New member

[hannahmaywils]

Hi!

I am very keen to share my story with all of you who suffer with dry eyes, its nice to to know I am not the only one out there! I am a frequent visitor of this website and have been for some time, so have decided to create an account and share my story.

It all started when I was 21 years old, in my second year at university. I was a contact lens wearer, as I played squash everyday for my university team ( I also represented wales and England!), however that all came to an end. I began having difficultly wearing contact lenses for more than a couple of hours as my eyes would feel so dry, so resulted to glasses and only wore my contact lenses when I was on the squash court. This was fine, up until the last year. I went into the chemist and brought myself some Hylo-Forte ( red ones) eye drops as my eyes were getting worse by the day. I finally reached out to my parents, to which I was referred to a specialist in Manchester. He put me on antibiotic drops at first and eye drops for a week, of course nothing changed. He then suggested punctual plugs in my lower tear ducts, so I gave them ago. I felt moisture straight away, however I was very aware of them in my eyes which unfortunately led me to have them out. Given that there was success with the plugs, in terms of an increased tear coating he suggest going ahead with permanent punctual cautery of the lower punctrum. I was of course happy to go ahead with this procedure. Everything went well, and my punctrum healed very well. However, it had been a few weeks post op, and my eyes were still dry and I was still using my drops every half hour or so. I went back and he put some punctual plugs in my upper punca. WOW! I felt amazing! Watery eyes, but not excessive! I really was not complaining about the few tears that streamed down my face. Anyway, I i felt 100% better, I was only used my drops once in the morning and that was it! I was able to wear make up again, go for runs outside, go out till late with my friends! I had my normal life back. This lasted for about 7 months. During this time, I also got an office job, it is 3-11pm shifts. All was going well for the first 3 months and then suddenly my symptoms returned. I was heart broken. My upper plugs were still in place so I was confused as to what went wrong. Anyway, I went back to my specialist in Manchester and he suggested recauterising my lower tear duct again as they apparently can re-open. I had this done, and he also put in complete ocluders plugs in my upper ( I didnt realise you could have different plugs). So i basically had no tear drainage. I felt good again, for a week. Anyway my issue now is that I have swollen eyelids ( DOES IT EVER STOP!). I have been told I have blepharitis so I am doing the warm compresses, baby shampoo etc. Not really helping if im honest. I am due to see my specialist again, although I feel he has played his part in helping my eyes. But I am desperate. So my questions are

1) Hormones? I have never looked into this side of things but have read a lot of info on this website. I have the marina coil in, does this affect dry eyes?!
2) I take all the supplements, flaxseed oil, tumerin, omega three etc. Anything else I should be aware of ?
3) HELP!

I was even considering having all of my tear ducts permanently closed, but my specialist is obviously hesitant to do this because of my age. He thinks the environment in my eyes will eventually change! I think the opposite. However, I will not give up. I will find a CURE for my eyes no matter what it takes. I feel for every one of you who suffers from dry eyes.

Its 2018, surely we are getting close now!

Anyway, feel free to ask me any questions, likewise I will be grateful to hear your feedback

[hannsho]

Hi Hannahmaywils

I'm sorry to hear of all the problems you have with your eyes. Although I haven't got any answers for you, I admire your attitude - that's the way to deal with the situation. Googling for information and reading as much as you can on the specific problems you have is the only real advice I can give you. Of course, belong to a forum like Dry-Eye-Zone is also a big help!

(Perhaps you should post your intro separately so that more people will see, rather than appending it to my introduction?)

Good luck, Hannahmaywils.

[Rebecca Petris]

I took the liberty of moving Hannahmaywils' post to create a new thread. Welcome!

Sorry to hear what you've been going through! A few questions -

What time of year did things get worse?

Do you have any more diagnostic details to share? Do you know for example how your aqueous tear production is?

Have you tried any other lid product than baby shampoo - it's good at cleansing but when it gets into the tear film, it's still, well, soap....

Do you know what condition your meibomian glands are in?

[MGD1701]

Hi, welcome.

Inflammation/blepharitis
You need to deal with this first, both bacteria and demodex.
I know most doctors only put plugs when there is no/low inflammation as plugs make it worsen.
MMP-9 test: seems London dry eye center does such test.
baby shampoo: most doctors now do NOT recommend it - good to find alternative soap-free and mild.

Gland images/status: did you take images? How is your secretion, clear, thick or toothpaste-like?
Now many doctors in USA highly recommend it as doctors can NOT see gland status with slit lamp.
These are important in order to decide how agressive treatments you need for a better result.

omega supplements: helps me especially when I combine (bio, cold-pressed) flaxseed oil with GLA.
If you have tried for 6 months and see no results, good to find out why. I find mix with salad (with Vit. E, C) seems works better.

Hormones does play a role, for example, birth control pills.
comestic also plays a role - many bad chemicals which are bad for glands.

[hannahmaywils]

Hey

Great to see some feedback

Rebecca, my symptoms seems to worsen around winter, but then again this was also in my 7 month period when everything felt great! My specialist has only diagnosed me with Evaporative dry eye ? I don't think I have anything wrong with my tears, I can still cry for Britain!

I use Tea tree oil lipwipes as well ( OPTASE), I do this before I do the baby shampoo scrub. I'm not really sure what order it should go in to be honest. I also have a warm compress.

When it comes to my meibomian glands, I honestly couldn't tell you anything! I have never been told anything about these or what state they are in. I have looked at a few dry eye clinics in Manchester that offer the lipiflow procedure and thorough consultants around the meibomian glands, however the cost is very high for one of these consultations. Again, I have read and read lots information around lipiflow, and can't say I am jumping to get the procedure done given its mixed reviews. I will save my money for something more effective.

Hi MGD1701, thanks for you reply

Can I ask what the MMP-9 test is ?

Unfortunately as mentioned above I do not have any information on my glands. Thanks for the advice on supplements, im thinking of upping my dose slightly.

I used to wear a lot of make up- just your typical 24 year old! However I barely wear it now.

I am still looking to find out more about my hormones. I was going to get my Marina IUD out, but then I thought there is no point. There isn't enough evidence for me to make me want to do this.

What are your views on potentially having my upper tear ducts permanently cauterised? So I will have all four of them shut permanently. Of course, once inflammation is gone.

Thanks

[Rebecca Petris]

I think it would be very unusual to even consider cautery unless you have a prolonged, severe reduction in aqueous tear production. Some doctors are against even plugging when the main problem is all about MGD, because of what they sometimes call the "cesspool" effect of trapping inflammatory stuff on the eye surface.

State of the art technology for examining meibomian glands is lovely but inaccessible for many patients and not really that vital IMO. A properly trained optometrist can do a reasonable job of getting you some information on the state of your glands when examining and pressing on them (fingers or a little implement). Also just for reference you probably won't find doctors volunteering a great deal of information - it's really, really helpful to go armed with a compact little list of the key questions. For example:

- How's my tear production? (Different doctors have different approaches to measuring it, but it should be done in some way!)
- How are my meibomian glands? (Clear and runny secretions? Thickened? Blocked?)
- How's my blink? Do my lids seal fully?
- Are there signs of inflammation?
- Any sign of ocular allergies?

[hannahmaywils]

Hi Rebecca,


I have had my bottom tear ducts permanently closed and everything seemed good with the upper occluder plugs as well until my eyes started to swell. I have never experienced this swelling of the eyes before. Its been about two weeks now, they have gone down marginally but nothing too drastic. How long does it take for the swelling to heal would you say?

What is your regular regime/ solution if you dont mind me asking ?

How do you feel now as to when you first had symptoms? And what is it you have ?

[MGD1701]

Gland images

According to Dr/Professor Preeya Gupta, MD, USA,
dr can NOT see glands structure etc from slit lamp, see video (as of 4/17/2018) from 0:44

She also mentioned it in another educational video when she presented a case - a patient has only 10% glands left yet still (some) oil secrets. (I actually posted this a few months ago). I remember clearly she said, she almost fall down from her chair when she saw the images.

Another dr/professor Elizabeth Yeu also mentioned a case that she did images for 24 years old patient for Lasik evaluation (NOT dry eye, ie patient did not have discomfort) - it turned out many gland loss (hard to tell from pictures but seems 70%?). She suspected maybe technical problems so she sent the patient to take another image at 'another' office - same results.

These two doctors are opinion leaders in USA, as far as I know and I adore them
(as well as Dr Laura Periman, Dr. Whitney Hauser & many others) for their great passion to share knowledge.

https://www.healio.com/ophthalmology...ity-of-disease

WASHINGTON ― At the American Society of Cataract and Refractive Surgery meeting here, Preeya Gupta, MD, discusses the utility of meibography in not only diagnosing meibomian gland disease but also charting a treatment course based on the severity of the diagnosis.

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MMP-9 is to detect inflammation level which is being used widely in USA.

Plug: some doctors recommend while some do not.

What imporport is to identify root causes. The problem is hard to find real expert.