Scleral = irreversible??

[PaulineD]

Hello!
I'm suffering from mild to moderate (according to docs), but painful dryness, from MGD. I say "mild to moderate" because my cornea has no damages, but it is still painfull. In order to write this message, I have to cry voluntarily...
I have a question about sclerals


There are artificial tears beetwen the lens and the cornea. Consequently, th eye doesn't need to produce tears, does he? And the lake of natural tears is more and more important... Is it a viscious circle?

Oh my god, I'd rather to be blind.....

[Rebecca Petris]

Hi there and welcome.

I'm not sure if I understand your question really. Do you mean that if you wear sclerals, you no longer need to make tears so your eyes stop making tears and you get even worse, so you become more dependent on things like sclerals?

If so, no, it doesn't work that way. Your tears are not produced by the eyes, they're produced from lacrimal and meibomian glands when you blink (which you will still do... a lot... wearing sclerals). And the tears don't just exist to keep the cornea wet but all the ocular surfaces (like the undersides of your eyelids). The point of sclerals is to cover the cornea in liquid either as a protective device for the cornea (in cases of severe dryness) or as a way to insulate hypersensitive nerve from overstimulation in pain cases. I'm probably oversimplifying things but that's how I see it.

It sounds like you have "mild to moderate" clinical signs of dry eye, but from the way you write, it sounds like your symptoms are a lot worse than mild. Try using this little survey: http://dryeyezone.com/documents/osdi.pdf and see what your score is.

[PaulineD]

Hi and thank'you
"I'm not sure if I understand your question really. Do you mean that if you wear sclerals, you no longer need to make tears so your eyes stop making tears and you get even worse, so you become more dependent on things like sclerals?" --> yes exactly
I say that because my doc said me that "too many artificial tears is not good because the lacrymal glands get used to producing less tears. It is wrong?

[Rebecca Petris]

I say that because my doc said me that "too many artificial tears is not good because the lacrymal glands get used to producing less tears. It is wrong?

I don't know. Not sure anyone knows. I do believe, for various reasons, that applying artificial tears too frequently is not a good idea in a lot of cases - but in a lot of those cases there are alternative methods available to give relief. (Some people use artificial tears because of actual dryness where they are getting damage, but a lot of people use artificial tears mostly to make their eyes more comfortable. There's a difference.) Probably some difference also between applying artificial tears, and wearing a scleral lens filled with saline. And most people wearing scleral lenses for dry eye (but not all of course) have severe dryness where their lacrimal glands are already damaged.