Hello from London

[david2404]

Hello everyone, I discovered this site a while ago and think that it is fantastic but haven’t got round to joining or introducing myself, until now. I’m a 28 year old male living in London. I’ve been having problems with my eyes for probably the best part or my 20’s. I am otherwise very healthy. I had experienced problems earlier when I worked in pubs in university due to the smoke, but the problems exasperated when I began to use computers on a more consistent basis. This was about 4 years ago and it has had a significant effect on my life since, including job changes and social life.

I was diagnosed about 2 years ago with dry eye, due to the quality of my tears, rather than quantity. I have tried a number of things which I’ll list below but the main problem for me is computer usage, and to a lesser degree television, cinema, sometimes reading. The last three I can live without but in my line of work I must use a computer at least a couple of hours a day. Even 20 mins a day I find tough so obviously hours causes me a lot of pain.

I’ve read through the computer usage tips on this site and others and I have put the majority of these into place. For me the factors that help are having a flat screen (not CRT), surrounding lighting conditions and taking breaks. The thing that helps the most though is inverting the computer screen so that all the white on the screen becomes black and the visa versa. So for instance I am looking at this website as a black screen with white type. (I haven’t read anyone mention this so if it is of use, you can do it on a Mac by going into system preferences and then universal access. I’m not sure how it’s done on a PC but I’m sure it’s possible.) I also have the brightness turned way down, which helps me a lot and tints on my glasses. So the brightness is a factor but then even with this I still have the problems. I’m fairly sure I blink more than enough, although I can’t swear 100% by this.

The confusing thing for me is why, up until the last two years or so, I have only had significant eye problems when I use a computer (which can effect me for hours and even days after). In the last couple of years I am experiencing eye problems even away from a computer and TV. This possibly coincided with moving to London, from Ireland. The pollution here in London can be pretty bad, especially in the in the Underground. As with everyone there are days when my eyes seem better or worse than others. Days when they can feel normal (if I’m not using computer or television) and days when they are burning and acidy regardless of what I do. But, generally, if I don’t have to use a computer my eyes are still much much better. For instance I have always found reading much easier. However in recent months I’ve also been experiencing severe strain on my eyes, behind the eyes and sometimes headaches when I use a computer (and even reading a book). This particular event feels like it is more a vision problem than dry eyes but I have had my vision checked and my prescription has not changed much. I have reading glasses and I am looking into getting computer prescribed glasses. Are there other possible causes of eye strain? My prescription can’t be far out and pain seems to occur very quickly – sometimes within 10 minutes. I haven’t seen an ophthalmologist specifically about this yet.

So far, I have seen only one private ophthalmologist here in London, over a year ago, and several NHS eye doctors since (a process I wouldn’t go through again!) I intend to see another doctor in the coming months. Along the way, I have been diagnosed with meibomitis and allergies and occasionally blepheritis. Roscea (Purple dye) shows some scarring on the cornea. I think my eyes look fairly normal and they almost never seem to become red or inflamed. Consequently, it’s very hard to be taken seriously or understand why they hurt so much.

I’ve tried a list of eye drops as long as my arm. I’ve tried steroid drops, and Cyclosporin ointment (similar to restasis I’m told), Doxycycline tablets and Antihistamines and I’ve had punctual plugs put in both upper and lower ducts. I’ve also tried an Anti Candida Diet (No sugar or yeast for 1 month).

I’ve had blood tests for the following:
Thyroid – Normal
Hormone levels – Normal (I have reason to believe there might be hormonal factors involved despite my blood test)
Sugar levels (Plasma Glucose) – Normal (Tested twice, early 2006 and early 2007)
Liver Function – Normal
Full Blood Check – checks for disorders and infections - Normal
Nutritional status – Normal

The things that help are warm compresses (twice daily), lid scrubs (twice) and Lacrilube at night. I find drinking lots of water so important, as is sleeping properly. And I find yawning helps. I only use drops occasionally as I find they have a diminishing effectiveness – I find Systane seems to do a good job.

I’ll sign off now, but if anyone has shared experiences, particularly with computers then please get in touch.

Best wishes

[Mcgoldilocks]

Hi, I am starting out on the whole NHS/private eye doctor cycle to try and find out what is behind my corneal erosions, which private doctor did you see? I am also in London.
I also use lacrilube at night, since finding this site a week ago I've been taping my eyes at night as well, this is helping I think as I wake up in the mornings and my eyes feel fresh and cool, which is a first - I had never even noticed that they were so dry and scratchy in the mornings, I thought that was just a normal morning thing.
I've been finding computers and large TV screens increasingly difficult to use as well, I will try inverting the colours as you suggested.

[Mcgoldilocks]

Alcohol-related dry eye

I wanted to add as well, living and working in London I've been doing the usual going out and drinking a lot, I've found this is a REALLY bad idea as drinking coffee/tea all day and drinking at night is a recipe for waking up in agony with my eyes the next day, so I've pretty much given up on the idea of getting drunk again. I would be too afraid to have a good time anyway. Shandy only for me from now on.

[david2404]

hey, I've never quite been able to put the two together, drink and dry eyes that is, but i suspect it makes a difference alright. I tried an anti candida diet for a month or so (no yeast, so no alcohol), and it made very little difference but I'm curious to see how it works for other members of this site who seem to be trying it. It all makes sense in theory.

I'll send you a PM about the Doctor I saw. You'll probably need a reference from your doc to go to Moorfileds or Western eye hospital. They might spot something but if you don't get a result first time it's not worth to keep going back. It can be expensive to go private a lot less hassle.

[Lucy]

I wanted to add as well, living and working in London I've been doing the usual going out and drinking a lot, I've found this is a REALLY bad idea as drinking coffee/tea all day and drinking at night is a recipe for waking up in agony with my eyes the next day, so I've pretty much given up on the idea of getting drunk again. I would be too afraid to have a good time anyway. Shandy only for me from now on.

Mcgoldilocks, your post made me laugh. Oddly enough, this statement has been made on this board before. Seems to some the party isn't worth the next morning. I hope you keep posting. Lucy

[Rojzen]

consider Dwelle at night

Just a quickie to suggest a trial of Dwelle, by Dr. Holly, for overnight use. . .Lacrilube and similar ointments may be counterproductive, especially in the long run. . .I've tried such ointments, and found the petrolatum and mineral oil content to inhibit actual wetting of the eye surface, even throughout the course of the day following use. . .With Dwelle, my eyelids easily slide open in the a.m., and I don't have the reflexive tearing I get for hours, in the a.m., if I fail to protect my eyes overnight. . .Yes, the Dwelle leaves a crust on the lashes, for some, but WOW is it worth it. . .And even if I don't use any more Dwelle over the course of the day, I feel its protective effects all day. . .

We are all different. . and have different needs. . .but there is nothing like Dwelle and its related Dakrina. . .Please consider giving it a try, new friend of ours. . .and please keep us posted on all the new approaches you try. . .

[eva b]

hello David

like you, I live in London, and have only just joined. And like you, I've been suffering with dry eyes associated with MGD and blepharitis for well over a year now.

We are definitely well behind the USA in terms of medical knowledge in the field of eye care here...I've seen countless NHS docs at Moorfields and Western Opthalmic, and also 3 private ones, all of whom found nothing seriously wrong except for the above mentioned, and suggest I go away and find which eye drops suit me by "trial and error".

Two of the members here have suggested a Dr Michel Guillon, in London, who seems very knowledgeable iin dry eyes. May be worth a try?

Anyway, nice to know there's a London support group in the making - check out the Open Forum - European section.

best

Eva

[david2404]

Hi Eva, I'm seeing Michel Guillon today as it happens so I'll let you know how it goes. I've only seen one other private guy in london and his name was Steven Bailey. Nice guy and he seemed to know his stuff but beyond punctal plugs and steroid drops he wasnt sure what to recommend. I got the plugs and i think i've still got em but they were silicon and practically invisible apparently and can fall out, so whether they're still in there or not i'm not sure. Either way they didn't make that much difference as my problem is more tear quality than quantity. He mentioned autologous serum drops but when i followed up he said that the lab that makes them (from your own blood) didnt do it anymore as they weren't proven.

I use lacrilube which helps immensly, but i've been using it for over a year and starting to agree with some of the suggestions that it hinders the natural production of tears. I found if i don't take it now my eyes feel much drier than they had before i started to take it, so i become reliant on it. I will try some new drops at night, staring with dwelle (thx Rojzen!) and see if it makes a difference. But i will wait until after this appointment today!

[eva b]

I'll look forward with great interest to see the outcome of your visit with Dr Guillon - in particular I'd like to know the details of how he performs the exam, and what eye drops he uses to look at them.

Last time I had an exam, I had an awful reaction to the drops used - both anaesthetic and dyes - which lasted 4 weeks. This makes me awfully nervous of going to see anyone.

Anyway, best of luck - and I wait with bated breath

best,
Eva

[Zarla]

Reading these posts, I'm starting to think that the pollution in central London is a real issue. I teach in a central London school and from our top floor classrooms you can see the layer of brown pollution over the city. Whenever we go on holiday abroad, always to somewhere quiet by the sea, my dry eye symptoms improve hugely.I wonder if it's the same for people in cities elsewhere in the world?

[david2404]

I had an appt. yesterday with Michel Guillon but it was only the first of what could be two or three. I've been having a lot of eyestrain/headaches so we decided to look first at my prescription and we will look at my dry eye problem the next time. So for the moment there is very little to report. My prescription is pretty much what it should be so wouldn't explain my eyestrain so he wants to try something the next time. It's possible that my eyes are not relaxing properly and so he wants to put in some drops that will make the muscles relax. He'll then do another eye test and if the prescription is different then we will know that my eye muscles are in a constant state of cramp/spasm. It's a theory but seems to make sense and fits with the way my eyes have felt in the last few months. It may be due to the fact that one of my eyes is stronger than the other, but i only wear glasses for reading and computer. So when I'm not wearing them my weak eye is constantly struggling to keep up with the other. I guess I'll find out soon. My follow up is in two weeks time.

By the way. There is no doubt for me that the pollution in London makes a huge difference to my eyes. Certainly when i've been on holiday somewhere with clean air like the alps my eyes are much better. I've moved somewhere closer to work so I don't have to use the underground which is horrible for the eyes and it's made a big difference for me.

[eva b]

thanks for posting that David - he certainly seems to think out of the box. I find his theory particularly interesting because I've got a similar problem - one eye much "lazier" than the other (had a squint which was corrected when I was a childl) and this eye is now having to do most of the work because of the scarring on the other cornea.

Please keep us updated, and good luck!

[david2404]

Hi folks, it’s been a while a haven’t updated my story so I’m afraid this post is a bit long!

I last saw Michel Guillon in Feb/March. I didn’t really get to discuss much of my history with him but I had a couple more sessions the results of which I’ll describe below.

He dropped some dyes in my eyes (purple dye then yellow dye). The dyes showed up staining in both eyes on the sclera, which highlighted some scratching/scarring. He told me this was due to a mucin deficiency. He also noted that no mucin on the underside of my lids meant when I blink I am scratching my eyes – so blinking does the damage.

The purple dye also showed some blocked meibomian glands representing some mild MGD.

He prescribed Systane preservative free vials for day time and Theratears (vials) at night.

For my eyestrain and headaches he recommended wearing my single vision reading glasses all the time. But he also wanted to check whether my prescription was adequate (he thought I might still be having accommodation issues even with my glasses) so he put drops in my eyes to relax them and dilate the pupils to check my prescription when my eyes were relaxed. The result was to give me a slightly stronger prescription.

As for the diagnosis, it is pretty much the conclusion my previous ophthalmologist came to. Though he seemed more sure that it was due to mucin deficiency more than anything else. Although, I was thinking, I do get a fair bit of ‘sleep’ in my eyes in the mornings (with or without drops the previous night), especially in my right eye which is usually the worse of the two. Does ‘sleep’ represent the presence of mucin?

Anyway, I tried the regime for two months. I think it definitely helped for the first month but it had diminishing effects. I had been using Syatane before I had met with Mr Guillon but not as often as he recommended (every 3 hours) My eyes never felt close to normal but maybe some improvement for a while.

Since then I have tried progesterone (15%) cream which had no noticeable effect. I have also been using Borage and Primrose oils 2000mg every day on top of the 1000mg of Fish oils. In the last two months I have been using Dwelle and Darkrina. I have primarily been on Dakrina because of the Vitamin A benefit for mucin and using the dwelle at night. Again, initially I had some good results but I don’t think I have improved much since then.

The opthamologist also recommended Supranettes instead of the Novaritis lid scrubs I was using. I found The Supranettes not ‘soapy’ enough and they seemed to scratch my eyes more so I have since returned to Novaritis.

He also said that the warm compresses were unlikely to help me (maybe because the MGD is less of an issue than the mucin) but after not doing the warm compresses for a while I started again and found it is definitely of some benefit to me.

As for the eyestrain and headaches (especially around the temples), I got a pair of glasses made up to the prescription the ophthalmologist gave me (which were stronger than my ‘normal’ prescription) and I found them impossible to see with beyond a foot in front of me and resulted in worsening of headaches and strain. So I tried my optometrist’s recommendation of a slightly weaker pair of reading glasses for use with the computer. They’re much clearer and can work better at distance but unfortunately I also get headaches with them. I think because when they reduced the prescription they also removed the astigmatism correction (0.25) from one eye. How and ever, I’ve been using my old glasses again which seem the safe bet for the moment. It’s an expensive hobby figuring out your eye problems.

I still haven’t figured out the headaches but for some reason but after 6 months they seem to be more sporadic, whereas before I was getting them every day. It’s also been complicated by the fact I had an ear infection so i wasn’t sure what was affecting what. What I can definitely say that when I go to work, if it the office is hot and bright both of these contribute massively to my dry eyes and headaches.

Dust and pollution are also definitely factors (and I was allergy tested when I was young and told I was allergic to dust mites) but I have tried antihistamines to no effect.

As almost everyone seems to find some days are much worse than others for reasons I don’t always understand. But although my eyes have gotten much worse over the years I am still able to live a fairly painless life if it is away from a computer and TV. In this sense the weekends are great, but even if I sit in front of a computer for a few minutes, bang, I’ll get a combination of dryness acidity and strain. Brightness is a major factor but then if I’m watching Tv, (which is some distance away) I get similar symptoms. I’m experimenting with goggles at the moment and my optometrist also mentioned prisms but said she thought I was too young for them. but obviously still searching for answers. Any advice is welcome ☺

By the way, I don’t know of there is anything in this but I have blue eyes and I am both long sighted and colourblind. I can’t find any connection between dry eyes and the latter (I don’t fully understand colourblindness but I know it is something to do with reduced number of cone cells in the retina of the eye- could this be a factor when looking at computers?) but I was wondering how many people having problems with computer work are long sighted? And how many have light coloured eyes?

I haven’t been back to Michel Guillion in so long because I wanted to try other things first (eg Dakrina) and because when I asked him what the next steps would be if the systane didn’t work he said he could try and get some more drops from France – but I’m guessing that he won’t produce anything that hasn’t been discussed on this forum. Though perhaps I’m wrong and I do intend to make a visit soon to see if he has any other advice.

Best

David

[bernmee]

Hi David,

Being from Ireland (nice and humid cause of the rain) and going to London could have something to do with the pollution and the humidity. I keep track of teh humidity where ever I travel, that way I know when things could get bad. Right now I live in San Francisco but when I travel outside the foggy city I keep an eye on the humidity levels. Who would ever have thought I would carry just a thing in my purse. It is nice to know though if I do ever return to Ireland I may enjoy that rain, never thought I would say that!

I use Dwelle, Systane pres free (though that has never given me any releif) and nutratear. As for relief I have had grear success with Genteal gel (not ointment) for severe dry eye. It was recommened by people on this site as I couldn't et through the night without waking in pain. The difference in the last five nights has been amazing, and a pain free night seems to lead to a pain free day. I can't say enough about the difference that has made for me.

Have you read the book by Dr. Rob L that is available through the dryeyezone shop. I'm sure you can get it in Europe also. It gives great advise on lifestyle, nutrition etc. I have cut out all alcohol from my life. I had two beers on Saturday and got a slap on the wrist on Sunday...not pain but enough to remind me of what I can and can not do. Being Irish the no alcohol has meant a serious change to my social life, but you got to do what you got to do!

Keep well,

B.