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From France - MGD + endometriosis

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  • From France - MGD + endometriosis

    Hi all,

    I'm a 27 year-old living in Paris, and I have recently been struggling with MGD.
    It seems there isn't much of a community like this in France, which is why I'm signing up here. I've been visiting this forum for a few weeks and thought it'd be good to connect.

    Although I've always been careful with them, I wore contacts for a very long time (pretty much 6 days a week from 13 to 24 years old). I then suddenly started experiencing discomfort when wearing them — my eyes felt dry. I saw a couple of ophtalmologists who advised I cut down on wearing contacts and use artificial tears when wearing them. I did just that for the next couple of years — wearing contacts only when I really couldn't wear glasses, or for special occasions, and taking them off after a few hours. I also switched to dailies, which made matters a tiny bit easier.

    I saw an ophtalmologist again at the end of 2019, who gave me a quick TBUT test, wasn't happy with the result, and prescribed corticoid drops for a few days, to see if it would help. A couple of weeks after the treatment, I started getting that familiar dry eye sensation all the time — not just when wearing contacts. I immediately thought "uh-oh", started reading up on it, and realized this probably wasn't an easy thing to cure and that most ophtalmologists wouldn't really know what to do beyond prescribing eye drops. I also realized I shouldn't waste time and would need to get a proper diagnosis as early as possible.

    I reached out to the two specialized services I was able to identify in public Parisian hospitals — at Quinze Vingt and Hôpital Bichat — but they both asked I provide an ophtalmologist's referral to be able to see a doctor there. I took the quickest appointment I could, at an ophtalmology centre where I've seen several competent doctors over the years. The doctor I saw that day was very skeptical and reluctantly did a TBUT test again. I've since learned that my result wasn't great, but she seemed happy with it and told me since my eyes weren't dry, there was no way she would give me a reference to a specialist. I tried to protest her diagnosis, but when I realized she was annoyed with me and started to let on that she found me at best annoying, at worst crazy, I didn't want to waste my time and left. She sent me off with a prescription for regular artificial tears and told me to come back in a year (!!).

    In early January, I finally managed to see a dry eye specialist at a Parisian private practice I found by doing my own research. He's very expensive, but was equipped to give me a Lipiview exam. Basically, I have MGD, with no atrophy yet, and my blinks are incomplete. He prescribed saline and corticoid drops and a corticoid gel, which I had to do for a couple of weeks without noticing much change, as well as daily hot masks, eyelid massage and fish-oil + vitamin A supplements. He asked that I come back in March if nothing changed — and here we are and nothing has, although the mask provides temporary relief. I don't feel like I've been able to express the glands yet. His practice provides Lipiflow and low-level light therapy (LLLT). Since LLLT is significantly less expensive and has, according to him, a good chance of providing results for me, he advised I start with that. I'm meeting him again later this week to discuss it.

    I have my doubts, as I've only really read about LLLT in combination with IPL. Since LLLT is already expensive and time-consuming, I have a hunch it would be better to look into someone who can perform IPL. I'm planning on discussing this with him this week.

    Basically, it seems I cumulate a bunch of possible causes and enablers: lots of screen time (I work in media), prolonged contacts wear, polluted environment, allergies, and a history of psoriasis.

    Another significant condition I have grappled with for years is endometriosis. It seems there may be links between dry eye and endometriosis, and I'd love to connect with people who have experience with both. I've taken several different birth control pills over the past couple of years, and I know hormones can play a role in dry eye. My endometriosis also causes digestive problems, which I'm sure can also play a part. (On the bright side, I feel more confident and in control with the dry eye journey after years of not knowing who to consult and of several doctors not taking my symptoms seriously, or simply not being interested in putting in the extra work.)

    Right now, the dry eye is bearable — I've grown used to the sensation and can still work on a screen — but I'm determined to nip this in the bud while it is still manageable. Any advice is welcome!
    Last edited by selah; 02-Mar-2020, 07:30.