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Finally there is hope!
I looked in the list Neil provided of Tear Film and Ocular Surface Society members ( http://www.tearfilm.org/ ) and found the only member who has a practise in London, England.
Made an appointment with him -- Dr. Michel Guillon.
The man is amazing. After extensive tests of my vision, front and back of my eye, tear glands and subjective reports, he made a few notes and announced that:
* My first, unhelpful doctor in Sweden had been essentially correct -- I am making too much oil from the meibomian glands, and I have blepharitis. (But she had had no suggestions on what to do!)
* The blepharitis' original cause is unknown, but the current cause is the excess oil dripping down onto the lid.
* The oil is not the right balance of polar and non-polar lipids and is therefore mixing with the liquid tear layer, contaminating the mucin layer, and causing conjunctival damage, visible with stain.
* One of my meibomian glands is a dead crater (visibly so) and others are in poor shape.
And he had some changes to make to my routine:
* Restasis and other oil-based emulsions (Soothe, Endura) are a very bad idea for me, since they just add to the excess oil and oil penetration. Stop them all.
* Warming is a bad idea for me, but cooling the lids helps. Cool compress at night.
* Regular lid wipes are essential to remove the excess oil. morning and night for now.
* Theratears gel at night, Theratears liquid in the morning, good for hypotonic cleansing and dilution of the excess oil. Systane unidose (preservative-free) several times daily to heal the mucin layer.
* wraparound shades when outside
* change to reading glasses prescription for more eye movement
*
Best of all, he thinks he can make some dramatic improvements, and I have started to see them! Eyes are feeling and looking better already.
The power of knowledge. Thanks to Neil and to all of you for your support. And let's add "excess hydrophilic lipid production" to the list of MGD types...
I looked in the list Neil provided of Tear Film and Ocular Surface Society members ( http://www.tearfilm.org/ ) and found the only member who has a practise in London, England.
Made an appointment with him -- Dr. Michel Guillon.
The man is amazing. After extensive tests of my vision, front and back of my eye, tear glands and subjective reports, he made a few notes and announced that:
* My first, unhelpful doctor in Sweden had been essentially correct -- I am making too much oil from the meibomian glands, and I have blepharitis. (But she had had no suggestions on what to do!)
* The blepharitis' original cause is unknown, but the current cause is the excess oil dripping down onto the lid.
* The oil is not the right balance of polar and non-polar lipids and is therefore mixing with the liquid tear layer, contaminating the mucin layer, and causing conjunctival damage, visible with stain.
* One of my meibomian glands is a dead crater (visibly so) and others are in poor shape.
And he had some changes to make to my routine:
* Restasis and other oil-based emulsions (Soothe, Endura) are a very bad idea for me, since they just add to the excess oil and oil penetration. Stop them all.
* Warming is a bad idea for me, but cooling the lids helps. Cool compress at night.
* Regular lid wipes are essential to remove the excess oil. morning and night for now.
* Theratears gel at night, Theratears liquid in the morning, good for hypotonic cleansing and dilution of the excess oil. Systane unidose (preservative-free) several times daily to heal the mucin layer.
* wraparound shades when outside
* change to reading glasses prescription for more eye movement
*
Best of all, he thinks he can make some dramatic improvements, and I have started to see them! Eyes are feeling and looking better already.
The power of knowledge. Thanks to Neil and to all of you for your support. And let's add "excess hydrophilic lipid production" to the list of MGD types...
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