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My History With Dry Eye - Suggestions Welcome!!!

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  • My History With Dry Eye - Suggestions Welcome!!!

    Hello everyone, this is my first post of this board and I have to say I’m thrilled to have found this place. There is not a lot of specific information about dry eye on the internet, and it’s great we have a place to come together and exchange information.

    I’d like to just give you all my background with chronic dry eye and if anyone has any suggestions for me, as far what direction to go, I would greatly appreciate it!

    Age: 36
    Gender: male
    Occupation: Computer work 8-10 hours per day

    BACKGROUND:


    -2004 - Experimented with contact lenses, I could not wear them very long without experiencing a lot of dryness and discomfort, so I discontinued use and switched back to eye glasses.

    - 2006 - I started wearing soft contact lenses again. When I started out, they were fairly comfortable to wear for a couple of weeks. After that, the amount of time I could wear them gradually decreased every week until eventually they were just too uncomfortable to wear. My eyes were very dry and irritated with them. It got to the point that I went back to my ophthalmologist about the eye irritation and dryness. This started my 5 years of misery battling Chronic Dry Eye.

    DOCTOR VISITS:


    2007 – Dr. Gordon Miller, Aventura, FL (several visits)

    - Diagnosis:

    - Giant Papillary Conjunctivitis. Probably from contact lens wear.
    (The GPC was cleared up)

    - Chronic Dry eye

    - Dry Eye Treatment:

    - Stop contact lens wear.
    - Try various artificial tears eye drops for dryness.
    - Change blinking habits to blink more
    - Omega 3 fish oil
    - Restasis 2x day


    Early 2008 - Dr. Kendall Donaldson, Bascom Palmer Eye Institute, Miami, FL (two visits)

    - Diagnosis: Dry eye (confirmed with Shirmer’s test)

    - Treatment:

    - Restasis continue 2x day

    - Pataday 1x a day (said eyes have an allergic look to them).

    - Artificial tears continue

    - Genteal Gel at night

    - Omega 3 tablets.

    - Warm compresses 2x day (1 minute per eye)

    - Try Dissolvable punctal plug in right eye. (actually made things worse)



    Late 2008: - Dr. Victor Perez, Bascom Palmer Eye Institute, Miami, FL
    (Chronic Dry eye, Dry eye research is one of his
    specialties).


    - Diagnosis: - This is basically what he said: “Most people with ‘severe’ dry eye have very obvious ocular surface irritation, problem that they can see with their instruments. BUT, for some people, people in my category, it is not as obvious under their instruments. He ‘knows’ the symptoms I experience are real, they just don’t know why.”

    - Treatment: - Try Autologous Serum drops. (These are tears that are prepared from my own blood serum). 4 drops per day in each eye. He said “For people in my category, the serum drops are a 50/50 chance of working. Versus people that have extremely dry eye, they normally work 80-90% of the time”.



    2009: -Dr. Christopher Gelston, Kantor Eye Institute, Sarasota, FL

    - Diagnosis:
    -Young for dry eye.
    -Shirmer’s test ( 7 and 9 out of 15)
    - eye’s look allergic (3rd doctor to say that to me).
    * He also had me do a complete workup by a local
    Rheumatologist for the possibility of Syogren’s
    Syndrome. My tests came back negative.

    - Treatment:
    - Pataday try again.
    - Restasis continue 2x day
    - Doesn’t think moist compresses would help my
    situation. He doesn't think I have a meibomian
    gland problem.
    - can try the moisture chamber goggles
    - try flax seed oil (2000mg 2x day) (give it 4-6
    weeks. ( I had previously tried Fish oil capsules
    and BioTears without any success. But he said
    the flax seed oil works differently and a lot of
    patients have success on it.)



    OTHER:

    - Took Accutane at age 17 for about a year.
    - Environmental allergy sufferer. Took immunotherapy allergy shots for about three years up until a few months ago.



    WHERE I STAND TODAY:

    What has helped:

    - Preservative free artificial tears (5-8 doses per day) I’ve tried several brands, but Alcon ‘Naturale Free’ seem to be the most cost effective.
    (The artificial tears take the edge off, but don't solve the problem by any means)
    - Restasis - I really don’t think this has helped me very much after four years of use. MAYBE slightly. Certainly not enough to justify the cost. I stopped taking it a couple of weeks ago.
    - Limiting air conditioning as much as I can.
    - Making sure I get 8 hours of sleep.


    Things I have not tried yet:
    *Everything else mentioned in my above visits I tried without success. (Even the Autologous Serum drops).

    - Moisture Chamber goggles.
    - Flax seed oil. (I’m torn with this one, as there are four studies showing correlation between flax seed oil and an increase risk of prostate cancer).
    - I am trying to blink more as my first doctor recommended (Hard to remember!).
    - Dr. Gelsten said the next thing to try would either be low-dose Doxycycline
    or a product called ‘Tylenol in a bottle’ (might also be known as Zybron, but I’m not sure about the spelling of that).
    - Drinking more water everyday "consistently".



    Words can’t express how frustrating this experience has been these past five years, and I’m really not sure where to go from here on this. I recently discovered a couple of doctors in Tampa, FL who seems to specialize in Dry Eye. Dr. Steven ****** and Dr. Lange. I can’t afford to see either of them right now, but I am going to order Dr. ******’s book and start reading Dr. Lange’s information he posted on this forum. I’ll probably give the moisture chamber goggles a try next week.

    If anyone has any advice for me, I’d love to hear it. Thanks for taking the time to read my long post!
    Last edited by JJdryeye; 17-Jul-2010, 13:03.

  • #2
    Originally posted by Chemia
    The "tylenol in a bottle" is Xibrom. I tried it for 4 weeks to see if I could get some reduction in pain. It helped slightly but not enough to justify the cost. I paid $50.00 per month and a very slight pain reduction. Moisture goggles are nice if you are in a troublesome environment. I wear the climate control wileys prescription and sunglasses. Your schirmers are not so horrible though. 10 is a more realistic number than 15. Low dose doxy maybe 20 mg twice per day is a good idea. I was on it for several months but stopped recently - worth trying though.
    If your glands are not clogged that's a good thing, but then why does your doctor want to start you on doxy?
    Have you tried doing your compresses longer?
    Hi Chemia, thanks for your response. I think my big concern on some of the meds are the unknown long term side effects. Perhaps the Doxy might be something to consider.

    My last doctor didn't know for sure if my m-glands were clogged or not, he just suspected that they aren't based on visual observation of my eye lids. Yet the other doctors recommended the warm compresses, so I think the jury is still out. What is the best method for using the compresses? I always had a feeling in the past that my washcloth wasn't warm enough and I wasn't using it long enough to make a difference.

    The other people in my house tend to run the AC at about 76 at night, so it comes on quite a bit. So I figure the goggles might be worth a shot. The only thing is, I can't say that my eyes are any more dry in the morning than usual, if anything, they are usually better in the morning and get worse as the day goes on. But, I figure I probably should try any possiblity at this point.

    Comment


    • #3
      Originally posted by Chemia
      Forget about the warm wash cloths and use the rice baggy sold at the dry eye shop. I made my own with Basmati Rice and it works great. I keep it on for 20 minutes and hold it with a velcro strap. I do it in the morning only. Yes I agree about being on meds long term and I guess that is one reason why I stopped experimenting with pain medication orally. Doxy at low dosages is a good anti-inflammatory and you can avoid the side effects at lower dosages. I eventually stopped only because I developed horrible heart burn but some take oracea and do quite well. Your opther option is azasite on your eye lids if doxy gives you trouble. Ask your doctor - he may even put you on both.
      I also use oasis tears plus - its pleasant and better than anything else I have tried. I may eventually experiment with dwelle. Both can be purchased from the dry eye shop.
      I like to wear my wileys in my car since I have a long commute to work or when I am outside and take long walks.
      Good luck!
      Thanks for the tips! I'll give that Basmati rice idea a try for a longer period. What did you put your rice in?

      Comment


      • #4
        Hi, I'm not chemia, but will put in my two cents . I use a sock for the rice. Socks are just the right shape to lay over the eyes. I use a fairly lightweight sock, don't really know if the weight matters though. I use plain rice, the cheapest I find. Works great.

        Chemia, is there an advantage to using Basmati rice? I was wondering if the aroma helps on some way.
        Last edited by magoo; 18-Jul-2010, 10:35. Reason: added question

        Comment


        • #5
          Thank you all who have read my thread. I was hoping for a few more replies and some advice on what my next step should be. If anyone would like to offer up some more ideas I'm all ears!

          One thing I should have stressed more in my original post is my suspicion that Accutane may be behind my dry eye condition. As I stated before, I took Accutane about 18 years ago for about a year to treat my acne. Ever since being on that drug, my lips have never been the same. I believe the Accutane permanently damaged the glands that provide oil to my lips. I've had to put chapstick on my lips 3 or 4 times a day for the past 18 years just to get by.

          It was right after my Accutane experience, that I first experienced some mild dry eye symptoms. And then about five years ago, those mild dry eye symptoms became more of a moderate-to-severe problem that has really interfered with my life.

          I'm not sure if knowing the root cause really matters or not, but I have to wonder. If the Accutane screwed up my lips, why not my eyes too? My last doctor didn't think my glands were clogged. So I think one theory could be, maybe they aren't clogged, maybe they just aren't producing enough oil because they were damaged. Sounds reasonable to me.

          Comment


          • #6
            JJ, without performing a search on here, I can tell you through the years Accutane has caused dry eye in many people. I can't tell you any more about it or if you can do anything more than for regular dry eye. But don't let any doc tell you Accutane can't cause dry eyes.

            You might also want to search this site. There is lots about accutane.
            Don't trust any refractive surgeon with YOUR eyes.

            The Dry Eye Queen

            Comment


            • #7
              Accutane & dry eye

              Accutane reduces sebum production. One treatment recommended in the rosacea community is DHEA supplementation. DHEA increases oil in the skin, eyes etc. I have found it to be very helpful. You may notice an increase in acne as a side effect.

              Comment


              • #8
                Thank you Lucy and Pinky! I'll look into the DHEA. I think if there is one thing I'm learning from this forum is that Dry Eye is one of those conditions where the patient really needs to take a proactive role in finding a solution that is best for him or her. It's mind boggling how many potential remedies are out there. Looks like I'm in for a long road of trial and error.

                Comment


                • #9
                  Originally posted by Chemia
                  Forget about the warm wash cloths and use the rice baggy sold at the dry eye shop. I made my own with Basmati Rice and it works great. I keep it on for 20 minutes and hold it with a velcro strap. I do it in the morning only. Yes I agree about being on meds long term and I guess that is one reason why I stopped experimenting with pain medication orally. Doxy at low dosages is a good anti-inflammatory and you can avoid the side effects at lower dosages. I eventually stopped only because I developed horrible heart burn but some take oracea and do quite well. Your opther option is azasite on your eye lids if doxy gives you trouble. Ask your doctor - he may even put you on both.
                  I also use oasis tears plus - its pleasant and better than anything else I have tried. I may eventually experiment with dwelle. Both can be purchased from the dry eye shop.
                  I like to wear my wileys in my car since I have a long commute to work or when I am outside and take long walks.
                  Good luck!
                  Chemia, Just thought you might be interested in knowing that the rice-sock treatment has been helping. At first I did it for 15 minutes, 3x a day, and found that it was actually irritating my eyes. But after backing down to 1 or 2 treatments a day, I find it does indeed help. My eyes feel awesome right after the treatment, and the benefit seems to last for quite a while, as well as having a cumulative effect as the days go by. It's not a cure or anything, but it has definetely helped.

                  What I'm not sure of is how long I should be doing lid massage.

                  Comment

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