Update

[Justpeachythx]

Hi everyone,

I had a followup apt with our city's supposed "top ophthamologist" this week. I saw him in Sept and his 5 minute diagnosis (dismissive at best) was that I had a few dry spots and I should rinse my eyes with water (cold or warm, no difference) and continue putting OTC lubricants in. I left feeling like a whining hypocondriac.

Since that first meeting I found a very compassionate optometrist who has been working hard to rule out different things. His assessment/diagnosis was:

- thin but intact tear film with very good TBUT (normal for a +50 woman)
- sluggish glands but no sign of blepharitis
- eyes look perfectly healthy -- "calm" -- inspite of the almost debilitating irritation I have in the corners of both eyes.
- possible allergy to something; left eye is reacting to an irritant of some kind with a lot of long stringy mucous. (He explained this is the eye's way of try to catch and sweep the irritant towards the corner of the eye to dispell it).

Anyway, since beginning of Octoberthe optometrist had me on:

- 10 days of patanol with no result (marginally worse, perhaps)
- tried dissolvable lower plugs with no improvement (marginally worse, perhaps)
- 5 days of Zatadol preservative free (no improvement, marginally worse)
- A three week course of a steroid/antibiotic, with patanol introduced again the second week (he was speculating I was perhaps too inflammed to see the benefit of an anti-allergy drug) -- but again, no improvement.

The opthalmologist appointment this week was even worse than the first time I saw him. I was trying to bring him up to speed on what the optometrist had done, and he kept cutting me off -- at one point telling me to "be quiet and not talk". His conclusion is that I am fiddling with my eyes too much. Too many different kinds of drops (with BAK). His advise was to stop everything except PF OTC drops. Inspite of his abominal bedside manner, I have nothing else to try except nothing, and the optometrist agrees.

I am at such a low point right now -- trying to hold on and believe that this is in fact just a fall allergy gone off the scale (we are still in the midst of am unusually long, dry autumn -- no snow yet). But it's hard to hold out hope that this will resolve itself. My day is pretty much done by 3PM when all I can do is alternately rest my eyes for an hour, then ice them, and so on until bed. It's somewhat tolerable if I keep the bad eye closed.

My question is about night time treatment. The past few nights I have used nothing but a couple drops of basic OTC drops (Refresh Plus) and a sleep mask. For a year a half I was using something called Liposic (love the stuff and never had a problem until this 3 month episode I'm currently in). I noticed in the morning the corner of my eyes are quite red and irritated looking -- and then noticed that Liposic has centrimide in it (ouch!). I tried to switch to Genteal Gel for a couple nights, but without much change. In the mornings, whichever gel I use, I notice it has slid to the corners of my eyes and is all gooey and stringy, and I need to gently slide it all out of my eye.

Is that a normal experience for gels? I don't remember ever having that problem before.

In the meantime, for the next two weeks I will try to use nothing but my Refresh, my 2x day warm compresses, and lots and lots of cold compresses in the evenings to keep my sanity. Any other suggestions would be welcome. I'll also give my Tanquileyes another shot for night sleeping -- use them during the day, but couldn't get them comfy for overnight use.

Thanks for listening.

[Jen72]

What about an ointment for nightime like lacrilube? I can relate- by the evening I just want to live with a compress on. Have you tried allergy testing- maybe something in your environment is giving you the irritation and mucous? I really swear by my plugs - without them I am way worse then I develop dry spots on my cornea. I know its so frustrating, hang in there.

[Justpeachythx]

Thanks, Jen

It is most frustrating, agreed. I've bought lacrilube, but it's still sitting untouched in my drawer. I've read so many negative things about it on here, I'm afraid to try it. I do have a very kind, compassionate optometrist who seems to know what he's doing (has simply run out of ideas) -- so I know I can always go back to him to retry the plugs.

For now, I'm trying to focus on my mental health and finding some way to relieve the stress (which I know isn't helping matters). As long as I still have some "last resort" tricks in my bag, it helps to remain confident that there will be a solution out there for me.

Hope you're having a good day.

[indrep]

just peachy
There is an OTC preservative free drop in Canada called I-drop. You might want to give it a try.

[Rojzen]

I am so glad you have been cautious about starting on a petrolatum-base product like Lacrilube. Rebecca and others here are very, very right to urge restraint on ointments, because these mechanically and chemically drastically disturb just about every function in tear film formation.

It is entirely possible that despite your normal TBUT, the pattern, thickness, and wave pattern of your tear film are nonetheless quite abnormal. There are videograms that can determine this, but once you're feeling as miserable as you feel, I don't think you need these to convince you that your tear film may be unstable, either as a result, or as the cause, of the painful and other awful sensations you experience.

I am not sure your exams have been sufficient to rule out, with certainty, infection, allergy, corneal irregularities (on surface or deeper layers), or conjunctival contour irregularities like conjunctivochalasis (which some here are having treated beautifully through surgical intervention), but if you feel confident that directly treatable pathology has been ruled out, would you consider trying something like Dwelle, for a solid few months? Dwelle can surely be used where there is pathology, such as with corneal erosions (and, in fact, is particularly indicated in many such cases), but if you end up having to take topical treatment for infection or allergy, e.g., the topicals needed for these can temporarily slow progress otherwise possible through Dwelle alone. Hence my question about ruling out conditions that may have to be resolved before your chronic picture can be teased out more clearly. (A propos allergy, have you seen the recent post about one of our members who responded well to high doses of topical allergy drops, but not to standard doses? ...something that your optometrist might like to evaluate, though you surely have given the antihistamines a good college try, and it may be time to conclude that allergy is not a big part of your problem.)

You may previously have written here about a trial with Dwelle. . If so, please forgive my oversight. I always forge full steam ahead on recommending Dwelle, even at the risk of missing earlier mentions of same, because my own dramatic healing through sustained use of Dwelle compels me to make sure that candidates for it are not skipping the crucial step of giving it a good try.