New dry eye sufferer

[Miker]

Hi, I'm a 56 year old male who started having trouble opening my eyes in the morning after a bout of bronchitis on 6/15/12. Been to several opthamologist and after 3 months the consensus is that I have MGD/Blepharitis. Some think it is from ocular Rosacea, so one started me on 40 MG of Oracea on 7/16. On 8/13 my dermatologist said that I do not have facial Rosacea but still could have ocular Rosacea. He switched my prescription to 100 MG of Doxycycline on 8/13. After no change he switched me to 75 MG of Minocycline on 9/13. Besides the oral drugs, I have been doing the warm compresses, lid scrubs and massages. Have tried Lotemax, tobramycin/dexamethasone, restasis but these drops all seemed to make my eyes burn. I also had tried Lipiflow on 8/8/12. This past Thursday 9/13, I just had punctal plugs installed. At night I use Refresh PM and tranquil eyes. What is driving me nuts is that one day the outside upper edge of my eye feels sticky, the next day it is the other. Very rare when I have a day when both feel ok. Any idea why it keeps switching from eye to eye? Also, been reading about manual expression to relieve the MGD, any opinions? Also does anyone know of anybody who would do the manual expressions close to Maryland. Another question, is the MGD causing the inflammation or is it the imflammation causing the MGD? Lastly, been reading of Azasite for MGD, any opinions? Thanks for listening.

[spmcc]

Also does anyone know of anybody who would do the manual expressions close to Maryland.

I've heard Dr. Akpek's name mentioned as a great ophthalmologist in Maryland. Here's her Johns Hopkins webpage: http://www.hopkinsmedicine.org/wilme...cvs/akpek.html

Also you can see that she has published on MGD: http://www.ncbi.nlm.nih.gov/pubmed/22592706

Perhaps she'll perform expression?

[Miker]

Saw Dr. Akpek on 8/23, she is the one who suggested Restatis and said I needed to give Doxycycline about 3 months. She ok'd my dermatologist switching to Minocycline.

[Rebecca Petris]

Hi Mike & welcome.

What is driving me nuts is that one day the outside upper edge of my eye feels sticky, the next day it is the other. Very rare when I have a day when both feel ok. Any idea why it keeps switching from eye to eye?

One of our earliest veterans, Lucy, always used to say it's the color of your socks. This kind of variability is just kind of par for the course with dry eye. There are fluctuations no one can explain.

Also, been reading about manual expression to relieve the MGD, any opinions? Also does anyone know of anybody who would do the manual expressions close to Maryland.

What works for MGD varies so much with the individual. Some people can manage it fine (once inflammation etc are under control) with some heat and lid massage at home daily. Others have a doctor manually express them now and then. Others go for the 'boutique' MGD treatments.

Any cornea MD (or OD for that matter) worth their salt should express your glands. It's not rocket science. If they can't/won't even if requested, I would leave and not go back, personally.

Another question, is the MGD causing the inflammation or is it the imflammation causing the MGD?

Ahhhh the age old question of chickens and eggs. Keep in mind MGD is kind of used as a catchall term for anything wrong with the MGs. So I would say, if there is inflammation, inflammation is causing the MGD, but then what's causing the inflammation? And then there we go in cirlces.

Lastly, been reading of Azasite for MGD, any opinions?

Quite a number of people here have found it helpful. One of those things that's 'worth trying'.

[robster]

The only advice I would give you is maybe not to try too many things in such a short space of time as it may be hard to tell what is having an effect and what is not. I know what you mean about the eye switching thing, 90% of my problems are with my right eye but on the rare days when my right eye is feeling good I can guarantee the left eye will be bad!

[Miker]

Hey Rebecca, what do you mean by the boutique MGD treatments.

[robster]

Things like IPL, Lipiflow and ****** probe.

[Miker]

Has anybody had success with the ****** probe?