Gunk on eyelids and eyelashes

[jennyoxon]

I am new to this site, living in the UK near Oxford. I suffer from acutely dry eyes - virtually nothing to show on a Schirmer test - and also have blepharitis. Working from current recommendations over here I use Celluvisc routinely, sometimes up to 4 times an hour when things are bad, together with Lacrilube at night and during the night.

I find that the edges of my eyelids get gritty pieces along them and my lashes get coated with a scaly deposit, which I imagine is mainly the residue from the cellulose in the Celluvisc, though it might also be partly residues due to the blepharitis - I do not know. It is irritating and then I rub my eyes, and have to scrape the crud out of the corners. This doesn't help my eyes! Despite using hot water pads and Q-tips five times a day, I can't get rid of all the deposits.

Has anyone any tips for getting rid of the stuff efficiently without drastic rubbing and scraping? All ideas gratefully received!

Super site - best wishes for your efforts. jennyoxon

[Rebecca Petris]

Hi Jenny and welcome!

Very sorry to hear about your eyes

Some thoughts...

1. 4 times an hour is a LOT. Some people seem to be able to do this without ill effects but personally I tend to think that when 'dropping' frequency creeps up to more than every couple of hours, one is better off investigating and maxing out other treatments, and when it's more than every hour, there are dangers, because all those artificial tears are basically washing away what few 'good' tears you may actually be producing and leaving the eye surface more vulnerable. Many people (not saying all of course) who drop that frequenty actually find they feel better when they cut back on the drops.

How are you treating the blepharitis? Lid hygiene, warm compresses, Omega 3s and doxycycline may all help with this.

Have you considered eyewear (like Panoptx) - this can reduce the need for drops as well.

You may also want to check out some of the tips here about controlling pain in other ways than constant drops. Warm compresses, cool compresses/ice, goggles, lots of ways to help get discomfort under control.

2. to try and answer your question about the residue... I used Celluvisc in my first year after lasik so I know exactly what you're talking about (also, Dwelle has residue like this though slightly different). For me the best way to reduce residue is apply a SMALL drop, try not to get it on the lashes, blot after application, and use a warm washcloth in the morning to remove residue. But to be quite honest when you're applying it that frequently I think there's no help for it and I would be worried that the residue, and dealing with it, just increases irritation of the lid margins.

3. Similar caution about Lacrilube. First it is preserved with chlorobutanol so probably not great to have that on your eye all night. Second - and this is just personal opinion (I'm not a doctor) - many people here have found an increase in dry eye symptoms when they use that stuff regularly. Possible alternatives are good quality eye covering at night and a long-lasting non-greasy lubricant.

[Guest]

Jenny

Being a fellow UK member, I have a fair idea what you are going through with limited access to product.

I support Rebecca's comments about Lacrilube. It did nothing for me but make my symptoms far much worse. However, when you have limited products at your disposal you use what you can.

In the UK, we can get a product on prescription called Viscotears Preservative Free. It is a fairly thick product that some of us use of a night. I sometimes switch between this and Genteal Gel (which is not available in the Uk).

If you want to try it, I have a few vials of Viscotears I can send you before you rush off and buy some.

Celluvisc is a good product, the other thing you can get on prescription is Refresh Liquifilm (it is a polyvinyl product), this may also be worth a try.

There are other products available (Systane and Theratears) but neither of these are available on prescription and are quite pricey in comparision.

Send me your details via email if you want to try some Viscotears.

Cheers

Ian

[Jade9923]

I'm sorry for all you are going thru. With regard to getting the gunk off of your eyelashes, you will need to use baby shampoo or one of the premoistened eye lid scrub pads. Water alone will not remove the residue. Get a good lather up and scrub them down. Do this several times a day if necessary. I pour some baby shampoo into a 3 oz dixie cup and then add hot water to make suds. I used q-tips to scurb and rinse my eyes. It totally takes care of the problem for me.

[jennyoxon]

Dear Rebecca, Ian and Jade

Many thanks for your very prompt and helpful responses. It's so good to know that there are lots of other people out there who understand the problem and are keen to help. And it's a wonderful site to have set up, Rebecca - congratulations.

I will now try to respond to the various comments made. Unfortunately I cannot figure out how to quote from each of you, or whether I have to respond individually or can do it all in one go, so will just have to try the latter and hope for the best! I will start with Rebecca's response.

I am using it so frequently because it is the only way I have found to stay sane! And the specialists have told me that I have dry patches on the corneas and that if I don't keep them lubricated I will damage the surfaces - get ulcers. When it has been really bad I have just had to sit with cold compresses on my eyes to cool them down. I am trying to treat the blepharitis with hot compresses 5 times a day, plus lid wiping with Q tips after each of them. I've been using baby shampoo, much against my better judgement but that is what the hospital specialists told me to do, and with no other advice I have simply done that. But as I am allergic to almost all shampoos, perfumes etc it always seemed risky, and I have now stopped using it and just using boiled water or saline. I might also try squeezing the glands. I am also taking omega-3 supplements. I always try to use a small quantity of celluvisc at a time and always blot after use.

I will try to obtain some Panoptx specs, but they only seem to be available over here by mail order from the US, and I don't know how easy it will be to adjust their fit for my use. Also I really need bifocals, and the local opticians say they cannot make these for wrap-around specs, so that is a real problem. Maybe I'll have to come to the States to have something fitted.

The Lacrilube that I use says on the box "Preservative-free", and the percentages of the three stated ingredients add up to 100, so I think that you must have a different formulation in the US.

Ian Many thanks for the suggestion of liquifilm, but I have tried this in the past and it didn't work so well for me as the Celluvisc. I will go to the doctor after Easter and ask for some Viscotears to try, starting first with using it just during the day. It is very kind of you to offer to post some, but I can get a (free) prescription, so will do this rather than putting you to the trouble, but I am extremely grateful for your offer. (Will be staying in Leeds over Easter - maybe the coooler climate up there will help. Have considered moving to somewhere cold and wet as a last resort - West Coast of Scotland perhaps!)

Jade Thanks for the advice. As I have already written to Rebecca above, I have been using baby shampoo but have been very wary of it, due to my sensitivity to detergents and perfumes - I can only safely use the Simple range of shampoo and other hypoallergenic formulations. I have stpped up the hot compresses from 2 to 5 per day, and dropped the baby shampoo, and that may be the cause of a possible slight recent improvement.

Once again many thanks to all three, and I will update you as things progress. Best wishes to you all Jenny

[Guest]

Jenny

The Lacrilube in the UK is preservative free - I checked with the pharmacist and they confirmed this also.

Viscotears comes in two formats here in the UK. It comes in a tube (10g I think) or you can get it in preservative free vials - 30 in a box. I would recommend the preservative free option as it is available.

I live just south of Leeds and I am not sure that the cooler climate makes much difference to be honest - we just have the heating on more than our southern friends and that is not good for already dry eyes.

I agree that I don't think you will find a colder and wetter place than the west coast of Scotland.

Take care and I wish you well

Ian

[Rebecca Petris]

Jenny,

I am using it so frequently because it is the only way I have found to stay sane! And the specialists have told me that I have dry patches on the corneas and that if I don't keep them lubricated I will damage the surfaces - get ulcers.

I understand. At that level of severity, one further step then that might be worth exploring with your doctors is bandage contact lenses.

But as I am allergic to almost all shampoos, perfumes etc it always seemed risky, and I have now stopped using it and just using boiled water or saline.

Good move. As with all treatments "your mileage may vary..." - I know some people who do great with baby shampoo and others whose symptoms are clearly exacerbated by it.

I will try to obtain some Panoptx specs, but they only seem to be available over here by mail order from the US, and I don't know how easy it will be to adjust their fit for my use. Also I really need bifocals, and the local opticians say they cannot make these for wrap-around specs, so that is a real problem. Maybe I'll have to come to the States to have something fitted.

The biggest challenge is a well-fitting frame. There ARE wraparounds that can be made with bifocals, including Panoptx and I think maybe WileyX, and even progressives.

OK here's a challenge for all our friends in the UK:

Can anybody find a friendly OD or optical shop that they can persuade to become a Panoptx dealer?

Maybe Matheson's, or that popular dry eye doc in the north whose name always escapes me? Being a dealer isn't hard, all you have to do is buy a fitting set (minimum five pairs I think). They could then just keep those pairs on hand for people to try on, and special order glasses for people who need them. It sure would be a great service for people there....

[jennyoxon]

Dear Ian & Rebecca

Thanks again for your prompt responses. Ian - I have always gone for preservative-free on the specialist's advice. Seems a good policy generally! Where we stay in Leeds doesn't turn up the heat that bit more - we wear extra clothes!

Rebecca Thanks for the bandage contact lens idea, which I will explore, and I will also try to gee up a local optician to become UK specilaist in Panoptx fitting. Clearly the advice I have obtained recently as to the impossibility of making bifocals for them is wrong, so I will keep trying.

Most grateful once again. Jenny