Chronic dry eye/blephariis tried everything but to no avail.

[Telo123]

Hi ive been suffering with chronic dry eyes for the past year now.I wake up first thing every morning to the familiar burning sensatuon in my eyes.The burning is constant ive tried every sort of drop/gel but to no avail.The problem is debiliatiting in many ways,so much so that I cant even study for my exams because of the severe burning sensation.Recent an eye specialist diagnosed me with blepharits/mgd also and I will soon be getting punctual plugs(hope they work).Im starting to feel quite depressed lately because of the significant impact its having on my life.My question is does it eventually get better or am I stuck with this problem?Thanks.

[LindaDawn]

Sorry to hear of your suffering. I am in the same boat. Where do you live? I need to know if punctual plugs could work for me. Here is lots of advice and support on this site for you. Hang on in there. Don't let it beat u. Difficult I know. X

[Telo123]

Im from Ireland.Thanks for he reply im getting my plugging done next month so il keep ye updated

[LindaDawn]

Thank you. Would be really interested in your experience. Have they tried you on steriods?

[Telo123]

Yea they only aggrivated my eyes even more unfortunately.

[MGD1701]

Hi,
punctual plugs as far as I know are for overcoming 'water' issue NOT for the glands.
so it is critical to find out your causes first so you use right drops etc.

Dry eye is progressive so you really need to identify causes first .
Good luck!

[Telo123]

Thanks.The plugs are to preserve my tears.For the glands im using lid wipes

[MGD1701]

Hi Telo
I have MGD too and now finally under control so you can do it too.
Perhaps be more specific about your problems would be easier for others to help.

1st: identify your problems, causes. Do your glands working/blocked and produce quality/enough oil?

2nd. morning pain - if you have so much pain, maybe try ointment, I find Vit-A Pos is good, or you use gel twice at night.
If you use ointment, make sure you clean your lids/lashes in the morning properly. Ointment is not good for long term.
Or try swimming goggle when in bed. Just search around in this site, I am sure you can find some helpful info.

3) if you have Demodex, only 4% 'tea tree oil' can kill them. There is commercial available wipers which others find them effective. Sometimes I use tea tree oil shampoo/shower Gel (soap free) to clean my lashes in the morning although Dr did not find Demodexs. Seems these wipers and shampoo may not kill Demodex (due to low %) but can 'scare' them away.

Good luck!

[Hokucat]

Hi Telo. I had severe MGD (likely due to autoimmune disease) and had also been diagnosed with blepharitis, but am much better now, many others in this forum too. You just need to find what works for your condition and you personally.

You say you've been recently diagnosed with blepharitis/MGD and tried everything, but were not specific except trying all kinds of OTC and prescription drops, and soon punctual plugs. So please forgive me if you are already doing or have tried some of the things below.

For immediate symptom relief, try getting goggles like WileyX or 7Eye, some people even use swim goggles. Also try Genteal Severe Eye Gel. The gel cannot be used while wearing contacts. This was the only drop/gel that felt soothing and was longer lasting than any other drop for me...for two years the only thing that somewhat helped. It's supposed to be preservative-free in the eye, but some people have developed an allergic reaction from long term use, so use sparingly to help get you through this rough time:

https://www.amazon.com/gp/aw/d/B000U...vere+eye+drops

Try using Ocusoft Lid Scrub Plus Foam for your lid scrub. One specialist told me this "Plus" and "Foam" version was helpful for many of his patients, and it indeed helped me better than baby shampoo, wipes or other topical treatments:

https://www.amazon.com/gp/aw/d/B000Q...lid+scrub+foam

Use warm compress for at least 10 minutes daily to get the oils flowing from your glands. I used ThermalOn Dry Eye Compress, because it molds well to the eye, and it stays very warm for 10 minutes after heating up only once in microwave:

https://www.amazon.com/gp/aw/d/B0043...lon+moist+heat

If your eyes are burning first thing in the morning, you might be sleeping with eyes slightly open which further dry out eyes. If your eyes are protected at night, it could feel better during the day. I use TranquilEyes for night time moisture gear, but have heard EyeSeals 4.0 works well too (when I had severely dry eyes, I also used Systane Ultra or the Genteal Severe Gel right before sleeping too).

https://www.dryeyeshop.com/mobile/ey...ucts-c122.aspx

Blinking exercises every hour can help the oils flow from your meibomian glands. It's possible from all the reading and using the computer for your studies, you are not blinking enough.

For MGD, there are procedures to stimulate and/or open up the glands, such as IPL, gland expression, and probing. These go a step beyond the general treatments usually offered, but have given many people relief.

Scleral lenses have had increasing success managing dry eye symptoms, when nothing else worked. I wear mines 12+ hours a day and it is one of the key things that helps me function comfortably daily. If you are able to wear them, they can help with reading, using the computer, driving, etc. Here is some info on scleral lenses, there different brands, this one from Boston just gives a good overview and is the one I use:

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome

All the above help manage the symptoms, but try find out why this is happening. Blood tests can determine if you have any vitamin deficiency that typically causes dry eye (potassium, vitamins A/B12/C/D, etc.), and if so adjust your diet and/or take supplements accordingly. You may need to experiment and see what foods/supplements makes your eyes feel better, or worse...gluten, sugars and dairy can make tear film worse. Changing my diet to include fresh squeezed lemon juice in green tea 2x daily was the absolute main factor in getting my meibomian oils to flow continuously, almost a complete turn around for me. For you it may be something else. Note: I started the lemon/tea after getting a probing procedure to first unblock my glands, otherwise any diet changes or treatment may not work. Also blood tests should check for autoimmune disease which often causes dry eye.

Or the cause may simply be related to using your eyes so much reading and using the computer, or wearing contacts (if you do), or some combination of these perhaps causing you not to blink as often as you should. This can cause the meibomian glands to atrophy in the long run, so still needs to be addressed. Some of the above mentioned can help, but you may ultimately need to limit how much you are using your eyes, at least for awhile.

Everyone is different, so you'll likely go through some trial and error before you find the thing(s) that work for you. Things will get better!

[MGD1701]

Hello Hokucat
I also used Systane Ultra before bedtime but I need about 3 days to finish one single piece. Is it ok? I use other drops in the daytime. I have tried Artelac - which even better.

Hi Telo
As far as morning pain is concerned. perhaps try to open your eyes slowly when wake up or put drops into eye before standing up from bed.

[Telo123]

Thanks MGD1701 and Hokucat really appreciate the replies.il take on board all the advice.Just wondering had ye any of ye have actual visible symptoms such as red eyes etc.Because my eyes look fine for the most part.But they feel shocking

[Hokucat]

Hi MGD. I personally would not reuse an opened vial of preservative-free artificial tears after 12 hours. One time I compared a recapped vial I forgot to throw away from the day before to a new unopened one, and the old one looked slightly cloudy. How long an opened vial lasts before bacteria can form might depend on the temperature and humidity where one lives. I've heard other people use them a few days and never had any problems. Some people put it in a ziplock bag in the refrigerator to slow the bacteria growth, and heard the coolness can also be soothing. I guess I'm just extra careful with my eyes since I used to be so bad off!

Hi Telo. I never had red eyes or swollen glands or eyelids. However many doctors told me 1) the surface of my eyes were like sandpaper, they were surprised I never had a corneal erosion, 2) my meibomian glands were very small, making them a little more difficult to probe. And when they were telling me all this, my eyes felt at their worst.

[MGD1701]

Thanks Hokucat for the details. Seems 2 days are ok for me. Indeed for safty sake, better finish in 24 hours.

Probing - how often you need to prob? how many times have you done? do you need to do on a regular basis?Just wondering! I thought after probing, warm compress should do the job, right? I'll ask dr about this and other possiblities for speedy recovery. Thanks again.

[Hokucat]

MGD, I did the probe procedure five times over 2 1/2 years, basically every six months. It's a relatively new process, and more invasive than expressing and IPL, so my doctors did not want to do it too often...it's not a comfortable procedure, so I didn't want to do it often either :-) After each of the first four procedures, my eyes always felt a little better, but started feeling dry again in less than a week. I think because my oil was so thick, it just quickly clogged up my glands again, despite doing warm compresses every day. Soon after the fifth probe procedure, I started drinking the lemon juice with green tea, and I have not needed another probe since then, that was October 2015. I do warm compresses only periodically now (last one was last summer), and I no longer use artificial tears, except for a couple drops in my scleral lenses before inserting them. So getting my glands unblocked and improving my oil quality was absolutely key to my recovery.

Maybe try IPL before trying probing. I think IPL has been around longer and is more readily available, is less invasive than probing, and have read several people in this forum have done well with it. Perhaps following with warm compresses, like you say, for you will keep your oils flowing after the procedure.

Here's hoping for a speedy recovery for you and Telo!

[MGD1701]

Thanks Hokucat.
Sclearl lenses: still a bit hesitate about it as soft lenses are not good for dry eye, I read, so I wonder why they work for many people?? How long do you wear it, 24 hours and for 4 weeks?

Debridement: will ask dr about it too as Dr Korb said it will smooth surface to distribute lipid/blinking. Have you tried?

lemo and green tea: Do you drink it after meal or with empty stomach (= before meal?) Just courious! Sometimes I drink like that too, about 1 hour after meal, to protect stomach.

Goji berry: have you tried it? it has rich Vit. A, C, iron, etc. more than carrot, orange and beef, very good for eyes and skin too.

Thanks again!