A success story

[hannsho]

I’m glad to be able to report that my eye condition has been bought completely under control, so much so, that I almost regard it as problem of the past. All that I do now, is to use Natrasan First Aid Spray, which is hypochlorous acid, to clean my eyelids in the morning and in the evening. I still have to use artificial tears, but in comparison to all the problem I had in the past, that is next to nothing. I also take one table spoon of flaxseed oil every day and one effervescent tablet of 600 mg acetylcysteine dissolved in half a glass of water daily. However, the past was very different.
Basically, the underlying problem of my symptoms is ocular rosacea that led to chronic inflammation of my eyelids, causing meibomian gland deficiency and superficial ocular hyperemia. I frequently experienced a foreign body sensation, stinging in my eyes or itchy eyelids. My eyes frequently went red. I had to use eyedrops containing a powerful corticosteroid almost continuously to control the situation. But only about 3 to 5 days after a treatment had finished, my eyes would go red again and I had to use another round of treatment. I also used 40mg doxycycline for 6 months without any success.
During the worst period, March 2017, I had trouble opening my eyelids in the morning, which was associated with pain and photosensitivity – then I thought this would never get any better! I believe an improvement came about using Restasis eyedrops, which I used for about 4 months. After that I continue for another 2 months with cyclosporine eyedrops made up by a specialized pharmacy. My intention was to use these drops indefinitely, until I found out that they contained NAC. Fortunately, via this forum I knew that NAC could be potentially very harmful, and I immediately stopped using the eyedrops. I discovered the solution to control my eye problem participating in chats in this forum. Particularly, I am grateful to MGD 1701, who told me about the Natrasan First Aid Spray and was kind enough to tell me about his experience with the spray. I think that it is quite possible that without the Dry Eye forum, I would still be doing battle with red eyes. My motive for writing this is to thank those who have provided me with advice, to emphasize how important it can be to participate in a forum like this and to offer hope to those that are near despair. I have been there, but improvements can unexpectedly occur, perhaps via a treatment you had not previously heard of – hope, I can testify, is always justified!

[Milo007]

Basically, the underlying problem of my symptoms is ocular rosacea that led to chronic inflammation of my eyelids, causing meibomian gland deficiency and superficial ocular hyperemia. I frequently experienced a foreign body sensation, stinging in my eyes or itchy eyelids. My eyes frequently went red. I had to use eyedrops containing a powerful corticosteroid almost continuously to control the situation. But only about 3 to 5 days after a treatment had finished, my eyes would go red again and I had to use another round of treatment. I also used 40mg doxycycline for 6 months without any success.

Firstly I would like to congratulate you for your success.

It's interesting that your ocular rosacea symptoms resolved with hypochlorous acid. I have been through many studies that associate ocular rosacea with an ocular demodex infestation. Hypochlorous acid is arguably known to kill the nymph forms of demodex species. You had eyelid itching which is a hallmark sign of demodex infestation. I wonder if continued use of HOCL actually eradicated demodex population by successively killing the nymphs of demodex not allowing them to mature and reproduce. Or was it purely a bacteria induced problem.

You said your eyes frequently went red. Can you specifically remember whether initially the redness was confined to the inside of your eyelids and the corners of your eyes?

I tend to have pronounced redness in the inside of my eyelids and corners of my eye. Never used HOCL.

The scleral part of my eye is almost clean with some dialated blood vessels much like the picture attached below.



I have had no past or present history of facial rosacea either.

[Alix]

I'm really glad for you. It's good to read success stories, it gives us all hope that one day we can be where you are today.
Thank you posting this.

[hannsho]

Hi Milo 007
Let me try to answer your questions.
As far as I know I have never been affected demodex, and I believe the itching I experienced on my eyelids was probably due to bacteria. Based on what I have read and learnt about ocular rosacea over the years, it seems that the precise cause of that affliction is not known. However, ocular rosacea is very strongly correlated with facial rosacea, so much so, that if you’ve got facial rosacea it’s almost certain that at some time you will suffer from ocular rosacea. Note, that the facial rosacea need not be very pronounced and often can only be diagnosed by a dermatologist.
The picture of the interior of your eyelids looks very much how my eyelids used to look like. Also, I think I remember the interior of my eyelids was affected before my eyes became red. The problem with inflamed eyelids, or posterior blepharitis, is that in time your meibomian glands can also become inflamed leading to a deterioration of the oil these glands produce. From there symptoms of ‘dry eye’ an ocular hyperemia often follow. This is where HOCL come in, as it can help prevent that the inflamed meibum affects the ocular surface.

Hope this is useful.

[How]

Thank you for posting, many of your symptoms sound like mine (though I also have lash loss, and think I have demodex on top of whatever else is going on). I ordered some of the spray and I am just waiting for it to show up. It's good to have some hope maybe things will improve. I hope you are "getting out there" with your improved eyes and making the best of life!

[hannsho]

Milo 007
Just one more thing. Looking at the picture you included in you last post, I noticed some red patches on your cheek, which, to me, look very much like a sign of facial rosacea. Of course, I’m not a doctor and these types of pictures often do not represent colours truthfully. But I think it is also worth pointing out that many doctors are still not aware of the connection between facial rosacea and ocular rosacea or posterior blepharitis.

[hannsho]

How, thanks for you comment. I’m not sure how helpful HOCLE is to deal with demodex, I have read conflicting reports. Also, don’t’ forget that I use Natrasan First Aid Spray as a form of maintenance treatment. The real curative effect was brought about by Restasis and the spray just helped me to prevent the situation from deteriorating again. When you do use the spray, sprayed on a cotton disc, wipe the disc along your eyelash line of your closed eyes several times and later also over your eyebrow. That might be beneficial in case you have demodex. I hope the spray works for you. Let me know how you’re getting on and good luck.

PS: I also suffered from lash loss.

[Milo007]

Milo 007
Just one more thing. Looking at the picture you included in you last post, I noticed some red patches on your cheek, which, to me, look very much like a sign of facial rosacea. Of course, I’m not a doctor and these types of pictures often do not represent colours truthfully. But I think it is also worth pointing out that many doctors are still not aware of the connection between facial rosacea and ocular rosacea or posterior blepharitis.

Thank you sir hannsho for pointing that out.

But the picture is not mine. I collected it from the internet. My facial skin doesn't have any redness whatsoever or typical signs of demodex infection. But my eyelashes have a lot of cylindrical dandruff and my opthalmologist confirmed that I have ocular demodicosis. The inside of my lower eyelids are almost similar to the one in the picture I shared. I had great success with oral doxycycline for a month when my meibomian gland secretions went up dramatically. So I am a bit confused about this. I can't figure out exactly if it's inflammation alone or inflammation from demodex infestation that's affecting my glands. Since the inside of my eyelids look similar as in the picture I thought I have ocular rosacea.

[hopeful_hiker]

I am excited to hear about your improvement. I am curious, do you know why HOCL helps? Do you think rosacea creates excessive thick oil that stagnates and invites bacteria to feast on it?

I stopped using Ocusoft spray and I think I noticed worsening of my symptoms.

[hannsho]

Hi Hopeful_Hiker
Yes, I think ocular rosacea (really chronic inflammation of the posterior part of the eyelids) can create oil deposits on which bacteria feed. This is mostly because the chronic inflammation of the eyelids will eventually lead to inflamed meibomian glands. I did a lot of research on this subject and this is what I wrote earlier about this subject:
HOW HOCL WORKS:
I think to answer this question requires first to outline how posterior blepharitis, meibomian gland deficiency (MGD) and dry eye symptoms are connected to each other. MGD has often been called posterior blepharitis because they are very closely related to each other. Posterior blepharitis is basically a chronic inflammation of the eyelid margins. This inflammation in time leads to the inflammation of the meibomian glands within the eyelids and to the deterioration of the oil (meibum) the glands secret. Healthy meibum covers and stabilizes the tear film preventing it's aqueous part from evaporating immediately. However, as the meibum thickens due to the inflamed glands it provides carbon for commensal bacteria that feed on it on the eyelid margins. This in turn leads to an overgrowth of the bacteria, for example of staphylococci aureus. Different types of bacteria fight each other for this source of this carbon and generate toxic proteins to attack each other, which may also harm the host tissue. In addition the bacteria generate enzymes, such as lipases, that break up the oil (meibum) of the tear film. Without the protective layer of the meibum, the tear film starts to evaporate much more quickly than would normally be the case, causing irritation and inflammation of the ocular surface i.e. dry eye symptoms. What's more the body's own response to these irritants can cause it to produce pro-inflammatory cytokines that further irritate the ocular surface. Please note that this is a simplified and shortened description of a very complex process.
So how can hypochlorous acid (HOCI) help?
First, HOCI destroys bacteria on the eyelid and eliminates any overgrowth. Second, HOCI inactivates the harmful enzymes released by the bacteria. Third, it suppresses the pro-inflammatory cytokines released by the body's own cells. All this is really phenomenal - it means that hypochlorous acid has an anti-inflammatory effect! Logically, it should also help to stabilize the tear film, which is no longer destabilized by harmful enzymes. In terms of dry eye symptoms this should translate into less inflammation, less irritation (foreign body sensation) and perhaps a lesser need to use artificial tear drops. Further, HOCI does all this without creating any bacterial resistance! I would summarize this by saying that hypochlorous acid represents an excellent and exiting new form to combat the symptoms of dry eye.

[hannsho]

Hi Milo 007

That sounds like a puzzle, and I can’t really think of anything that might cause the inflammation of your eyelids. I think it is important though for you to try to reduce the inflammation on the inside of your eyelids, since this could inflame your meibomian glands and affect the discharge of healthy meibum. Using HOCL has considerably reduced that inflammation in my eyelids. So, the only thing I can think of is for you to try HOCL to see if it also works for you. Sorry, cant’ think of any other idea that might be helpful.

[miche84]

Thanks so much for sharing your experience with HOCL. I have been using a HOCL product (first Avenova ,then Heyedrate, and now HyClear, all of which are basically the same product) but am still experiencing a lot of sclera and behind the eyelid redness. So I am super curious as to how you apply the HOCL. Do you spray it directly onto your closed eyelids? Do you wipe it on to your open eyes along the lid margin with a q tip? What do you think is the best method and what has been most effective for you? Thanks for any info!

[Milo007]

Hi Milo 007

That sounds like a puzzle, and I can’t really think of anything that might cause the inflammation of your eyelids. I think it is important though for you to try to reduce the inflammation on the inside of your eyelids, since this could inflame your meibomian glands and affect the discharge of healthy meibum. Using HOCL has considerably reduced that inflammation in my eyelids. So, the only thing I can think of is for you to try HOCL to see if it also works for you. Sorry, cant’ think of any other idea that might be helpful.

Yes honestly I am puzzled too. I know for sure inflammation is the regulator of my meibomian gland secretions. But couldn't figure out the cause of inflammation yet. I will try HOCL though.

[hannsho]

Hopeful_Hiker
Just one more thing. You mentioned that you had used Ocusoft. I think when you evaluate the results you might also consider that Ocusoft contains a preservative - sodium hypochlorite or bleach.

[MGD1701]

HOCL
The secret is the purity. Before I found NatraSan spray almost 2 years ago, I found/tried two other brands -
one is not pure which made my eyes inflammed.

In short, not all HOCL sprays are the same. NatraSan is pure like Avenova.
They have added: 'can be used in and around eyes', in their (new) bottles - I just brought some a few months ago.

Another new brand: Bruder, USA, not sure its purity.