Hi Everyone, This is (the begin) of My Story

[Yello]

Hi everyone and thanks for this forum.

I'm italian and I'm not 100% comfortable with english so I apologize for my errors.
I also apologize if I skipped some FAQs, this forum is very rich of info and I'm sure I will have the time to explore it.

I’m an Italian 27-year-old patient with vision problems (myopia on 5-6° and astigmatism on 0.5-1°) from an early age. In adolescent years orthokeratological treatment (night lenses with the dual objective of stopping myopia and seeing well the next day) for about 5 years.
I suffer from about 15 years of age from a slight Gilbert, now is better and the yellowish doesn't bother me much anymore (you can find here the very first post on DryEyeZone that I made: http://forum.dryeyezone.com/forum/dr...ert-s-syndrome, I forgot it (: )
On average at the age of 18 I noticed the appearance of several red veins in the eye, so I recklessly used the vasoconstrictor Iridine 2 for 1 year in order to "whiten" the eye, running into the well-known rebound effect. Thanks to a gradual "detoxification" after the visit at Dr. Benelli, the situation was kept under control but orthokeratology had already stopped (at 18 and a half years of age) and contact lenses were used very sparingly.
At the age of 24-25 I notice progressive deterioration of the conjunctiva of my eyes, especially the left, which always present large red veins and periods in which the "tension" of the various goods is more or less painful.
In some periods, like now, even the simple blink of the eye causes pain and a feeling of discomfort (often of foreign body, sand, etc.).
I make extensive use of my PC for work and my smartphone, using lenses with a blue light filter and other shrewdness in the displays.
The difficulty in wearing contact lenses (due to the frequency and duration in which I wear them) has significantly worsened my quality of life (for running glasses, sunglasses, changing lenses outside, etc.).

I have 3 objectives:

1. Decrease dryness and eye pain:
   - what is the cause of my dry eyes?
   - Are there any pulsed light therapies or treatments such as LipiFlow that can significantly improve the condition of my eyes (and possibly are one-time or to be repeated every how many months/years)?
   - Which "daily/periodic" therapy to follow (I use daily eye drops without preservatives + cortisone eye drops per month + omega 3 (every day every month all year round? At what dosages?) + blueberries naturally or as a supplement (in addition to the ones I already take)?
2. Improve vision
   - Can I be a candidate for laser therapy to permanently solve my vision problems, even if I also have other eye problems (dryness, swollen veins, etc.)? For this topic I just had an appointment, right before the COVID19 pandemy, with an expert surgeon in Italy. He suggested me to have a deeper evaluation of my condition to go under surgery, but he just said me "there's nothing to do" about my dry-eye, he think is caused by ortocheratology in my adolescence (but my eyes, especially the left, is still getting worse!)
3. Improve conjunctiva aesthetics
   - Is there any therapy that can be done to reduce the presence of veins (eliminate or narrow them), especially in the left eye?
   - Closing veins by cauterisation, photocoagulation, other techniques? WhiterEyes/iBrite treatments (famous in USA)?

I have no hurry but I want to take a path to an improve version of my eyes, I can go in detail of every mentioned step.

Many thanks in advance!

[epicjinx]

1. Causes could be contact lens use and or computer use since you've mentioned this. 2. Lasik I'd avoid if you already have preexisting dry eye as it can make things alot worse for you. 3. Try finding a diagnosis in your dry eye, it could be mgd, aquaeous deficient, mucin deficient that's all I'm aware of. Treatment wise, find out the cause and then start treating it from there, you wont know until you find someone. Maybe, I'd suggest a warm compress try finding a mask online and use this maybe 2 times a day for 10 minutes, within a few weeks you can have blurring which ends up being oil getting back into your eye. Use eye drops, I havent found any I like so that might be a route for you. Omega 3 I normally take a drink of it daily as it is liquid form for me. Again IPL and lipiflow might help but you need to know what's causing the dry eye. I'm going to tag rebecca Rebecca Petris just incase she has anything to add herself.

[Guest]

Hi epicjinx,

many thanks for your answer.
Actually, I didn't get a real diagnosis yet, all the doctors just watch my eyes and make me the classic Schirmer's test.
The last doctor that visited me is very famous in Italy and maybe also in some part of USA, he wanted me to have the pre-surgery visit in order to see if I am a good candidate.
Honestly I've been wearing glasses for all my life and I would not have any problem to wear them for working, watching TV etc (especially I have blu-light filter on my glasses), BUT it would be very important to me to be able to see well enough without glasses (i.e. running, going outside, swimming, etc.).

I'm thinking about this.

I will try to do this "warm compress", could you suggest me what is more specifically?

Yes I'm using daily (from 3-5 times, depending on necessity) preservative-free eye drops, with ialuronic acid.

Accordingly to both the recent ophthalmologists, I take 2 caps of Omega-3 every other month. Doses are 1400 mg Omega 3 fatty acids, of which 720 mg EPA and 480 DHA. Is it better to take them 365/365?

Thanks for attention and any suggestion (also referring to other italian cases) is appreciated.

[Yello]

Hi epicjinx,

thanks for your answer.
The last ophthalmologist that visited me is very famous in Italy and I think also in some parts of USA, like New York.
But I don't think he is specialized in dry-eye, as he simply told me "There's nothing to do", even if I have got visited by 3-4 good ophthalmologists I still have not received a proper diagnosis.
By the way, he wanted me to have a pre-surgery visit in order to check if I am a good candidate, he repeated me many times that if he will operate me he will do in safety.
Honestly I really wish one day to get rid of my glasses, at least for going outside, doing sport and so on, I don't tolerate very well lenses and I feel like living "with the handbrake pulled". Of course I wouldn't have any problem in wearing glasses (mine also have blue-light filter) for work, watching TV etc.

Actually I was thinking what about if:
1) Do something for dry-eye (i.e. lipiflow) AND THEN go under surgery
2) The viceversa

But I think that maybe I should follow 1), what do forum members think? I would like to get precisely diagnosed.

epicjinx, could you tell me more in detail how to do a warm compress? Thanks.

Accordingly to the last 2 ophthalmologists, I take every other month 2 capsule of Omega-3 per day. Doses are: 1400 mg omega-3 fatty acids of which 720 mg EPA and 480 DHA.
Maybe is it better if I take them 365/365?

Thanks again for the attention and I'm at disposition for hearing and get suggested (also with link to other threads) by this precious community.

Ciao!

[Yello]

Hello to all the community,

as I wish to share my experience in order to be useful for future users, I tell you that I booked an appointment in Milan (Italy) with the "Centro Italiano Occhio Secco" (Dry Eye Italian Center) for July, 10th (hopefully the CODIV pandemic will be less dangerous, I hope).

They promised me to make me a detailed visit of about 2 hours.

I will keep you updated when I will get the visit, in the meanwhile I will go on with my artificial tears preservative-free Iridium A Free (i put it 3-4 times a day, or more if necessary) and Omega-3 every other month.

I also forgot to say that I use 3 times a day for 3 days a month a corticosteroid eye drops called Cortivis.

For the moment, the thought of LASIK surgery is postponed.

Wish you all the best,
Ciao!

[TARYN]

Hi Yello, I can speak to you on your 3rd objective which is to improve your conjunctiva aesthetics. I had redness, visible veins, inflammation and burning caused by a loose or wrinkled conjunctiva in my right eye and pingueculas in my right eye. I had amniotic membrane transplantation surgery which gave me a smooth ocular surface and got rid of the redness, veins and burning.
This is how my eyes looked about 3-4 weeks after surgery.

[Yello]

Hi Taryn,

thank you very much for your reply.
Your eyes are very nice!
How many years ago did you go under surgery?
Actually my problem is the "internal" part of conjunctiva, I mean that one "towards" the nose (I hope to have been clear).

However maybe is the same issue.

I really appreciated your intervent, it is an additional hope for me!

[TARYN]

Hi Yello. I had one surgery more than 10 years ago and the other surgery about 2 years ago. I also had one in the nasal area like the area you are asking about.
The first photo is how the eye looks one week after surgery and the second photo is how the eye looks at one month after surgery

[Yello]

Taryn your testimony is so precious, I never got in contact with anyone that went under procedure, and you went many years ago!
That is an ispiration for me, thank you!

May I ask you:
1) the name of the institute where you got the surgery?
2) Do you think that amniotic membrane transplantation surgery is available also in Europe? I'm from Italy
3) Did the treatment give you relief also from eye pain / dryness?

Really thank you again!!

[TARYN]

Hi Yello. I got the surgery done by Dr Scheffer Tseng at ocularsurface.com in Miami, Florida. As I said he pioneered the surgery. I tried several doctors and eye drops and IPL and nothing worked until I met Dr Tseng and he was able to diagnose the the reasons for the burning and redness and inflammation. I had pingueculas and a loose or wrinkled conjunctiva. I needed a smooth conjunctiva so my tears could spread evenly over my ocular surface. He removed the damaged conjunctiva and placed a covering of amniotic membrane over that area. To answer your question, I never had eye pain but I did have burning and redness. The surgery gave me a clear white conjunctiva and completely got rid of the burning. I'm so grateful I found Dr Tseng and he was able to solve this problem.
I would call or text Dr Tseng. Maybe he could recommend someone in Europe.

[Yello]

Thank you so much Taryn!!

[Yello]

UPDATE:

I've been visited in Milan the last week by a specialised eye center.

According to the doctor my dry eye has a moderate degree and it is due both to orthokeratology done for a few years during adolescence and to a mild blepharitis in progress.
According to the doctor, my Meibomial glands have a moderate dysfunction.
Then she marked reduced tear meniscus, which I don't know what that means exactly.

I was prescribed therapy based on:
- antibiotic and cortisone eye drops, with a "decreasing" posology that covers three months
- single-dose eye drops Optive Fusion because she said the doctor has lipid components missing from my tear. To be used about every 3 hours, so in the end even 5/6 times a day.
- Naviblef mousse, to be used in the morning to clean the eyes (the eyelid edges)
- Omega 3, 1 capsule per day
- heating mask, once a day. In this regard the specific mask is Eyegiene (or Posiforlid)
- hot mauve wrap, once a day (not at the same time as the mask).
- pulsed light, to do in the fall, I think 3 or 4 sessions.


I include also the following details about myself:
- I have a "very good" predisposition to tooth decays, which along with the dry eye is a typical picture of someone with Sjogren's syndrome. According to my dentist, however, it is the roughness and porosity of my teeth that facilitates the proliferation of bacteria (while for Sjogren it should be a dry saliva that I don't really think I have).

- My mother has undifferentiated connectivitis, an autoimmune pathology that came to her a few years ago. I did some blood tests recently which showed that the ANA and ENA antigens (I don't know if I'm saying a big deal in medical terms) say that I don't have autoimmune disease in progress, ergo I should NOT have Sjogren's (besides connectivitis).

- I remember that I suffer instead from Gilbert's Syndrome, that is I have the highest bilirubin in my blood and this also reaches my eye, giving me a yellowish and not very white color. I don't know if this also plays a role in dry eyes.

- In my head I tend to have scalp desquamate, while on my arms and back I have pustules even though I am no longer a teenager. Therefore, the doctor suspects that I have seborrheic dermatitis which can also affect the proliferation of dandruff in my eyelashes causing / aggravating blepharitis. In fact, my eyelashes often fall out (although I always have a lot of them).


I will update my report on the forum keeping track of the evolution of my condition.

Thank you all for the attention

[LindaDawn]

Thank you for your update.,Always good to hear people’s experience.

[Yello]

Hello everyone, it's already 2 weeks that I started my new routine and especially the first week I was definitely better.


Sometimes, especially if I don't get enough sleep, the eye tends to come back dry and irritated, but I hope that with time and constancy this situation improves, now it's really early to draw conclusions.

Probably soon I will wear my contact lenses again and I hope that my eye will bear it better.

My routine starts with cleaning the eyelid edges with Naviblef foam, after breakfast I do heat treatment with EyeGiene or Posiforlid, I frequently (about every 3/4 hours) use single dose Optive Fusion drops in my eyes and in the evening I do warm compresses with mauve.

I use Omega3 after dinner.
I'm still using antibiotic and cortisone eye drops, but I won't be using that indefinitely.

I have 4 Posiforlid masks and I bought 130 disposable EyeGiene wafers. Posiforlid masks are cheap and reusable, but they need to be boiled for later use, so they take enough time.
The second ones are very quick to be used but expensive.

Doing 4 times a week the Posiforlid and the remaining 3 EyeGiene I hope to find a good balance between money and time spent, in fact I only need to boil the 4 Posiforlid masks all together 1 time a week, this facilitates my compliance.

I've noticed however that the Posiforlid mask tends to generate more heat than the EyeGiene, I'd like to know if any of you have tried both and if so which one you suggest or what suggestions you have!
Maybe the warmth of EyeGiene is enough, or I need to spend more time posing to benefit from the slight heat generated.

Thank you all for your attention and wish you all the best!

[Yello]

Hi everyone,

after a couple of months since the beginning of the treatment I see my eyes a little healthier.
Only one week I had broken vessels on my eye with eyepain, but now I feel to tolerate lenses better.

During the summer I used lenses 2-3 times a week, while now I'm 0-2 times a week, depending on my personal appointments (surely I don't wear lenses at home ).

The next friday I will have my first session of Intense Pulsed Light at CIOS in Milan, Italy.

I'm carrying on the current therapy even if I'm not that constant with hot mauve in the evening, I will try to be more attached

Thank you all for your attention and wish you all the best!