21-year-old hoping CLD is cause of 7 years of deteriorating Dry Eyes

[dryeyedad]

Hi All,

My 21-year-old daughter has suffered from dry eyes since she was 14 and they are progressively getting worse. She is also suffering from GI and hormonal issues, and while they have been improving, her eyes have not. She has recently been diagnosed with chronic Lyme disease (CLD). She had to drop out of college and is focusing on regaining her eye and general health. She is very involved with investigating her general health issues, but is too scared and worried to research eye issues.

She is actually thrilled to now have a potential cause of her dry eyes, but CLD can be very scary stuff as well. There is also a lot of controversy around CLD and the evidence for her having it is not overwhelming. I'm still hoping we'll find a hormonal cause or find that long-term SIBO/leaky gut is the real culprit.

We've been to 5 optometrist this year alone, traditional doctors, functional medicine doctors, etc. Sorry for the long post, but I'm hoping someone can spot something we've missed so far.

Dry Eyes:
Symptoms:

1. Dry, painful eyes; TBUT = 4 seconds,
2. Optometrist can manually express thick cloudy oil
3. Picture of glands shows distorted MGs and 4-6 glands dropped out per lid
4. No corneal staining

Diagnosis: NOMGD and aqueous deficiency

Present Treatment:

1. Lid margin wash and warm compress.
2. Celluvisc gel eye drops
3. Supplements including Omega 3, 6 and about to start 7 (seabucksthorn oil)
4. Just started (12/31/15) Doxycycline 20 mg 2x/day and restarted Restasis (overlapped with 4 weeks of Lotomax)
5. Addressing general health

History:

1. Dry eyes started age 14 during her 2^nd infection of mononucleosis. Stopped wearing contacts and make up; Tried Restasis for 5 months, punctual plugs for 12 months. No help.
2. DE became significantly worse at age 17 following concussion and gut issues (candida). Gut issues potentially due to long-term use of oral birth control and doxycycline she had been taking for acne. DE improved as gut and concussion healed, but still worse than before gut issues and concussion.
3. DE became significantly worse this past summer during period of very high stress, prior to diagnosis of SIBO and Lyme, and immediately following Lipiflow treatment. Cause unknown and present treatments not providing much relief.

General health:

Symptoms:

1. Dry eyes (see above)
2. Right knee and foot pain (sole burns, top hurts) which gets worse with use; no inflammation; no known cause (extensive physical therapy with little benefit); left knee pain started with minor injury which should have healed in a couple week; it has now been six months
3. Very short period cycle (~21 days) from age 17 to this past summer
4. Fatigue and loss of appetite (started with SIBO treatment this fall)

Test Results:

1. EBV titters consistent with past Mononucleosis (2005, 2008)
2. Nutritional mal-absorption via fecal smear test-high split fats),
3. Low morning cortisol,
4. Low vitamin D (despite supplements),
5. Very high Reverse T3, low T3 and fluctuating TSH
6. Normal sex-hormones (although estrogen levels in very high normal range),
7. Abnormal: low HDL but very high Omega 3 (takes 4 g fish oil/day;
8. No heavy metals
9. Identified limited food allergies (IgE) and eliminated consumption
10. Abdominal Ultrasound normal
11. Normal CBC, CMP, CrP,

Diagnosis

1. Leaky Gut
2. SIBO (both methane and hydrogen)
3. Chronic Lyme Disease
4. Adrenal insufficiency

Treatment

1. For Leaky Gut and SIBO: Probiotics, Specific carbohydrate diet, supplements
2. For CLD: Natural antimicrobials, herbs and supplements, Detox protocols
3. For Adrenal insufficiency: Drenatrophin PMG and A-Derenal
4. Plus T3 supplements and increased vitamin D

Thanks for reading this!

[waterbee]

hi there, did your daughter managed to get some treatment? did you get tested for lyme co-infections? would love to hear from you regarding this.

[meibomian]

Other than the CRP, were there any other tests for collagen vascular diseases like lupus, juvenile arthritis, etc. Collagen vascular disease would be much more common in young females than CLD or SIBO and would give similar clinical findings to those described. Common diseases are common. One cannot make a clinical diagnosis in this case without a thorough exam and workup.