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How I have treated my dry eye problems (blepharitis and mgd)

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  • How I have treated my dry eye problems (blepharitis and mgd)

    I am writing this here because I hope it helps somebody with similar problems as I have had for the last four years.

    My dry eyes problems were caused by four things:
    • At work hanging above a small heater unit during the winter (while wearing soft contact lenses).
    • Wavesurfing at least once a week for a year (also while wearing soft contact lenses). My eyes got very red and dry because of the salty water.
    • Riding long distances on the scooter without any wind protection
    • And last but not least the soft contact lenses themselves.

    Three years ago I had to stop wearing contacts (except for surfing as I'm blind without them). Two years ago my eyes couldn’t handle contacts at all anymore. What was even worse, was that my eyes were extremely dry even without the contacts.
    I went to an eye doctor. The first one just gave me eye drops and gave hardly any information about what was wrong. The second one said it was severe MGD and blepharitis and there was nothing she could do. She said I would just have to use the eye drops and deal with the pain for the rest of my life.

    When I used Artelac drops (very low viscocity) I had to reapply a drop in each eye every 5 minutes. Vidisic carbogel (high viscocity) worked a lot better; I ‘only’ had to reapply drops every hour.

    I did not accept the diagnosis of these eye doctors, so I went to the third one. She basically told me the same thing as the previous doctor.

    I started reading about my affliction on the internet. I found a scientific article, written in my native language, about the problems I had. I found out the person who wrote it also treated people with this condition.
    So about two years ago I went to see her. Her recovery plan was the following:
    • See her every few weeks and after a couple of times, every few months. When I was there she would monitor my eyes and manually extract the contents from my meibomian glands. (Something my eye doctor did not dare doing.) They were so clogged up that she couldnt do them all the first time (some would be too painful, she said). She also was a great mental support, telling me of improvements every time I visited even though at times I felt there was no improvement at all.
    • Every morning and every evening heat treatment (microwave a small bag of, I don’t know rice?, and put it on my eyes for ten minutes). Very important is that the bag should not feel hot as it worsenes the problems. After 10 minutes squeeze the eyes as hard as you can two times, 30 seconds each time.
    • Every morning and evening clean my eyes with Sterilid (a kind of foam). After six month this decreased to only cleaning in the morning.
    • Every night before going to bed apply a bit of Vitapos in each eye (it is a thick gel and also contains vitamine A, although I don’t know if that helped).
    • Don’t use as much heating in my home. In the winter I’ve kept it at around 16-18 degrees celcius. This releaved the symptoms quite a bit (and I saved A LOT on my energy bill :-) ).
    • Switch the computer/tablet/smartphone off for more outdoor walks (if the humidity is not very low) and eat healthy.
    • Use Vidisic carbogel drops as much as needed. (Best is to use the kind of eye drops that has the optimal viscosity for your eye situation)
    • If you have one eye bothering you the most: check if you lie on that eye on your pillow at night (was the case with me)

    I have done this routine for the last two years and finally things have improved enough to write this story. Since a few months I hardly use my eyedrops anymore. Maybe one drop in every four/five days. I can’t express how happy I am to disprove the diagnosis I had received from the eye doctors.

    So my advice is find a proper dry eye expert to help you and maybe try a similar routine as I have. And don’t give up hope! It took me 2 years to come where I am now, so don’t despair when you don’t see much improvement after a couple of months.



    Update: I wrote this down in january this year. It is now may and I only have to use a drop every few weeks. :-) I am still doing the above mentioned routine each and every day though.


    If you have questions, I would be happy to answer them!

  • #2
    Thanks for sharing and congratulations! You are so so lucky to find a real expert who is proactive/serious with solutions.
    Could you tell us
    1) your glands status? how many are functional? thick/clear oil or just clogged?
    2) did you do LipiFlow, IPL, probing, expression, BlephEX etc - seems not?

    3) warm compress: did you feel oil secretion when you do it, how long then, at least 7 minutes?
    Some doctors say best is 15 min. and the more secretion feeling is better.

    4) clean eyes with Sterilid (a kind of foam) - any brand name or its contents,
    tea tree oil, hypochlorous acid and free from soap/sodium laureth sulfates/sodium coco sulfate, for example?
    I am trying to find something with above quality - to control inflammation/demodex (prevention is better than cure!)
    + NOT to cause irritation to eyelids/tear film. All these are available in USA but not where I live.

    Vitapos - I used it before and found it is great but my concern is its wool wax.
    Now I use swimming goggle + oil-based drop before bedtime and I do not suffer night/morning pain anymore.

    Thanks again!
    Last edited by MGD1701; 03-Jun-2017, 09:23.

    Comment


    • #3
      Yes, I do feel lucky. Sadly there are not a lot of dry eye experts out there. In my experience eye doctors don't really have a clue, or maybe it is just too time consuming for them. It is my experience in general that the industry is more content with treating symptoms, than the cause of the symptoms.

      Now I will answer your questions:
      1 Last time I went to visit her (december 2016) I remember maybe 1 or 2 glands being clogged up a bit. The others are flowing with a tiny bit of pressure applied. Still a bit thicker than a proper functioning gland though. That is why I still benefit from the daily heat treatment. But defnitely not clogged up. I remember the first couple of times I visited her: After she excreted my glands I had a lot of eye irritation, because of all the extracted content from the glands. These particles were very hard, so they felt like sand particles in my eyes. The last few times she did it, it actually felt good, like there was oil inserted in my eyes (which was the case of course).
      2 I am not familiar with most of those terms. The only things I have done are listed in my first post.
      3 I don't feel oil secrection after the heat treatment, at least not as noticable like when my eye physician manually excretes my glands. But when in the morning I would wait too long with the heat treatment, then after a while I would notice my eyes getting dry a bit. That feeling is gone after the heat treatment, which is why I know it is effective. My bag is from TheEyeBag Company and is called MGDRx eyebag. It has two sides: The silk side gets hotter, so you can turn the bag after +-6 minutes and put the silk side on your eyes. I keep it on my eyes for 10-15 minutes (as long as it feels warm enough to be effective). The company says it loses its function after about half a year and needs to be replaced, but mine is still working fine after 2.5 years.
      4 The brand name is Thera tears. It is quite expensive, but I will keep using it as long as I feel my eyes can improve more than they already have. Thankfully a bottle lasts me about 5-6 months. I have tried other, cheaper eye cleaning products but they irritated my eyes.

      Why is wool wax in Vitapos a concern for you?

      Comment


      • #4
        Hello RJ
        Thanks for your tips/reply.

        1) Expression: Seems your eye physician manually expresses your glands.
        If so, again, you are so lucky as most people do not have such luck. I think that really makes a big difference.
        I visited 12 doctors, only the last 3 doctors checked glands, one was honest telling me she could not help.
        They have no time to tell me what have been checked and the results - I only knew very roughly.
        I even needed to pay the fees as they do not accept the insurance.

        2) you wrote, ''squeeze the eyes as hard as you can two times, 30 seconds each time''
        https://www.youtube.com/watch?v=FFjT...4&spfreload=10
        Is it the way you squeeze? I think it is from Singapore??

        3) wool wax: My concern is the pollution/chemical issues as they are from sheep.
        For skin is ok but into eyes? Dont think it is a good idea for a long-term. Besides, there are better alternatives.

        4) Thera Tears eyes- foaming cleanser with tea tree oil - without doubt it is effective.
        I would love to have it but NOT available in where I live.

        5) warm compress: I use Blephasteam/42.5C - many studies show it is effective/safe for its constant heat and steam.
        Now I can feel oil secretion in about 3 min toward the end. Facial steamer helped my thick oil flow -
        I actually found such solution by mself. 2 doctors just said 10 min. but I hardly had oil feeling with it.
        Now my oil is about half thick - I think I need to improve squeeze/massge lids (a bit harder).

        Thanks again.
        Last edited by MGD1701; 04-Jun-2017, 07:22.

        Comment


        • #5
          1 Yes indeed, it is manual expression. I think this is quite an essential element in the treatment. I had the same experience as you: eye doctors are not used to doing this. The lack of knowledge in the field about the dry eye syndrome is pretty big sadly.
          2 No I dont squeeze like that. I did something similar at first, but it caused more damage than it cured anything. I don't use my hands at all, I just close my eyes and squeeze them as hard together as I can.
          3 Okay, yes I am not so worried.. I don't think it will do much harm but you're right nobody knows for sure about in the long term.
          4 If you can't find an online store, you could always buy from a seller on ebay...most times they ship worldwide. But you should check with the seller first about the expiration date, so you don't get old stock (Even new bottles right from the factory have an expiration date of only about a year later).
          5 Good to hear that device is working for you!
          6 No I have never heard about this, I will read into it, thanks!

          Comment


          • #6
            VitA-POS - The company who make this seem pretty good so could contact them to ask about the lanolin, I recently asked them a different question and got a reply. They actively avoid phosphates in their products and engineered a special bottle design that allows for preservative-free eye drops in multi-dose form instead of single-dose vials, other companies are starting to use the same design. Of course no product is 100% safe though no matter what (coming from someone who nearly died to a common over the counter medicine with a 1 in a million chance of occurrence).

            https://www.ursapharm.de/de/kontakt/kontaktformular/
            Or their UK distributor:
            http://www.scopeophthalmics.com/contactus

            Glad you have found relief RJ, thanks for sharing your methods.
            Sufferer due to Toxic Epidermal Necrolysis.
            Avatar art by corsariomarcio

            Comment


            • #7
              VitA-POS: Ursapharm indeed is a well-regarded company,
              that is why my doctor selects it rather than another brand (which another dr recommended and in fact it is not good as VitA-POS).

              For RJ
              Damage by squeezing lids/glands with fingers
              What do you mean you squeezed (by fingers) and it caused more damage than it cured anything.
              Did your doctor detect some damages? if so, where (glands??) and what kind?
              Actually such squeeze by fingers is recommended by Dr Korb, inventor of LipiFlow, to avoid damages to cornea.
              Well, if you massage too soft - useless, if too strong - might cause damages!
              So you are lucky to have a trained professional expresses for you - effective/safe -
              And you just need to do ''forceful blinkings'' after the heat at home.

              Forcefully blinking: how many times you do for each time? you wrote: two times, 30 seconds.

              Thanks!

              Comment


              • #8
                When I did the squeezing like in your video, after a few days the area between my eye and eyelid started to ache. Maybe I did it with too much force.

                Yes I just keep my eyelids firmly pressed together for 30 seconds. Then pause for a minute or so and do another 30 seconds.

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