Blepharitis, Very Dry Eyes - aged 24 and suffering - please help

[SharonS]

Hello there, just thought I would introduce myself and my story and wondered if anyone has any further information/advice.

I am 24 years old and have had posterior blepharitis for 2.5 years. It went undiagnosed until 3/4 months ago having tried various optometrists and doctors. My only symptom for 1.5 years was that my lids stuck together in the morning. Last summer I started to develop contact lens intolerance - not all of the time but sometimes my eyes would start to become red after a certain amount of time and my eyes felt tired. My only other symptoms aside from contact lens intolerance were that my eyes would still stick together in the morning and would be itchy at end of the night. In January this year, my eyes started to feel better with contact lens and I was able to wear them for longer periods. However, this all changed after I fell asleep on a train for roughly 2.5 hours wearing my lens. Immediately afterwards, my eyes were bright red and were intensely dry/burning sensation. Most of the redness went away the next day - but since then, my eye symptoms have completely changed. They are red all the time, with quite prominent veins that were never there before, redness worse in the morning and night, I struggled to read and use my computer. There is a constant burning sensation and a tight feeling. I feel so confused because I believe this shift in symptoms was a direct result of napping in my lens but not quite sure what happened?

2 weeks after that incident, I sought out a private ophthalmologist for a thorough examination. He told me I had posterior blepharitis - I started a regime of twice daily eye bag, 2x lid cleanse, omega eye supplements and hylotear eye drops. After 6 weeks, I felt no improvement so returned to him and he said my eyes looked much better, to continue with the regime and advised me to reduce eye bag use to 3/4 times a week. Recently, I went to see another optometrist who also told me I had done a great job with my blepharitis but that the dryness has persisted, and that my tear film is very thin, with my tears breaking up after 3/4 seconds. She told me that she didn't know why this was the case as my glands seem to be secreting oil fine, and that sleeping in my lens would not have done long-term damage. She advised that I continue my regime, particularly with the Omega 3 and believed that in 3 months time, I should see more improvement.

I really want to believe her, and stay positive but at the moment, the dryness in my eyes is making me feel stressed, anxious and incredibly sad. I never wear contact lens anymore and find glasses uncomfortable. I suffer with the pain every day, and the change in my appearance has really affected my confidence. I don't know what else to do? Whilst I've been told the blepharitis has improved, my dry eye has worsened so much following lens incident and subsequent treatment, and I just don't understand what has happened, and what to do.

Sorry the long story! Thank you for listening.

[Alex91]

Hi, I dont know if i can help much but I unedrstand how you feel, I am 23 and suffering from dry eye, I think you shoul continue with your regime and also to use eye drops to relieve the pain and add some moisture, I totally understand how you feel it so frustrating also you better avoid windy/dusty conditions because that just wont help your eyes, Of course i cant tell you exactly what you need to do but at least I can give you some advice like that, also drink plenty of water to keep your overall hydration
I personally use the refresh tears by Allergan and Im looking forward to try an eye gel for bedtime by this same brand because my lids also stick together in the morning and sometmes I feel like I cant have a decent sleep because my eyes are soo dry and with burning sensation :/
Hope everything works out for you

[SharonS]

Hi Alex, just wanted to say thank you for your kinds words. Sorry for the late response I haven't been signed on the forum for a while! I was wondering how you are getting on and if you have had any improvement? Best of luck to you xxx

[SharonS]

Hi all, I am quite new to this forum but would like to post an update on where I am with dry eyes and to see if anyone has any suggestions.

I have evaporative and aqueous deficient dry eye, posterior blepharitis and age 24. My symptoms are burning, redness, stinging, recently I have clumps of gel like mucus that gather in corners of my eyes, sore eyelids and constant awareness of my eyes. Symptoms are awful in the morning, I have such pain opening my lids, mild swelling and very heavy feeling that lasts 1-2 hours, redness also. Have had allergic reactions to ointments so only use either fresh kote or hylo forte at night, neither of which are strong enough.
So far, I have had lipiflow, 1 month use of FML, 8 x daily capsules of omega eye (omega 3 and vitamin d), 2 x daily warm compress and massage, eye drops as and when needed.
Today I had a 2 month review post lipiflow/FML, and nothing has changed. My Schirmer results were extremely low and oil glands are mostly open but it's not clear oil, its thick gunk that's coming out.
I have been using cliradex wipes for one week but have seen no improvement.
I am starting to become convinced there's some kind of allergic component to this (to explain the aqueous deficiency?) but do not know how to pursue this in the uk. I am becoming convinced because the only time I experience any relief from the horrible burning and irritation is when I bathe my eyes with cool boiled water and a pinch of bicarb. The doctor who performed lipiflow told me to be patient and to see her again in 6 months as my eyes are not ready for punctal plugs yet and she doesn't think she can justify restasis use. I do not think I can continue on like this for another 6 months and simply do not know what to do now. I am from Edinburgh and have been travelling down to London for appointments.

Thank you

[waterbee]

Hiya, your symptoms are the same as mine, though my bleph is very mild. I was given lower plugs with in weeks of my dry
Eyes staring (not a cure, but a help) it does seem unnecessarily long to wait 6 months to try them? What was the reason to wait?
I get huge relief when wash my eyes too, they feel normal for those few seconds after! could this be a sign of allergy? What's the theory behind it? It's got me thinking.by the way
Have you tried the heated steam goggles? They help a lot with the stinging for me. Forgotten there name but perhaps someone can remember and post it.

[cathy8889]

Hi Sharon

Sorry youre going through this. It's horrible but things have got better for me so keep working on creating your own treatment plan.

Your symptoms sound exactly the same as mine this time last year, heavy lids all day, gritty, dry, burning sensation, it was awful. I dont have the clumps of mucus like you. When the ophthalmologist expresses your glands what is the oil like? Is it thick or frothy? Mine were frothy and full of bacteria. The ophthalmologist I saw in Birmingham put me on oral doxycycline for 8 months, they helped me so much. I strongly believe now that my mgd was caused by bacteria and demodex. I use blephasteam goggles, warm compresses made my lids even more swollen and I only wash my eyes in cold water.]

Have you ever been on doxycycline? For me I dont believe that lipiflow would help me as I believe that lipiflow is best for people who have thick toothpaste secretions that need to be thinned. If your oil is frothy it needs to be cleared and the doxycycline did this for me, alongside strict eyelid hygiene with sterilid eye gel by thera tears which I leave on for two minutes to kill demodex and then wash off thoroughly.

I had punctual plugs put in about 7 months after I started the doxycycline. The ophthalmologist did not want to put them in before the course of doxy because she wanted to clear the glands out first and improve the oil otherwise toxic tears would be trapped in my eye for longer with the plugs which would continue the cycle of inflammation.

Do you feel like your ophthalmologist knows what theyre doing? Are you seeing someone private?

Cath x

Hi all, I am quite new to this forum but would like to post an update on where I am with dry eyes and to see if anyone has any suggestions.

I have evaporative and aqueous deficient dry eye, posterior blepharitis and age 24. My symptoms are burning, redness, stinging, recently I have clumps of gel like mucus that gather in corners of my eyes, sore eyelids and constant awareness of my eyes. Symptoms are awful in the morning, I have such pain opening my lids, mild swelling and very heavy feeling that lasts 1-2 hours, redness also. Have had allergic reactions to ointments so only use either fresh kote or hylo forte at night, neither of which are strong enough.
So far, I have had lipiflow, 1 month use of FML, 8 x daily capsules of omega eye (omega 3 and vitamin d), 2 x daily warm compress and massage, eye drops as and when needed.
Today I had a 2 month review post lipiflow/FML, and nothing has changed. My Schirmer results were extremely low and oil glands are mostly open but it's not clear oil, its thick gunk that's coming out.
I have been using cliradex wipes for one week but have seen no improvement.
I am starting to become convinced there's some kind of allergic component to this (to explain the aqueous deficiency?) but do not know how to pursue this in the uk. I am becoming convinced because the only time I experience any relief from the horrible burning and irritation is when I bathe my eyes with cool boiled water and a pinch of bicarb. The doctor who performed lipiflow told me to be patient and to see her again in 6 months as my eyes are not ready for punctal plugs yet and she doesn't think she can justify restasis use. I do not think I can continue on like this for another 6 months and simply do not know what to do now. I am from Edinburgh and have been travelling down to London for appointments.

Thank you

[SharonS]

Hi Waterbee, thanks for your reply. My doctor wanted me to wait until the oil from eyes clears so as not to trap any inflammatory particles in my eyes with plugs. I understand that but after lipiflow/omega eye/compresses for 6 months, my eye glands just seem to be getting worse?!

I am thinking allergies because this started with a reaction to an eye makeup remover where my lids became swollen, ever since my lids stuck together in the morning although I had no other symptoms for a long time. A course of antihistamines for one month stopped the lids sticking together (I took those for prickly heat, didn't even think of the impact on the eye benefits at the time). I was reading about dry eye and allergies somewhere- it was something like bathing the eye with a saline solution won't help dry eye symptoms but it will get help remove any inflammatory particles if you have allergies. I think allergies caused this and I've since developed dry eye due to chronic inflammation of the oil glands and tear glands... It's the only way I can explain the aqueous tear deficiency as well the oil glands. If I only had MGD, I would have enough tears... Doctors just don't seem to have time to Listen to this theory... It might be crazy but I feel like I need to eliminate everything.

[SharonS]

Hi Cathy, thanks for your reply.

I've been told that the oil from my glands is thick like toothpaste, and that it needs thinner out. I haven't been told it is frothy but I will ask the next time I see someone. Lipiflow did not help to unclog my glands. I get itchy eyes and my symptoms are worse in the morning so I did wonder about demodex. I haven't asked a doctor about this yet. I have been using cliradex 2x day for one week and changing my pillow cover every night. So far it hasn't made a difference but I know treatment can take time. I haven't been on doxycycline before - I have asked about it but every doctor and optometrist I've seen has advised me to use omega eye supplements instead and I was recently told by my optometrist again that doxy wouldn't help in my case. I wonder if I should I pursue this again? I am open to trying anything.

I have blephasteam goggles that I try to use 2 x a day but sometimes I need to use an eye bag if I haven't enough time. I then use a cotton bud dipped in warm water and press on my glands gently. Then I bathe my eyes in cool boiled water and pinch of bicarb (this brings me the greatest relief, sometimes if my eyes are really sore, I will do this alone and I get some relief). I use a cold eye mask first thing when I wake up to help swelling and last thing at night. I also use sleep goggles or a sleep mask if too tired.

What is your diagnosis Cathy? Do you have any tear deficiency? What are your symptoms at the moment? I have been to see a private opthalmologist in scotland twice but he really dismissed my condition and it hurt my confidence for a while in trying to pursue this. I have a good optometrist who is kind and understanding but they don't offer much in the way of treatment. The doctor in England performed lipiflow and I have seen her twice. I finally managed to convince my go to refer me to an nhs opthalmologist but still waiting for an appointment (6 weeks now). I am absolutely desperate for a thorough diagnosis and considering going to the the dry eye clinic in Norway which seems to be excellent. Have you had luck with any doctors in the uk?

Sarah

[waterbee]

I understand how you feel, I'm waiting still for my nhs referral too, but have sought private specialists in the mean time. I've also tried lipoflow and am now looking into IPL, as I've read some good things about it. There is a specialist in London that does it, and they do quite a few tests first to try and help but nothing to do with allergys alas. Does anyone know any medical role that exists for purely diagnosing allergy s like this? Not just a few, but 100s of tests that could be done for different reactions? There must be someone who does this...