New to the forum! Eye problems out of nowhere!

[Topher3]

Hey everyone!

my story starts in February this year. Out of nowhere at work (IKEA) my eyes were beginning to feel dry (extremely red, dry and irritated). I didn’t think much of it until I couldn’t get through work anymore. I thought maybe the air conditioning might have caused that however I was working there for 1.5 years 38 hours a week with no problems until then. I visited an optometrist and told me that it was eye strain. I then visited doctors, the consensus was ‘allergic conjunctivitis’ so I used the brand ‘cromofresh’ needless to say that was the worst thing ever and dried my eyes beyond my imagination. Over the months I’ve seen multiple ophthalmologists and optometrists, they seem to say I have ‘aqueous deficiency and evaporative dry eye (MGD)’. I have been receiving IPL and finished that, my eyes have seemed to be a little bit better however “not a normal amount of oil” is coming out. And I cannot be in air conditioning for more than 2 seconds. I’m a 25 year old male and I have no clue how this has happened. No lasik, never had an eye problem before hand. Tested for sjorgrens syndrome and that came up negative. I’ve tried lid scrubs, eye drops, blephasteam goggles, fish oil (dry eye forte), gland expression 5 times, IPL as stated above.I’m so upset as I cannot work and I have no known ‘reason’ for this to have happened. It’s completely turned my life upside down and it’s been so hard to adapt and do normal things anymore. It doesn’t make sense I’m so frustrated.

[MGD1701]

welcome
First, you need to get an accurate diagnose - rosocea (since you did IPL), inflammation (bacteria, demodex), ...etc.

not a normal amount of oil coming out = blocked, scar tissue?

What are 3 things bother your eyes the most and when do they occur?

moisture glasses is a must for you, if you have not got one.

what tests have you done and results?

perhaps my earlier posts might help, especially warm compress as most people do not perform it right.
http://forum.dryeyezone.com/forum/ar...a-tea-tree-oil

[Guest]

Let me ask...do you snore? Do you sleep on your side? Has anyone ever told you, you sleep with your eyes open? Are your eyes worse in the morning? If not, do you notice a time they get bad?

[Topher3]

Hello! One optometrist said I have a tiny bit of rosacea on my lower cheek but nothing to cause my level of discomfort.

Optometrists have looked up close at my eye lashes, nothing was really there except one clump of stuff around one lash.

IPL was advised to help with ‘kickstarting my glands’ trying to help the nerves that link to the glands. Also to kill any bacteria that was causing extremely mild belpharitis (tiny amount of redness around eyes)

3 things that annoy me most

1. Top eyelids and top corner feel like they’re sticking to eyes (discomfort) generally starts 3 hours after waking up.

2. Cannot have ANY air blowing at all! Or instant dry irritation / complete picking eyelids off eyes.

3. Photophobia from light in darker situations. Triggers very irritated eyes. Tvs and computer screens destroy my eyes and they go completely bloodshot

i had blood tests done doctors were brief and said no sjorgrens was detected. I did a Schirmer test however they put the paper in for like 5 seconds and then determined it to be deficient. Looked to be like 10mm (based off memory) My TBUT is 2.7 seconds in each eye. No corneal staining, “corneas are healthy” for now I guess.

My meibomian glands are producing oil but not the amount that’s needed. Is what they said, it has improved over the last 2 months from practically nothing expressing.

Its so so weird it just happened I cannot explain this my only guess would be that a virus must trigger a systemic response causing inflammation to certain tissues disrupting homeostasis. thankyou for your interest and I’ll look into those glasses

[Topher3]

Hi do work! I do sleep on my eyes when I sleep, I put my head into the mattress I also sleep on my back occasionally. my fiancé hasn’t noticed me sleeping with eyes open however it could be a real possibility. Sometimes before I sleep I see the light on and wake up. As if my eyes may be opening, but that’s rare to happen. My eyes don’t feel good upon waking up however a drink of water and one eye drop in each help. They feel better in the morning and gradually get worse throughout the day, leading to photophobia at night :/

[MGD1701]

Moisture Glasses
Try lens can absorb blue light, uv etc.

tear volume
schirmer is not objective - it is complicated. suggest you read my earlier post listed above. I put all necessary info there.

staining
the objective ones should be done both corneal and conjuncativial as people could have no staining on cornea but extreme on conjuncativa, according to opinion leaders in USA.

[Topher3]

Thanks for the information. I have lots of veins in my eyes, is that an indication of conjunctival staining?

[Alix]

@Topher3 I am sorry to hear your story and can sympathise greatly as it is very similar to mine. You can see my previous posts for details but in summary my dry eye symptoms
developed overnight 10 months ago, and since then have tried every type of eye drop, supplements, warm eye compress etc - nothing is working.

I would like to reiterate the importance of accurate diagnosis advised by MGD1701. It is so so important.

Having been back and forth to hospitals, I finally went to a dry eye specialist and had Lipiview. They discovered that when I blink, my eyes are not able to close completely, and that because of this the lipids are not spreading over my eyes, What is more, I hardly have any meibomian glands left because they haven't been stimulated due to my eyelids not touching. It was absolutely shocking
to find this out but at least now I know what the reason is behind my condition.

No wonder none of the eye drops worked, it had all been a complete waste of time and money.

In your case, because you know you are sleeping with your eyes open it is likely you are also not blinking completely (not visible to the human eye, only detectable via Lipiflow where they take
a slow motion video of your eyes blinking).

Only when you know the real reason for your condition you can take the correct action to manage/cure it.

Good luck.

[Meibum Ian]

Having been back and forth to hospitals, I finally went to a dry eye specialist and had Lipiview. They discovered that when I blink, my eyes are not able to close completely, and that because of this the lipids are not spreading over my eyes, What is more, I hardly have any meibomian glands left because they haven't been stimulated due to my eyelids not touching. It was absolutely shocking
to find this out but at least now I know what the reason is behind my condition.

Sorry to hear about this. Was it the dry eye centre in london? Do you have a treatment plan?

[Alix]

Meibum Ian Yes this was the Dry Eye Centre. They told me I have EDE due to incomplete blinking and loss of >50% of meibomian glands. My tears are evaporating immediately therefore my eyes are in a permanent state of dryness.

Apparently there is no way to regenerate meibomian glands, once they are lost that is it. Also eye surgery will not solve incomplete blinking, so the best I can do it manage my condition.

So for now I have been given steroid drops and once the inflammation has gone down, I am to be prescribed Ikervis (which may or may not work for me).

In the meantime I am to sleep with moisture goggles. In the long term they said scleral lens may help to prevent my eyes from drying out, but I am rather sceptical as if I am unable to do full blinks now, it will be even more difficult with scleral lenses in my eyes.

[MGD1701]

Hi Alix,

How about your lipid layer thickness? secretion/oil quality?

Glands
Dr Toyos, 1st dr applied IPL to treat MGD says if glands are blocked, gland images wont show them. but once blockages are removed, glands will show up.
Some doctors believe so too. so dont be too frustrated. I have read, we only need 5-7 glands each lid for functional.

Incomplete blinking is due to excessive computer use or ..? if compuer use, you can train your muscle and normally it works too.

[MGD1701]

hi Topher3

secretion is not enough: some medication can have such issue. what did your dr think of the triggers then?

eye sealed. Dr Korb said eyes might be closed but not sealed. ointment or mask would help.

[Alix]

Hi MGD1701. Lipid layer is thin and oil is of poor quality.

They said IPL may help in conjunction with everything else, but I need to research this further before committing myself to this as my funds are very limited.

They cannot say what the incomplete blinking is due to. It may be related to the fact I used to wear contact lenses, or the fact I am using the computer excessively (can't change this unless I change profession), or I could have been born like this and it is only now that my eyes can.t take it anymore.

I am making a conscious effort to do full blinks but this is easier said than done and my eyes still burn like never before.

[MGD1701]

Hi Alix
Manual expression will do the job too, if you find a right doctor.

Hope the dry eye center can help you. Meanwhile, I would encourage you keep learning too as dry eye is too new and could have many triggers. After all you know your health condition better. omega 3 + GLA works better than alone which can improve oil quality but doxy might work faster.

blink reminder, I use this. Dr Korb's rule is 20, 20, 20.
http://www.protectyourvision.org/

[Alix]

Thank you for the link, I am already learning so much here. I still have hope that my condition will improve, I refuse to give up.

Do you think I can do manual expression myself?

As for doxy, the doctor at the dry eye centre said that this was a bad idea in my case (forgot to ask why), but they did say to carry on taking omega 3, GLA, as it cannot do any harm.