Punctate Epitheliopathy

[nitrodrops]

Hi All,

Have lasik done in 2003, DES worsen in 2009. Been seeing a normal eye doctor for a 2 years, without much improvement, and got referred to see a Dry-Eye specialists early this year.

My dry-eye specialists diagnosed my eyes having 'punctate epitheliopathy' 4 months ago.
Took doxycycline for 2 months, and increased the TheraTears 2 x capsules.

Last week, he noticed my punctate epitheliopathy has gone down/ improved.

He has mentioned, my DES is due to my lasik surgery done, because some nerves need to be cut during the Lasik ops.

Forget to ask him, if 'punctate epitheliopathy' improved totally, does it means my DES will be cured?

Also, my DES worsen in year 2009 after 6 years, during the 6 years, have been using normal eye-mos without taking good care, eyes kept blinking but does not feel severe dry, only in year 2009 started to feel the severe dry eyes.

Just wondering is there a possibility that during the 6years, my cornea nerves are damaged? And if damaged, can it be cure and regenerate by consuming more DHA(Omega3)



Currently, on the followings medication

Refresh+ : one tube throughout the day
Systane : x 4 times throughout the day 4 hrs interval
Retasis : 4 throughout the day 4 hrs interval
TheraTears : 3 capsules in the morning
Duratears : ointment @ night


Much appreciated for any kind replies

Cheers
Nitro

[littlemermaid]

Forget to ask him, if 'punctate epitheliopathy' improved totally, does it means my DES will be cured?

My daughter had punctate lesions which cleared totally when she was given good treatment to maintain tear film, clear bacterial infection and control inflammation. We have to maintain chronic dry eye treatment to prevent lesions and surface inflammation from coming back.

Just wondering is there a possibility that during the 6years, my cornea nerves are damaged? And if damaged, can it be cure and regenerate by consuming more DHA(Omega3)

She takes omega 3 oils to help restore a good consistency of meibom from the meibomian glands which produce an oily component to the tear film. She has reduced sensitivity on the eye surface (not due to LASIK) but I've never read that omega 3 oils improve corneal neuropathy, just meibom.

Hope this helps.

[nitrodrops]

My daughter had punctate lesions which cleared totally when she was given good treatment to maintain tear film, clear bacterial infection and control inflammation. We have to maintain chronic dry eye treatment to prevent lesions and surface inflammation from coming back.



She takes omega 3 oils to help restore a good consistency of meibom from the meibomian glands which produce an oily component to the tear film. She has reduced sensitivity on the eye surface (not due to LASIK) but I've never read that omega 3 oils improve corneal neuropathy, just meibom.

Hope this helps.

Thanks my punctual epitheliopathy is improving, my DES specialists said lesser punctals now, was consuming Doxy and Theratears then.

However didnt see any much improvements on DES 8(

[littlemermaid]

And if damaged, can it be cure and regenerate by consuming more DHA(Omega3)

Omega-3 Fatty acids in Dry Eye and Corneal Nerve Regeneration after Refractive Surgery,
Jiucheng He and Haydee Bazan, Prostaglandins Leukot Essent Fatty Acids 2010.

Hi Nitro, So glad that your punctate lesions are clearing and that your new ophth is doing a better job looking after you post-LASIK. I was just reading in http://www.ncbi.nlm.nih.gov/pubmed search 'omega 3' that, as you say, these oils seem to be helping to regenerate nerves as well as improve lipids. http://reference.medscape.com/ is good for research evidence and current debate.

Some docs are worried people are taking too much, esp if they have other metabolic issues. Some think fish oil is easier to metabolise than flaxseed oil. We are rebalancing meibom like you by taking Theratears fish/flax capsule, minimising other fats, dairy, processed fat, sugars - this seems to be the key for us, without this careful diet the meibom clogs again. We particularly avoid emulsified fats in frying oils, pastries, processed cheese.

What do you know about your MGD? Do you need to warm the eyelids to get it flowing? Are you using wrap-around glasses?

[nitrodrops]

My DES specialists did not diagnose me having MGD. Will ask him in my next appt in Nov, have been doing warm compresses 2 times per day, eating Theratears every day, not much improvements.

Yes, wearing wrap-around glasses, it does really helps.