10 months Post Lasik and seeking advise/treatment

[tealeaf]

LaDiva,

Thanks for your reply. Will take what you said into considerations when coming to plugging the upper tear ducts.
I think I read somewhere in this forum that you mentioned about warm compress not massaging the eyelids and using Q-tip is better. Please could you let me know why massaging is no good (I have been doing that for a week as my eye specialist told me to massage gently when doing warm compress! Oops!), is it causing pressure to cornea? How do you use Q-tip on the eyelids?

Thanks!!!

[LaDiva]

When I massaged my lids, they became dry, red, sore and swollen. I actually got a rash and had to go to the dermatologist. Too much friction, and too hard on my eyelids. I am not a kid, so maybe that is part of it. I use Q-tips just under the lid margins and press gently. Different things work for different people. Some don't need to press at all, and just use a warm compress. It depends on what works best for you.

[tealeaf]

Thanks for the advise on Q-tip. Indeed, different things work for different people. Wishing all the best to your eyes

[LaDiva]

Thank you tealeaf. You too!

[patientpatrick]

I am going on 3 years post lasik myself. It too was the worst decision of my life. I've been quadra-plugged, been on serum, restasis for close to 2 years, warm compresses 2-3X per day and pretty much thrown all I could at the problem and am thankful I've made whatever improvement I've made thus far.

Regarding your MGD I've found the best thing I've done for my routine has been a warm compress for 10-15 min followed by a lid massage then a lid expression with a pair of silicone contact tweezers. It's been very beneficial for me.

Wish you all the best.

P

[tealeaf]

Hi patientpatrick,

Are you still using serum, restasis and doing warm compresses? Does quadra-plugged help?
I have used restasis for 6 months, twice a day, so far ok. But I am not sure if it has improved my dryness.

After you did warm compress and lid expression, do your eyes feel sticky? Mine usually feel sticky right after warm compress, the stickiness will go away after I do lidscrub. I am wondering if the stickiness is from the thickened oil.
This morning when I did lid scrub, I saw a tiny yellow dot on the wipe, is it oil from eye lid (My wipes had always been clear after lid scrub, this is the 1st time I see a yellow dot)?

How do you do lid expression with tweezer? is it painful? Will it cause any damage to the eyelid

Sorry for the many questions.

[tealeaf]

Dear all,

Feeling rather down these few days. My eyes have been really dry recently. When I first used temporary dissolvable eye plugs, they worked and gave me relief, thus I thought permanent ones will definitely help (maybe back then I was also using lotemax). After a week on the permanent plugs with cap (in lower tearducts), my eyes are feeling worse. I am not sure why is it so. I have gotten used to the permanent plugs and they are very comfortable by now but they are not providing the help. Anybody faces the same problem?

I have Shirmer test of 0mm (R) and 2mm (L) and TBUT of 5-10sec (R) and < 5sec (L). Should I try plugs on upper tear ducts as well? Or should I wait and see how things go?

All opth. I saw said I have some Blepharities and I am doing warm compress once daily and lid massage and lid clean twice a day.

I am also using restasis twice a day and systane ultra few times a day. Taking 3 thera tears capsules.

What else should I do? Kindly advise please. Thank you so much.

[DryLondoner]

So sorry to hear you are having a rough time, TeaLeaf, I hope it passes quickly.

Do you do anything to relax? Sounds so silly, but I found deep breathing excersises really helped me. (You tube breathing techniques). I also find eating loads of greens helps, as well as jogging.

No studies to back this up, but surely the body will heal quicker if there is less stress?!

Perhaps you could focus on this?

I know it's tough. I was such a happy confident person, and now I'm always anxious and have no self confidence. But things will get better, just slower than we would like. Also, I read that plugs can take a while to reduce osmalarity of your tears, I wonder if this is the same for comfort???

Take care of yourself, I hope better time are ahead.

[Gerri55455]

Hi Tealeaf,

Sorry about the rough phase you are going through. I do agree with DL that diet and relaxation do help.

Regarding upper plugs, perhaps you can get temporary upper plugs first to see how you fare with those.

In early June when I was at my worst, I was quadra-plugged. However, too much tearing drove me so crazy that five days later, I stood in front of my bathroom mirror and pulled out the upper plugs with a pair of tweezers! I couldn't even wait the following morning to get them pulled out by a specialist.

Because my problem is related to epithelial irritation and nerve damage, and also because the quality of my tears is poor due to disruption of the oily later (mgd), the quantity of my own tears can only do so much.

All the best, ~Gerri

[tealeaf]

Thank you for your kind words and encouragement always. So sweet

Do you do anything to relax? Sounds so silly, but I found deep breathing excersises really helped me. (You tube breathing techniques). I also find eating loads of greens helps, as well as jogging.

No studies to back this up, but surely the body will heal quicker if there is less stress?!

Too many things in life cannot be backed up by studies / evidence. Yes, I supposed less stress, body will heal better. Recently have started to increase my greens and maybe as suggested, do jogging. I used to love jogging, since DES, I become inactive. It's time I wear my spectacles out for a jog. Maybe better blood circulation may increase nerve regeneration

I know it's tough. I was such a happy confident person, and now I'm always anxious and have no self confidence. But things will get better, just slower than we would like. Also, I read that plugs can take a while to reduce osmalarity of your tears, I wonder if this is the same for comfort???

Same here, I can't find the previous confident me now, but like you say, yes, things will get better. There is always hope.
I read from this forum (think from indrep) that tears accumulated on the eyes will reduce osmalarity. With more tears there, the occular surface more lubricated, over time, will reduce MGD problem and nerve on the cornea will also grow. Something like that.

I do find more comfort with the accumulated tears (eyes feel better in the morning and blinking more comfy), but I guess (nottoo sure, guessing and trying to figure out) that the oil from my lids are not enough thus keep having the cold and dry feeling in my eyes.

Am going to see my opth. next Monday and request him to express the meibomian glands.

[tealeaf]

Gerri,
Thanks for reply
Am sorry to hear the over-tearing, oh, must be so uncomfortable. I am not too sure if quadra-plugged will help me. I started with temporary dissolvable plugs, the tears accumulated were not as much, yet my eyes felt more comfortable. But with the permanent plugs in, I kept having the cold and dry feelings in my eyes, thus I guess could be due to MGD. Have you tried Doxycline? I think Doxycline helps in MGD.

[cathy8889]

Hi Rebecca, sorry to bump in on this thread, I noticed this about schirmer test and I was just wondering if they were both accurate ways to measure year production? Or is reflex tear production inaccurate because it's being caused by something unnatural?

They did my schirmer test for 5 mins during which time the paper kept coming out and then they had to put it back in, and it just kept poking me in eye and then making them water, I'm concerned that I have aqueous deficiency mainly in right eye as they said my meibomian glands in left were worse than right but I have most trouble from right eye.

I underwent the test without anaesthetic. Is there a best way to perform a schirmer test?

Many thanks

Cath

With anaesthetic measures your basal tear production. Without measures your reflex tear production .

[cathy8889]

Hi tea leaf,

I was just wondering how your eyes felt day to day? I've been experiencing all different symptoms, as I'm guessing most people on here do lol, since I've started treatment for mgd I am experiencing less of the dry feeling touch wood, I now have the heavy eyelids like pin pricks and I do have grittiness and in night eye lids still stick together. I have to do a warm compress every time I start to feel the pin pricks in my upper and lower, I'm on holiday at the moment and not working so I have time to do this which has been like 5 times a day, I then use a q tip on bottom and lower lids, then clean with a systane lid wipe and wash my face with warm water (i use this mask - http://www.butterflies-eyecare.co.uk...FYMewwodbL0AKg ) . I take 4 omega three by scope and 2-4 seabuckthorn oils (http://www.omega7.co.uk) if I buy them in bulk they are less expensive. I'm also going to re add fortifeye focus when I have enough money http://www.fortifeye.com/products/fortifeye-focus/ . I do eye exercises to when I feel the grittiness starting and sometimes this helps, Harvard eye website tells you how to do them properly. I'm trying to work out whether I have a wheat intolerance too. I use vismed multi and thera tears as anything else just aggravates my eyes straight away, gels or anything slightly viscous are a no for me. So I tend to have to put a lot if vismed in, but when I have that pin prick feeling the only things that helps is warm compress, drops relieve me for like 2 seconds!

I'm sorry if this is all known to you, and I am probably stating obvious, I don't know my schirmer results precisely so things are probably a lot different for us. Just wanted to share what I do, I feel that it's working, the biggest thing for me has been the doxycycline and I firmly believe now that the antibiotics I took for something else over a month ago started the process of my eyes feeling a bit better.

I really hope thins get better for you,

Cath x

Dear all,

Feeling rather down these few days. My eyes have been really dry recently. When I first used temporary dissolvable eye plugs, they worked and gave me relief, thus I thought permanent ones will definitely help (maybe back then I was also using lotemax). After a week on the permanent plugs with cap (in lower tearducts), my eyes are feeling worse. I am not sure why is it so. I have gotten used to the permanent plugs and they are very comfortable by now but they are not providing the help. Anybody faces the same problem?

I have Shirmer test of 0mm (R) and 2mm (L) and TBUT of 5-10sec (R) and < 5sec (L). Should I try plugs on upper tear ducts as well? Or should I wait and see how things go?

All opth. I saw said I have some Blepharities and I am doing warm compress once daily and lid massage and lid clean twice a day.

I am also using restasis twice a day and systane ultra few times a day. Taking 3 thera tears capsules.

What else should I do? Kindly advise please. Thank you so much.