New Member, from Australia

[FearlessTearless]

Hi all. What a great site! I'm still amazed to see all this information in one place. Also more than pleased by all the personal stories and the support you offer to each other. I hope to be able to repay in kind, with anything I learn along my own dry eye journey.

My dry eyes started about 20 years ago (mid 30's), out of the blue and gradually. I have a few 'issues' that all seem to add up to an autoimmune disorder. It started with inflamed tendons in my wrists and went south from there. Sometimes I test positive for antibiodies that point to Lupus, but have pitted nails, which the rheumatologists seem to think may indicate a mild case of psoriatic arthritis. Hm. Diagnosed hypothyroidism, fibromyalgia, rosacea (thankfully not ocular), ad nauseum. You get the picture, there is no picture! I like to describe it as BBS (bad body syndrome).

I did have Lasix about 12 years ago, but truthfully, it didn't seem to make a lot of difference to the dry eyes.

The pain meds which work best for me contain codeine, which doesn't help the dry eyes, but life with dry eyes is enough fun without putting up with more pain. A compromise.

Other than, "you have dry eyes and blocked oil glands" I have never been given any more specific diagnosis. Until I found this site, I didn't even know there were different sorts of dry eyes! Tests? There are tests?

I've managed, more or less, for years a with maintenance regime of hot wet wash cloths, a bit of eyelid hygiene and a variety of 'goops'. Symptoms vary and seem to come in bouts. Persistent scratchiness, 'sand in the eyes', blurry vision, foreign object, the stabbing pain of occasional corneal ulcers and so on. Because I do have good days I have simply put up with the problem, as I have too many other issues to deal with. This is not the fun way to be a 'high maintenance' woman!

What has pushed me to look for answers is recent cataract surgery which has caused the dry eyes to redouble their efforts. I will post my questions about this new thrill in a different section.

Because I usually wake with 'stuck' eyes, the moist sleep goggles sound great. For a few years I've been using a sleep mask to block out light, but had to discontinue after the cataract surgery. Not using the sleep mask may also have contributed to this current dry eye flare up. Who knew??

My wonderful GP of about 15 years retired and now I am at the mercy of a doctor who makes me feel like I'm an irritation when I bring up any new symptoms, like tinnitus, loss of circulation causing tissue death on my toes and so on ("So, what would you like me to do about it?"). No need to describe her non response to my current dry eye flare up. Finding this terrific source of information and inspiration gives me hope for figuring this out. I now intend to be a lot more aggressive (in a nice way ) in getting some answers. Oh, and I'm shopping for a new GP.

From suggestions on this site I decided to try using a rice baggy (sock), nuked. I've been unreliable using the various hot packs because they drape across too much of my face, which makes the rosacea flare up. Having to do one eye at a time doesn't encourage compliance; I have another life besides dry eyes, damnit all. Anyway, with the sock, I can leave it loosely packed and twist the centre so the heat isn't lying across my nose. Doh! So simple that it never occurred to me!

Thank you to the rice baggy pros who kept repeating this advice in post after post (yeah, I'm a lurker). Having a cup of water in the microwave seems to make the rice into a semi moist pack. I think it would be better to use a sheer cover, such as a bit of panty hose as I'm now concerned that I'm going to breed up some delightful fungus in the not entirely dry rice ? Never mind, it works better than any of the other hot packs suggested by optometrists/ophthalmologists.

Cheers,
Polly

[SimpsonDesert]

Hi Polly

Symptoms vary and seem to come in bouts. Persistent scratchiness, 'sand in the eyes', blurry vision, foreign object, the stabbing pain of occasional corneal ulcers and so on.

I'm from Sydney. Your symptoms sound *exactly* like mine (post cataract surgery, but minus any other health problems). I was in total misery and had had all sorts of run-around - "it's blepharitis so just use drops and put up with it; It might just go away; It's chronic and nothing can be done; I've seen worse so what's your problem..." Then I found a specialist with a regime of treatment that has brought me from a really bad state to still subnormally dry but no longer in pain in about 4 months, preceeded by 10 months of suffering.

The key to the treatment seems to be inflammation control, along with other supporting measures. After 4 months on Minims .05 prednisolone steroid drops, my ocular inflammation is right down, and corneal staining and erosions are all clear from an initial status of 6/10 in severity! I have also been using the hot compresses and ongoing lid hygiene, doxycycline in diminishing doses, omega-3 suplementation and anti-depressants which help by raising the pain threshold. The steroids can raise ocular pressure (and give you cataracts!!), and fortunately the pressure remained normal. Through the course of the treatment I sometimes felt even drier and more uncomfortable, but am now almost symptom-free and can tolerate mild breezes and ambient air conditioning. The mebomian glands though still compromised have improved under this treatment. Patience over a period of months is required.

I'm just about to taper off the steroid and go onto autologous serum drops, in the hope that the still substandard TBUT and other indicators will gradually improve. Dr believes in proceeding step by step, as opposed to the 'kitchen sink' approach of doing everything at once and concluding that nothing works. I am converted to the idea of inflammation control as a precursor to further improvement - in my case the difference has been life-savingly spectacular though the dry eye condition remains.

There are no magic bullets, only conventional treatments intelligently and consistently applied, with dry-eye specific tests to monitor progress. Dr Chan runs the only (so far as I know) specialist dry eye clinic in Australia. If you're within cooee of Sydney I'd strongly advise you to see him - a referral from your GP or an Optometrist is all that's needed.

Dr Colin Chan
MBBS, FRANZCO, Ophthalmic Surgeon
Level 2, 75 Grafton St
Bondi Junction NSW 2022
Tel (02) 9387-4355, Fax (02) 9387-5573
(This is the location of the dry eye clinic - at Vision Eye Institute, alas a lasik mill).

Re heat treatments - I use the smaller gel surgical packs from the Chemist for sprains etc - only the strong expensive ones, two on the go dunked alternately in a lidded saucepan of hot water, with a wet hanky as a buffer zone. You can still twist them to spare the face (yes that is a hassle) may be a bit more 'sterile' than the rice?

Do feel free to PM me if you wish. You can go into your user settings and click on the option that will let you know by email if anyone has contacted you via this site. Later on I'll post info on Plug-a-doc re Dr Chan, as he has given permission to do so. I'm waiting to see how my results pan out longer term before trumpeting triumphs on this excellent forum.

Cheers mate!
Simpson Desert