Dry eyes and permanent veins in eyes

[Bones1579]

What other tests did the doctor do on you? Did he do a Schirmer Test (putting test strips in the eye to measure tear production)? Did he do meibography (taking pictures of your meibomian glands)?

There was some sort of test with a paper strip. They put something in the bottom of my eyes and also gave me some sort of drops and looked at my eyes with a bright light. No pictures but they pressed on my oil glands. This was just the first visit so I felt like it was adequate for that. I have to go back in 3 weeks.

[pythonidler]

Bones,

Based on what you posted, it sounds like the doctors diagnosed you with both tear deficiency (not enough watery tears) as well as meibomian gland dysfunction (oil glands not producing enough oil). Do you recall your doctor mentioning this? If you have MGD, have you heard about heat masks? They can be great at getting the oils flowing. I use mine every night for about 10 minutes.

Regarding images of your eye, I think any half-way decent doctor should be able to do meibography on your first visit. Personally, I've seen 4 dry eye doctors, and the last two I've seen (also the two best) have done meibography on my first visit. I'm not saying you should abandon your doctor right away, as you can still get good treatment - but it would raise some warning flags for me. I'd say give your doctor 6 months to make you better. If you feel like you're getting worse or staying the same, it's probably time to find another doctor.

[Bones1579]

Yes the doctor said to use a heat mask twice a day but I haven't purchased one yet. I was doing some research on them and I'm concerned about the hygiene. Is it possible to get an infection from them? And is using a heat mask for a few months actually going to cure the MGD or is just going to provide some relief and I'd have to use it the rest of my life?

The treatment plan is as follows:

1) Alrex eye drops for four times a day the first week, three times a day the second week, twice a day the third week, and once a day for the fourth week
2) Systane Balance as needed up to 4 times a day maximum
3) Sleeping goggles at night
4) Heat mask twice a day for 10 minutes

[pythonidler]

The heat mask will not cure MGD. Right now, there is nothing that can actually "cure" MGD, but you can do certain things to make yourself feel better. A heat mask is the cheapest and easiest option.

As for whether you have to do this the rest of your life - I would say you should do this indefinitely. The thing that sucks about dry eye is that it's a chronic disease. Generally speaking, chronic diseases can't be cured and can only be "managed". Heat masks are one way of managing it.

I would follow your doctor's advice and use the heat mask at least once a day. If you're not good about using the heat mask, your MGD will get worse, and the treatment options will only get more expensive. Lipiflow is about $1500/eye right now, and IPL can be anywhere from about $300 to $500 per treatment.

[Bones1579]

My eyes are feeling a lot better than before but aren't perfect. Over the past few weeks there have been many days where my eyes have felt completely normal. I have even slept without the goggles a few times and my eyes still felt pretty good. I'm assuming the Alrex eye drops have been helping. I also started using a heat mask.

[pythonidler]

My eyes are feeling a lot better than before but aren't perfect. Over the past few weeks there have been many days where my eyes have felt completely normal. I have even slept without the goggles a few times and my eyes still felt pretty good. I'm assuming the Alrex eye drops have been helping. I also started using a heat mask.

That's awesome news. I know probably many people on this forum would like to be in your situation, where they can feel "normal" for at least one day.

Now that you're feeling good again, hopefully your doctor will let you take away certain treatments to see what's really working for you and what's not. The heat mask, though, I would still probably use on a regular basis.

[chuto]

Hi Bones1579, I am happy to hear you are doing better after the recommended treatments. I would like to ask about veins, have their appearance decreased along with your dry eye symptoms?

[Bones1579]

My eyes don't feel as bad before but the redness and blood vessels are still bad. My eyes don't feel good all the time but I've had more good days now than before. The doctor didn't really seemed concerned about the blood vessels and I have lost any hope that I'll ever be able to get rid of the redness/blood vessels.

[Mad198302]

I too have visible blood vessels in my eyes. My doctor said that it was due to the infection I got in my eye and the blood vessels were my body's response to it. I know how you feel.

[Bones1579]

Update: Still having problems with my eyes. I've started taking vitamin D since there have been studies finding a correlation between dry eyes and vitamin D deficiency. It'd make sense that I'm deficient because I'm inside all day. I'm going to get my blood tested and also find a new specialist.

I have to do about 4-5 things every single day just for my eyes to feel somewhat normal. The blood vessels in my eyes continue to get worse and will not go away no matter what I do. I've tried over 20 different things.

[Bones1579]

Last night I didn't have much time to post something. I've started using OcuSoft Lid Scrub and taking vitamin D supplements.

I started using the lid scrub a few weeks prior to ever taking the vitamin D supplements and it seems to have helped somewhat. My eyes actually felt normal for the first time in a long time after using it. I use it twice a day. Once in the morning right after waking up and once before bedtime. For the vitamin D, I am taking D3 5,000 iu on a daily basis and will have my blood tested to check my levels. I'm almost certain that I'm deficient because I'm rarely in the sun. I'm also going to get my testosterone and other vitamin/mineral levels tested.

All in all, my eyes feel somewhat better than before but no where near ideal and there's good and bad times. Aesthetically, my eyes continue to get worse. The blood vessels are like a road map and will not go away no matter what I do.

[Bones1579]

Another update. I will soon be moving out of state and will be living near Duke Eye Center but I'm not even going to waste my time going there or seeing any other dry eye specialists because none of them seem to have any idea what they're doing and will just give you treatment options that have plenty of risks and can actually make things worse.

Instead I've decided that I will visit Dr. Latkany in New York since I'll be living closer to him than I was previously.

I suspect that I may have ocular rosacea because I've been having other symptoms such as dry/white/patchy skin, dry hair, itchy skin, etc. My skin just seems to be really sensitive now and I had a really bad reaction to laundry detergent and can't use bar soap either. I don't recall ever having any problems like this years ago.

Before I make the visit to Dr. Latkany I am going to have all my hormone and vitamin levels tested, get a comprehensive allergy test done, and visit a dermatologist.

I will post an update towards the end of the year.

[Hokucat]

Bones, since you are planning to have various blood tests, you might also have them check for autoimmune disease, as some of the symptoms you mention fall into that category. You might get referred to a rheumatologist to have a more extensive set of autoimmune tests.

Besides severe dry eyes from both MGD and low/no tear film, I also had some of those other symptoms you have, like dry skin and hair, itchiness and sometimes a slight rash from certain laundry detergent, etc. Then it got worse where I had other symptoms like dry lips that would crack in the corners, dry mouth at night, numb limbs, and aching muscles and joints. My rheumatologist said all these combined with dry eyes are symptoms of Sjogrens and other autoimmune disease, where the immune system can attack moisture glands in the eyes, mouth and skin, and other organs. So there are medications to manage autoimmune symptoms. I personally opted to approach it with diet, which has worked for me.

[MGD1701]

Hi Bones,
Thanks for sharing. Seems you are on the right track. Good to visit dematologist to confirm the rosacea.
Have you tried omeg 3 (for infammation issue and oil quality)?

effective lid cleaner: is particular important for inflammation and MGD. If you suspect rosacea which is often related to demodex - try tea tree oil wipes. I personally use 2 different brands at the same time, just for safety sake.

Night pain: I no longer suffer night pain nor do I need sleeping mask. What helped me seem to be
wash eyes with running warm water about 10 times (before compress), after compress, massage, then put 12-15 drops saline into each eyes (to remove debris, dirts etc). x2/day - saline thing is something Dr Latkany wrote in his book.

If you have MGD, warm compress, massage are important but hard to master. Good to ask Dr Latkany to show you how including the pressure you should massage.Someone from the forum mentioned he showed patients on this - how nice!. I need to massage harder to thin the oil but too hard might damage cornea. not hard enough is useless - so frustrating. Taking doxy is my last solution.

Hope you will find more relief soon.

[Bones1579]

Bones, since you are planning to have various blood tests, you might also have them check for autoimmune disease, as some of the symptoms you mention fall into that category. You might get referred to a rheumatologist to have a more extensive set of autoimmune tests.

Besides severe dry eyes from both MGD and low/no tear film, I also had some of those other symptoms you have, like dry skin and hair, itchiness and sometimes a slight rash from certain laundry detergent, etc. Then it got worse where I had other symptoms like dry lips that would crack in the corners, dry mouth at night, numb limbs, and aching muscles and joints. My rheumatologist said all these combined with dry eyes are symptoms of Sjogrens and other autoimmune disease, where the immune system can attack moisture glands in the eyes, mouth and skin, and other organs. So there are medications to manage autoimmune symptoms. I personally opted to approach it with diet, which has worked for me.

I'll look into it.

Hi Bones,
Thanks for sharing. Seems you are on the right track. Good to visit dematologist to confirm the rosacea.
Have you tried omeg 3 (for infammation issue and oil quality)?

effective lid cleaner: is particular important for inflammation and MGD. If you suspect rosacea which is often related to demodex - try tea tree oil wipes. I personally use 2 different brands at the same time, just for safety sake.

Night pain: I no longer suffer night pain nor do I need sleeping mask. What helped me seem to be
wash eyes with running warm water about 10 times (before compress), after compress, massage, then put 12-15 drops saline into each eyes (to remove debris, dirts etc). x2/day - saline thing is something Dr Latkany wrote in his book.

If you have MGD, warm compress, massage are important but hard to master. Good to ask Dr Latkany to show you how including the pressure you should massage.Someone from the forum mentioned he showed patients on this - how nice!. I need to massage harder to thin the oil but too hard might damage cornea. not hard enough is useless - so frustrating. Taking doxy is my last solution.

Hope you will find more relief soon.

I've been taking fish oil every day for a very long time now. I've used OcuSoft Lid Scrubs and hot compresses but I'm not sure if that's a good idea if I do in fact have ocular rosacea.

I started doing cold compresses instead and my eyes actually got somewhat whiter for the first time in a very long time. When I went to a doctor earlier this year they said there was inflammation in my eyes, that my tear volume is low, and that I'm a partial blinker.

Also, I've been doing more research.

I have IBS-C (Constipation) and found that there is a link between IBS and dry eyes and IBS and ocular rosacea because they all involve inflammation. My dry eyes and skin problems started after I developed IBS.

It's all starting to make sense now.