Hello! New member.

[PoeFan]

I hope I'm posting this in the correct place—apologies in advance if not.

I've been suffering from chronic dry eye since early 2015. I now live in a humid state without severe winters, as compared to when I lived in the Midwest (Indiana, Ohio, Missouri), however my eyes still suffer. I am an avid reader and computer user, for reasons such as collegiate studies, running a website and a blog, etcetera. I cannot give up any of these, unfortunately. I've found it difficult to maintain a job with my dry eye, so I am currently not working. I have been to my optometrist several times, as well as an ophthalmologist (have a followup this October) to try and tackle these conditions. I currently use Systane nighttime eye ointment with a silk eye mask for overnight relief, Restasis, Xiidra, and Systane lubricant eye drops (not sure they're really doing much), and I've used Lotemax in the past, which eventually stopped working for me. I've also tried the gel pack on my eyes for 20 minutes and rubbing baby oil on my eyes in the shower to cleanse them. I'm only 25, so it's discouraging to have to deal with this and take each day without knowing whether or not my eyes are going to act out. I've just joined this forum because I've been going through a miserable two weeks of "vacation," which have basically left me severely depressed and discouraged. I do suffer from depression and was on anti-depressants for about four years. I also have a thousand or so allergies and have to take even small doses of antihistamines to control those symptoms. I'm at a loss. I'm not sure that I can afford the higher end treatments, although we are seriously looking into those as a last resort.

I look greatly forward to meeting others, following the various forums and gathering tips from others to improve this condition so that life can become bearable again. Thank you for your consideration!

[MGD1701]

Welcome.
You need to collect objective data to identify causes particularly gland images
since you are already on max. medical theraphy & still find no relief.
MGD/dry eye is progressive and it is easier (cheaper too) to fix at earlier stage.

Some medications, especially anti-depression or allergy drops could make eyes dryer.
Good to tell your dr what medications you are on next time.

Allergy - allergy test may help.

baby oil/shampoo: Do you feel ok after using baby oil? If not, maybe try sulfate-free baby shampoo since it is more economical
but most doctors now do not recommend it as it removes our natural oil so sulfate-free should be better.

Warm compress is important for MGD but not easy to master.
Keys are: constant heat and 42-44C, about 12 min. & feel good afterwards.
Dr Korb latest video 2016 explained pretty well on this. There are a total of 4 at youTube which can be easily found - just type, ''Dr Korb''. He said, Bundle Method is the most effective, there is a video at YouTube too.

Last tip, educate ourselves as dry eye is too new and a real expert is hard to find.

[diydry]

Welcome! Just a quick thought: did you try stopping the anti-histamines? I found they dried out my eyes like nothing else... like zero tears. Once I switched to Flonase (not an antihistamine) my symptoms improved. Now I practically never take seasonal allergy medication because I worry about side effects, but that’s just me.

[PoeFan]

Welcome.
You need to collect objective data to identify causes particularly gland images
since you are already on max. medical theraphy & still find no relief.
MGD/dry eye is progressive and it is easier (cheaper too) to fix at earlier stage.

Some medications, especially anti-depression or allergy drops could make eyes dryer.
Good to tell your dr what medications you are on next time.

Allergy - allergy test may help.

baby oil/shampoo: Do you feel ok after using baby oil? If not, maybe try sulfate-free baby shampoo since it is more economical
but most doctors now do not recommend it as it removes our natural oil so sulfate-free should be better.

Warm compress is important for MGD but not easy to master.
Keys are: constant heat and 42-44C, about 12 min. & feel good afterwards.
Dr Korb latest video 2016 explained pretty well on this. There are a total of 4 at youTube which can be easily found - just type, ''Dr Korb''. He said, Bundle Method is the most effective, there is a video at YouTube too.

Last tip, educate ourselves as dry eye is too new and a real expert is hard to find.

Thank you for responding. I appreciate the tips you have provided. The information I provided was just a basis to see where I'm coming from. To address some of the recommendations:

I am no longer on lotomax, nor am I on any anti-depressants or taking allergy eye drops. The only anti-histamine I am taking is an oral solution. I have had several allergy tests in the past, as recent as two years ago, so that's not an issue.

I use baby shampoo, and will look into the specific type of shampoo you are describing—thank you.

As for the warm compresses, thank you for your thorough tips on how to master them. I didn't feel as if I was doing the correct thing. I sincerely appreciate your tips.

My ophthalmologist is at Duke University, so I feel fortunate to have leading experts work with me on this. I hope I can provide my own tips in the future.

Many thanks again.

[PoeFan]

Welcome! Just a quick thought: did you try stopping the anti-histamines? I found they dried out my eyes like nothing else... like zero tears. Once I switched to Flonase (not an antihistamine) my symptoms improved. Now I practically never take seasonal allergy medication because I worry about side effects, but that’s just me.

Thank you for your reply, I appreciate it! I do have Fluticasone; however, I haven't been taking it in fear of stressing my eyes out further. My allergies are also skin-related, in that I can have rash outbreaks if I'm not careful in my current environment, which the oral solution helps stabilize. Unfortunately, I'm not sure that it can be helped—am contemplating restarting shots in the fall. Thanks again for your suggestion!

[MGD1701]

Duke Uni.? Woo, that is where Prof. Preeya Gupta works - envy you. Then you dont need our tips.
Would be great if you could share us how they treat you so we can learn somehing. Thank you.

Lid cleanser
I know she recommends Avenova (with pure HOCL), expensive but seems most top leaders in USA recommend it to control bacteria overgrow. There are 2 more cheaper brands from USA, you can easily find them if you goggle.

For compress, she recommends Bruder, as far as I know.
But I find Blephasteam is the best/safer which Dr Korb finds it helpful too - he considers wet heat is more effective.

Good luck! Can not wait to learn something from you too.

[PoeFan]

Hi all! So here's some basic information from my report. A lot of the suggestions seem to be redundant, but maybe they can help. She didn't specify on the compresses. If anything needs clarification, please let me know. I'm happy to list specifics where I've mentioned specifics can be provided. Again, I have a followup in October, so maybe I can get more information then.

I was diagnosed with Mixed Mechanism Dry Eyes OU (+aqueous deficiency and MGD). The recommendations she gave were the following:

Refresh PM Ointment or Genteal Gel QHS
Lipiflow (discussed)
IPL (discussed)
Continued use of Restasis and Xiidra
Blood testing to rule out Sjogrens, thyroid disease, and lupus, all of which I tested negative
ACE Tears (discussed)
TrueTear (discussed)
Wearing a silk mask rather than moisture chamber goggles. I've been using the mask right after putting Systane ointment in both eyes and it seems to help moisturize them fairly well throughout the night. I have a silk mask recommendation should you think these things be posted publicly.

I showed mild atrophy in both eyes, My base eye exam was normal—I do wear glasses, don't wear contacts. There are no visual symptoms of my dry eye, so I don't have the redness, irritated look, etc.—just excessive eye blinking.

I had both an external and a slit lamp exam. I'm happy to post these results if needed.

Over all visit diagnosis showed "Dry eye syndrome of both lacrimal glands" and "Inflammation of eyelid."

She suggested the following over all (not my specific routine):

Warm compresses: "Hot Pillow," "Warm Cloth," "Gel Packs," "gentle massages"

Lid Hygiene: "Avenova Eyelid Cleanser," "Johnson's Baby Shampoo or any mild cleanser," "Ocusoft Cleansing Pads"

Environment: "Be aware of overhead vents or fans," "Blink often when at computer," "Humidifier," "Sunglasses outside or when driving"

Artificial Tears: "Systane," "Refresh," "Genteal Tears," "Blink"

Ointments: "Systane Nighttime," "Soothe PM Ointment," "Puralube Eye ointment," "Refresh PM," "Genteal PM (gel or ointment)"

[edmunder]

Did you do the Oculus or Lipiview meibography?

You mention gland loss so im thinking you did.

Did the doctor press on your glands to see which were producing oil and which were blocked?

I would get lipiflow asap. The sooner the better. Go from there.

[edmunder]

If you converned with the expense you don’t understand how bad dry eye can become.

Consider tsking out several credit cards now. Do all treatments. Lipiflow. Ipl. Prokera. Use the cards. Make miniumum payments.

Then stop paying. File bankruptcy and walk away. Your eyes come first. You may need to move in with parents for a while afterwards with low credit. But you eill have your eyes in better shape.

[PoeFan]

If you converned with the expense you don’t understand how bad dry eye can become.

Consider tsking out several credit cards now. Do all treatments. Lipiflow. Ipl. Prokera. Use the cards. Make miniumum payments.

Then stop paying. File bankruptcy and walk away. Your eyes come first. You may need to move in with parents for a while afterwards with low credit. But you eill have your eyes in better shape.

Thank you for your suggestions. The doctor did press on my glands, I believe. As for Lipiflow, I have been heavily considering exploring that treatment, just have been giving cheaper suggestions a try first as directed. My followup is in October, and I will seriously discuss that option with her then. Thanks again for responding and for your suggestions!

[MGD1701]

Hi PoeFan

Thanks for sharing. Such thorough/effective diagnosis/report/recommendation. Reall envy you.
Hope now you feel better. Think positively often yields beter results, right?

Thanks again! That is indeed very kind of you.

[Milo007]

I hope I'm posting this in the correct place—apologies in advance if not.

I've been suffering from chronic dry eye since early 2015. I now live in a humid state without severe winters, as compared to when I lived in the Midwest (Indiana, Ohio, Missouri), however my eyes still suffer. I am an avid reader and computer user, for reasons such as collegiate studies, running a website and a blog, etcetera. I cannot give up any of these, unfortunately. I've found it difficult to maintain a job with my dry eye, so I am currently not working. I have been to my optometrist several times, as well as an ophthalmologist (have a followup this October) to try and tackle these conditions. I currently use Systane nighttime eye ointment with a silk eye mask for overnight relief, Restasis, Xiidra, and Systane lubricant eye drops (not sure they're really doing much), and I've used Lotemax in the past, which eventually stopped working for me. I've also tried the gel pack on my eyes for 20 minutes and rubbing baby oil on my eyes in the shower to cleanse them. I'm only 25, so it's discouraging to have to deal with this and take each day without knowing whether or not my eyes are going to act out. I've just joined this forum because I've been going through a miserable two weeks of "vacation," which have basically left me severely depressed and discouraged. I do suffer from depression and was on anti-depressants for about four years. I also have a thousand or so allergies and have to take even small doses of antihistamines to control those symptoms. I'm at a loss. I'm not sure that I can afford the higher end treatments, although we are seriously looking into those as a last resort.

I look greatly forward to meeting others, following the various forums and gathering tips from others to improve this condition so that life can become bearable again. Thank you for your consideration!

Hello friend, seems like we are on the same boat. I am 26 pursuing post graduate studies. Interestingly I am suffering from MGD 2015 onwards too. I am finding it difficult to cope up with as well. Have you tried using humidifiers and pedestal fans for air circulation below your waist line? Don't let fans blow directly onto your eyes or even above your waist.

You said you are an avid reader. May I ask how do you manage reading for long given the condition of your eyes?