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  • New member. Would love to get suggestions.

    Hi All,

    I'm new to this forum. I believe I read about it in Dr. Latkany's book, which I bought when I realized that the doctors I visited weren't taking my problem seriously and couldn't give me an explanation as to what was happening.

    My dry eye problem started a year ago. Perhaps there were a number of factors that contributed to it, I don't know for sure. It was cold and dry, I was working long hours at the computer and I also started wearing contact lenses at work b/c I felt I could see better this way. Prior to that I was mostly wearing glasses to work and wore contact lenses on the weekends.

    One day I noticed some redness in my right eye that didn't seem to go away. I had a check up with my optometrist and asked her whether I could still wear contact lenses. She said that redness around my eyes suggested I had blepharitis. She said that contact lenses weren't an issue and that I had the best contact lens on the market--I was wearing Day and Night at the time though I was not sleeping in them. She also prescribed Alrex for a couple of weeks to reduce the inflammation.

    About a month later, I started getting intense pain in my eyes during work, to the point that I couldn't keep my eyes open. It became clear that contact lenses were contributing to it though they never bothered me before except for occasional tearing and styes, which I thought were normal. I stopped wearing them completely and went to see a different doctor.

    By the time I saw the doctor, my eyes became covered in very enlarged and prominent red blood vessels going across both of my eyes. Despite not wearing contact lenses, both the redness and the pain kept getting worse. This doctor gave me a list of over-the-counter drops I should try. As for the blood vessels, he said they rarely go away. The drops didn't help and I was getting extremely depressed, so I found an ophthalmologist in the area who did lid expressions. She said she could help me. A few days after the visit, my eyes were feeling a bit better. She also prescribed Lotemax to reduce the inflammation, but it did nothing. In a few weeks, the burning and the pain returned.

    At the beginning of March, I found Dr. Latkany's book and started doing warm compresses and eyelid scrubs. Some days I would feel better, but it never felt quite right. I thought that maybe it had something to do with my computer, so I played with resolution, reduced brightness and got anti-glare screens. For a while this seems to do the trick. The pain and the burning went away, but my eyes were as red as ever. My doctor than prescribed Flurometholone for a few weeks, but I had an adverse reaction to it, so I didn't finish the entire course.

    I didn't want to give up, so I found another doctor. While everyone I saw seemed to agree that I had blepharitis, they didn't know why nothing I tried was working. She tried to test me for tear production by putting little pieces of paper on my eyelids and giving me some drops, but the test failed because my eyes started tearing. It's hard to tell whether it was a reaction to the drops or the realization that no one will be able to help me. Eventually, we decided to try Doxycycline (100MG twice a day). I've been taking it for 3 months now--the burning and the redness got worse.

    I'm not sure what else to do. No compresses or scrubs or prescriptions seem to make it better. I tried doing eyelid scrubs with tea tree oil shampoo and baby shampoo, and it’s not doing anything. I use GenTeal drops and other preservative free drops multiple times a day. Sometimes the symptoms seem to go away only to come back again. But even when my eyes feel better, they remain devil red, and it keeps getting worse. I can't use contact lenses at all at this point because even wearing them for a couple of hours results in immediate permanent redness. But even with glasses, the condition keeps getting worse albeit at a slower rate.

    Is there anything I can try to reduce the pain and to make the blood vessels less visible? It’s been a year, and my eyes are covered in them. Even when eyes start feeling better, they never look better. I don't want to use vasoconstrictors because I know they will only make it worse in the end and I haven't been, but is there anything else that could help? The only thing that I haven't tried at this point as far as I know is Restasis and plugs. Could these do anything for me? I refuse to believe there is nothing that can be done. Could the diagnosis be incorrect? I would appreciate any suggestions. Thank you!

  • #2
    Hi KateLi and welcome.

    There are a lot of people here with persistent redness who will know more about it than I do and will probably have some good ideas to pursue. I'll share a few things that come to mind though.

    1) moisture chambers, moisture chambers, moisture chambers. My mantra lately. The faster people get into this the faster the pain usually gets under control, and it can give you some hope while in parallel you're continuing to pursue better diagnosis & treatment.

    2) Check out the tips in the archives about computer use. Top tip always moisture chambers. Computer use is a major trigger for a lot of people here because of the 'blink rate' factor among other things. There's also other tips like adjusting your position and the computer so you're looking down rather than straight or up so that you reduce the amount of exposure of the cornea.

    3) Allergy possibility ever mentioned by one of your doctors? - Something we all have to bear in mind is, a dry eye is more vulnerable to everything, including allergens.

    4) Any possibility something you're currently using is perpetuating the problem? A way to test this (not fun but... worth trying) is, get into moisture chambers and go cold turkey on drops for a couple of days. I've often come across people who have a sensitivity or allergy to the carbomethylcellulose so common in artificial tears.

    5) If everybody agrees you have bleph and you improved after an expression, well, you've got bleph but... sometimes the devil is in the details with bleph treatment. How are you doing the compresses? the scrubs? ever tried Azasite?

    6) How do you feel about Restasis and/or plugs? did any of the doctors want you to try? They really do help some people.

    7) I know a couple of optometrists who are good at this stuff... both of them I learned about from people in this forum. Paul Jensen in Renton, and Paul Williams in Tacoma. Not close but worth it.
    Rebecca Petris
    The Dry Eye Foundation
    dryeyefoundation.org
    800-484-0244

    Comment


    • #3
      Hi All,

      Thank you for your replies! I ordered Tranquileyes last week, so should be getting them in the mail soon. With respect to Azasite, this was the drop that my doctor prescribed a few weeks ago. The bottle seemed to last me only about a week, and my eyes did burn pretty bad. I'm willing to put up with some burning if something is helping, but I saw no improvement. Could it be that I didn't use it long enough?

      I mentioned Restasis to my current doctor, but she seems hesitant to prescribe it. She says it's meant for patients who don't produce enough tears, not for those with MGD/bleth. I'm happy to try it if she lets me. Can it do harm? I'd prefer not to use plugs, but if it means my eyes will feel and look better, at this point I'd do it.

      GenTeal has been the only drop that has worked for me over that past year. Everything else seem to dry out my eyes even more for some reason. But I have been mixing drops recently--Azasite, GenTeal and Rerfresh and the Optics MiniDrops (I was running out of GenTeal and they got one time use ones free at work). Perhaps I should just stick with one type. GenTeal is preservative free in the eye--is it safe to use 4+ times a day? I also ordered Dwelle and Oasis from the shop last week but haven't tried them yet.

      One of the doctors (the one who does lid expressions) mentioned that I had bumps under my upper eyelid when she inverted it. She gave me a drop that was supposed to deal with the allergy, but I didn't see any difference (threw out the bottle, so can't remember the name).

      I scheduled a visit to Paul Jensen in January in his Bellevue office (found him through this website). I'm hopeful he can recommend something others haven't.

      For warm compresses, I heat the Eye Spa Pad in the microwave for 30 seconds. Place it on my eyes for 3-5 minutes. Then, I mix a drop of baby or tea tree shampoo with hot water in a shot glass. I then use this solution to wipe my lid margins with a Q-tip for a few minutes. Am I doing this correctly?

      Thank you!

      Comment


      • #4
        Originally posted by KateLi View Post
        I mentioned Restasis to my current doctor, but she seems hesitant to prescribe it. She says it's meant for patients who don't produce enough tears, not for those with MGD/bleth.
        That's correct as regards the basis on which it got FDA approval... however I think in the last couple of years the dry eye specialists have been observing improvements to MGD with Restasis. I'm not pushing it (never used it myself) just mentioning as it's being used for this a fair amount now.

        GenTeal is preservative free in the eye--is it safe to use 4+ times a day? I also ordered Dwelle and Oasis from the shop last week but haven't tried them yet.
        I think given the level of irritation/redness it would be safest to stick exclusively with 'true' preservative free drops. The sodium perborate in Genteal certainly can be an irritant for some people.

        One of the doctors (the one who does lid expressions) mentioned that I had bumps under my upper eyelid when she inverted it. She gave me a drop that was supposed to deal with the allergy, but I didn't see any difference (threw out the bottle, so can't remember the name).
        GPC from the contacts maybe? How long did you use the drop? (pataday, patanol, something else maybe)

        For warm compresses, I heat the Eye Spa Pad in the microwave for 30 seconds. Place it on my eyes for 3-5 minutes. Then, I mix a drop of baby or tea tree shampoo with hot water in a shot glass. I then use this solution to wipe my lid margins with a Q-tip for a few minutes. Am I doing this correctly?
        Sounds good BUT baby shampoo and tea tree oil shampoo can also be irritants for a lot of us (certainly for me). You might want to try dumbing this down - either using one of the mildest lidscrub products (like ocusoft regular foam) or like I used to do, just plain unpreserved saline... again, eliminating as many chemicals as possible so you can start ruling things out.
        Rebecca Petris
        The Dry Eye Foundation
        dryeyefoundation.org
        800-484-0244

        Comment


        • #5
          Possible computer problem?

          Some years ago while looking for a permanent position, I took a temporary computer position working evenings entering company data on the then common green on black CRT screen of an IBM computer. (1970's) I liked the job but even though until then I'd been able to read books for many hours at a time, I found my eyes would sting within an hour of sitting down to enter data and I ended up having to cover one eye just to continue the eight hours.

          I soon figured out that the big problem had to do with the fact that the CRT display was not well focused and that my eyes were trying to compensate by working extra hard to focus properly. I don't know if any computer display problems these days are like that but it seems worth looking into. I certainly have been very careful ever since to only use displays that are in clear focus. Maybe one could check the display with a magnifying lens and see if the type is still in clear focus. I don't know if this helps but I sure wish you success in finding answers.

          Comment


          • #6
            Not dry-eye related, but...

            I still have trouble focusing on a modern flat panel. I wear reduced strength glasses (myopic, presbyopic) but still have problems.

            My focusing problem: After working at the computer for even a short time (1/2 to 1 hour) my eyes don't work together to see in the distance. It's like I get temporarily crossed-eyed and then I see double in the distance. This is very annoying when I have to drive someplace right after using the computer. Sometimes I have to close one eye to see without distraction.

            The double vision goes away after about 20 minutes.

            Oddly enough, I don't have this same problem reading. I can read for hours without my eyes getting "locked."

            Calli

            Comment


            • #7
              scrubs

              Eyelid scrubs, baby shampoo, tea tree oil is all for anterior blepharitis which means inflamation on the outside of the eyelids in the eyelash area. Miebomian glands being plugged with hard oils and overgrowth of bacteria living on them is called posterior blepharitis, or meibomitis. Warm compresses, oil expression, and antibiotics are all therapy for posterior blepharitis. (Which may or may not work)

              Comment


              • #8
                I have the same thing as Calli. I can read forever and not have vision problems after but a short time looking at the computer screen and my vision is terrible for awhile afterwards. And, my dry eye symptoms really increase terribly, the longer looking at the screen, the worse my eyes get.

                Comment


                • #9
                  Calli, I believe that problem you describe is something called convergence insufficiency or something like that. It's where the eyes don't work together and I think it's a muscle issue. I remember an optometrist telling me years ago that I show some signs of that. But I never had an issue with reading and it didn't bug me. I think there are exercises that you can do to strengthen the muscles and help them to work together better.

                  LL

                  Comment

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