Problems at a young age

[Gavin]

Hello all,
This is my very first post so forgive me if it's a bit unorthodox. I might be one of the youngest members to join since I'm only 18. I'm currently attending a university and living on campus which makes it embarrassing and difficult to deal with daily red eyes. It all started just a tad bit less than a year ago, when I was still in high school. I suddenly and gradually had dark red eyes during the mornings and they looked very "dirty". I thought this was very strange since I was at such a young age and experiencing these symptoms of dry eye. I was very worried so I went to see a doctor, mainly because they weren't getting better and under brightly lit areas my eyes would look bright red. After using artificial tears for a while they seemed to help a bit, and they were only bad when they were irritated the most. Fans, air conditioning, wind, even driving in my car all affected my eyes and made them red, although I only felt a slight sting sometimes. My old doctor told me to use artificial tears, but when I complained about my symptoms progressively worsening--even with the tears--he decided to use punctual plugs. I hardly noticed a difference with these and am still questioning their use today. I've used Lotemax (no change), Restasis (no change and actually made my eyes worse in the mornings), plugs (no change), night ointment (makes eyes look a little worse in the mornings), the blood serum, and even those small grain-like objects you put on the inside of your eyelids, to no avail. My eyes have reached the point to where they are always their worst in the mornings and no matter if I put a mask on or stay away from the A/C in my room, I can't find a solution. My eyes are now constantly red throughout the entire day, and to be honest I've only seen them a bit white when I visit the Doctor's office and they instill some heavy, irritating drops that dilate your pupils. Since I now live in Tallahassee, I have changed doctors and am currently going to "Eye Surgery Associates of Tallahassee". My doctor has prescribed me Azasite, which really bothers my eyes and makes them burn, and a bit more red. He is going to test it for 8 weeks before I return for another appointment. I use cold compressions which make my eyes white only momentarily, but when I have to be around people it's the only way to look acceptable. I try to use warm compressions at night, because they make my eyes look way more red. Last time I visited the doctors office, he said my glands were clogged, and I think it might be because of the cold compressions. It's very hard to stop something that seems like it's the only solution, even if it only lasts a bit. To be completely honest, when I was in high school my eyes were quite red in the morning and I didn't want my youthful days to be ruined, so I used Clear Eyes, which only made the problem worse over time. I've heard of rebound redness and am quite positive I had that since I constantly used Clear Eyes before I even knew about artificial tears. When I discovered I stopped for a while, and my eyes didn't change too much. I even use them occasionally when I have important meetings with people, although I know I shouldn't. I am constantly surrounded by people, and my self-esteem has been severely affected by this problem. My tears even make my eyes redder and I can bear to see my eyes red all the time. It's a shame I have this at such a young age, but I really want to find something that'll make my eyes normal again. Sorry to write such a long paragraph, but I really needed to vent.

[LisaC]

Crossing my fingers for you

Hey... Even though I'm not as young as you, my problems started when I was your age. It sounds like you have been more proactive about finding relief with doctors so I hope you find a fix for your eyes very soon! I've been dealing with red dry eyes for a while but I'm ready to seriously and aggressively treat it. Keep us updated on your progress!

By the way, I feel less conscious about the redness when I wear my glasses (though I hate wearing them because I'm active). You mentioned you like to have whiter eyes for important meetings... You may want to consider glasses (even no prescription) for these. I know I feel like I look more professional with them and people can't see my tired looking eyes as well! Good luck!

[littlemermaid]

Gavin, Hello, hoping you've read everything on http://dryeyezone.com/. Is your doctor treating for blepharitis or meibomian gland dysfunction? You're listing anti-inflammatories but not an antibacterial or low-dose oral antibiotic to help clear the glands. Have you ever seen clear meibom recently? As Lisa says, can you protect your eyes during the day?

[Gavin]

I appreciate it Lisa, and yes I do wear glasses. During the day I only have time put artificial tears in until I'm done with my classes. I've noticed my eyes burn in class, and they are always bloodshot in the morning. It takes a while for them to get better, but at best they only become a "dirty" red. I'm not sure what that could mean? My doctor has put me on Azasite and told me recently for the first time that my glands were clogged. I assume this is a cause of meibomian gland dysfunction, but I can't be sure. He also said that after eight weeks if I didn't see any results, he would perscribe oral antibiotics. I can't definitively say that I have MGD, but I know that many anti-inflammatories haven't worked. Also, I've had plugs in for a while now and I'm not sure they are helping, should I have them removed? Next appointment I'll try to get a diagnosis of my problem.

[Rebecca Petris]

Hi Gavin and welcome. Sorry to hear what you're struggling with.

Familiar pattern. Don't want to jump to conclusions but it sure sounds like the doctor basically churned through a whole bunch of classic remedies for aqueous deficient dry eye one after another before anyone even assessed the possibility of lipid deficient i.e. MGD.

I think your story is a great argument for why redness relievers (vasoconstrictors) should NOT be sold over the counter. People just don't realize how harmful they are till the damage is done.

I don't think I saw anything in your posts about ocular allergy as a possible component to the problem. Might be worth looking into.

My eyes have reached the point to where they are always their worst in the mornings and no matter if I put a mask on or stay away from the A/C in my room, I can't find a solution.

What kind of lubricant are you using at night. - are you using over-the-counter tears/gels/ointment? I wonder if possibly at this point lubricants might actually be making you worse in some way. Or, what about any environmental factors. Pillow, laundry soap and so forth. Not necessarily as causes but as exacerbating factors. Sometimes once you get in a deep hole with an inflammatory cycle of some sort, it's a complicated path finding the way out... but I do want to encourage you that it can be done....

My doctor has prescribed me Azasite, which really bothers my eyes and makes them burn, and a bit more red.

Are you putting it IN your eyes or rubbing it on the lid margins?

Can you buffer it a little... if there's a bland artificial tear that works well for you, maybe put a little bit of that in (otherwise just plain unpreserved saline aka unisol 4) about 5-10 minutes before the Azasite. Also a lot of people who can't use Azasite (topical antibiotic) can use Doxycycline (oral antibiotic)

Last time I visited the doctors office, he said my glands were clogged, and I think it might be because of the cold compressions. It's very hard to stop something that seems like it's the only solution, even if it only lasts a bit.

I've never seen/heard anything compelling that that could happen. If someone else has, please post it here. If I were in your shoes, I'd be cold-compressing up the wazzoo till someone gave me hard evidence that it was harming me.

I even use them [vasoconstrictor] occasionally when I have important meetings with people, although I know I shouldn't.

Sigh. It's really hard to tell you not to. I understand why you would. Just try to be disciplined about making it as infrequent as possible and try to balance it out with maxing out ways to be kind to your eyes before and after.

Hang in there. It's a painstaking process but it sounds like you're at least starting to find a little more direction in it with someone at least looking at your meibomian glands. I would push for more information. What are the oil secretions like? Thick, thin, discolored? Get advice on whether to attempt massaging/expressing them at home or not. Also probe the allergy angle.

[alia]

What's the best way to cold compress? Does it help reduce inflammatory response?