean that an isotonic drop with nourishing capabilities (if one exists) would do the trick for folks like me and dryeyedave?

[regina]

I also cant use drops. Like you the drops feel well at first but then they get more pissed off afterwards. Yeah moisture chambers are the only thing that works for me. Also I used honey for my eyelid inflamation....works great

[indrep]

No Tears, I have never spoken with a doctor or research person regarding this phenomenon. My only exposure was the research in the DEWS report. I will make an effort this week to find the source for that info and see where it takes me. I do remember the study stating it was unlikely that the body could switch back once the cells polarity changed.

I am not sure if the osmolarity would make a difference now, it would have more to do with the positive or negative charge of the water, I think.

[NotADryEye]

Like you, best for me is no drops at all. That's what I do now. Just warm compresses, O3, low dose doxy, keeping an eye on my thyroid levels.

What are you doing for mgd? Improving mgd alone can improve comfort even with chronic AD.

Looking forward to indrep's research.

[No tears in ATL]

Indrep, I can't thank you enough for responding to my posts and endless questions on osmolarity. You've been such a valuable resource to all of us on this forum!

No Tears, I have never spoken with a doctor or research person regarding this phenomenon. My only exposure was the research in the DEWS report. I will make an effort this week to find the source for that info and see where it takes me. I do remember the study stating it was unlikely that the body could switch back once the cells polarity changed.

I am not sure if the osmolarity would make a difference now, it would have more to do with the positive or negative charge of the water, I think.

[No tears in ATL]

NotADryEye, MGD is being managed same as you--low dose doxy, compresses and massage, baby shampoo lid scrubs, krill oil as omega 3 source (about 1.5g), trying to avoid wheat, eggs, meat, poultry, and some high histamine foods, although I don't think I'm sensitive to many of those at this point. My thyroid checked out ok last year, and the only thing I haven't looked at is hormone levels. Good to know there are others that can't do the drops, I had doctors look at me like I had 3 heads when I told them every drop burned! : )

Like you, best for me is no drops at all. That's what I do now. Just warm compresses, O3, low dose doxy, keeping an eye on my thyroid levels.

What are you doing for mgd? Improving mgd alone can improve comfort even with chronic AD.

Looking forward to indrep's research.

[Feralfeline]

honey question

Hi Regina,

Can you tell me how you use honey for inflamation? TIA.

-Ginny

I also cant use drops. Like you the drops feel well at first but then they get more pissed off afterwards. Yeah moisture chambers are the only thing that works for me. Also I used honey for my eyelid inflamation....works great

[NotADryEye]

NotADryEye, MGD is being managed same as you--low dose doxy, compresses and massage, baby shampoo lid scrubs, krill oil as omega 3 source (about 1.5g), trying to avoid wheat, eggs, meat, poultry, and some high histamine foods, although I don't think I'm sensitive to many of those at this point. My thyroid checked out ok last year, and the only thing I haven't looked at is hormone levels. Good to know there are others that can't do the drops, I had doctors look at me like I had 3 heads when I told them every drop burned! : )

NTinATL, We're doing almost the same. I don't massage since that was one of the things that drove me into this state. And the sensitivities now include anything including baby shampoo, so I don't wash with anything but warm water when bathing. It's hard to imagine that these things that are supposed to be helping us, like all those different OTC can cause us problems, but they do. And like you, I have only one head :-)

[grant555]

NTinATL, We're doing almost the same. I don't massage since that was one of the things that drove me into this state. And the sensitivities now include anything including baby shampoo, so I don't wash with anything but warm water when bathing. It's hard to imagine that these things that are supposed to be helping us, like all those different OTC can cause us problems, but they do. And like you, I have only one head :-)

ATL - i have always been the same way until somewhat recently. Previously, ALL eye drops would make my eyes feel worse and more red immediately five minutes later (after the nice feeling wore off). Recently, I have had a little luck. Most eye drops no longer make my eyes feel worse, but most do not do anything. I am having some success with Oasis Tears Plus, but I still use it sparingly (once in the morning, in the afternoon if i need it, then in the evening). If I use tears more, I find it to be counterproductive as most people seem to agree on this forum.

I'm not entirely sure what has changed for me but I think I have a pretty good idea. My dry eye is caused by lagophthalmos -- nightime and partial blinking. I don't think I ever closed my eyes once for 10 years. Now that I know this is the problem, I've made some progress with my eyes at night and at least being able to forcibly close them when I try. I think the blinking function is key to distributing eye drops onto the surface of your eye, and if it is not working correctly, eye drops may simply irritate and compound the problem.

Just a thought - probably not applicable to you. It's also quite hard to tell if you are a partial blinker. I believe the Lipiview tells you if you ever decide to go that route.

Stay strong.

[alisonW]

grant555 - may I ask what's working for you at night? I'm pretty sure I have lagothalmus as well and am having similar problems as No Tears in ATL (and you) with regard to drops.