New to site - have excess tears from DES

[Florida Lady]

I've been reading a lot of the posts here, and don't see anyone mention excess tears resulting from dry eyes. That's my current issue. My dry eyes began a few years ago. I'm a gramma in my 60s, and still work daily -bookkeeping on a computer 5-6 hours a day. The dry eyes became more and more annoying - not painful, just, well, dry. I began using liquid tears, and as most report, got minimal temporary relief. They were never debilitating or prevented me from doing anything. Last December, I contracted Conjunctivitis. After nearly 4 months of treatments with various combinations of drops and ointments, the Conjunctivitis appeared to be gone. However, within 4 or 5 days of stopping all drops and ointments, the tears began to flow. That was late March. I'm still blotting my eyes. Some days the whites of my eyes appear pink or off white. My doctor began another series of trial and error drops and ointments to see if anything would provide relief. The eye doc tells me the one ointment that gives the best results may create pressure in the eyes from prolonged use. So, I'm staggering use of the ointment, using warm compresses twice a day, and using liquid tears intermittently, all of which seem to help a little. The doc has mentioned Restasis, which he says I would have to use the rest of my life once I start it. He also mentioned duct plugs, but wasn't high on those either because they can fall out. Does anyone have a success story about excess tears?

[littlemermaid]

Hello Florida Lady,

Our excess tearing (epiphora) was because meibomian glands were blocked - tiny oil glands on the eyelid margins that normally supply oils to the tear film on the eye surface when we blink or rub the eyes. The oil keeps the aqueous tear film from evaporating off too fast, and without it the lacrimal glands overcompensate making lots of aqueous tears. My daughter's spectacles used to be quite spattered and we cleaned them carefully every day.

Is the ointment you are using now a steroid eyedrop? Or a mixed antibacterial + steroid ointment?

Once the meibomian glands have clear oil again, the tear film starts to improve so much. Like you, we achieve this with warm compress, short courses of antibacterial ointment/drops if really necessary, and meanwhile control inflammation with steroid eyedrops if unavoidable. Then we taper off drops to absolute minimum, and keep things good with tear substitute eyedrops if needed (normal saline for us, though many people need something more viscous). I think it's useful to regard these eyedrops and ointments not as healing, but rather as keeping things going until the eye can restore itself. So I can give you a success story of a sort.

Like so many other things in life, we get used to maintenance to keep things well. We use wraparounds, humidifier while on the computer (adjust your angle so minimum eye surface is exposed, ie you're looking down on the screen - remind yourself to blink frequently), stay away from a/c, drink water, keep the eyes good with daily warm compress and gentle cleaning. Being super-careful helps the eyes to recover. Your case is so promising while you still have excess tears (before the eye surface toughens up too much - very early stage). The trial and error process made us more sensitive to what helps/what doesn't.

It is very important to consider with your doc that you need to minimise any possibility of getting too sensitive to the chemicals in the eyedrops (especially not to use preservatives) because this 'toxicity' seems to change the eye surface, reducing the prompts to tear up, and make the meibomian glands pack in too. Also, fluid passes through to the tear film from inside the eyes, hydrating the outside layers, and this function gets damaged by the chemicals too. Sensitivity to the eg preservatives could be stopping your eyes getting better. Prof Christophe Baudouin explains all this is so well in this YouTube video on dry eye http://www.youtube.com/watch?gl=GB&v=XOAkmt7RTYk

So, now the eyes are more sensitive than before, think about and eliminate chemicals that might be making your eyes allergic-sensitive at home, like shampoos, perfumed products, makeup, face creams. Some people even get nickel allergy to their spectacles. We are finding these things distress the glands and the eye surface too (click on SAAG and MaryVA61's names for past posts, when 'search' is working again).

Another improvement for MGD (meibomian gland dysfunction) is by diet - maybe consider more of an anti-diabetic regime and we take fishoil sometimes to help clear the oils.

(Assuming that the doc thinks the epiphora is definitely dry eye not a blocked tear drain after the conjunctivitis infection http://www.moorfieldsresearch.org.uk...s/Epiphora.htm If you're wondering now, try pressing firmly under the inner eye corner to see if yellow stuff comes out of the tiny hole on the bottom eyelid margin.)

Plugs falling out is not a problem - couldn't he just put different ones in if you needed them? Did you definitely have bacterial conjunctivitis? Not seeing why he thinks you would have to stay on Restasis for the rest of your life. The doc needs to show you how to check the meibom yourself so you can see if treatment's working. Dr Robert Latkany's book 'Dry Eye Remedy' might be useful at this stage. Any doubts, maybe try another eye doc as well.