An unexpected medical response to Dry Eye

[Ariel]

I'm sure most of you have heard everything, particularly when you began looking for answers without really knowing what's wrong with your eyes.

I'm on that stage now as I have not even been "properly diagnosed" as having blepharitis and dry eye. The "thorough examination" from a caring doctor with expertise on the subject has alluded me so far so I'm now at that herbraking stage in which all you do is knocking on doors only to find out there's nobody home.

Suzy123, on this forum, mentioned on a recent post having received PRP at the Vissum Center in Alicante, Spain and that prompted me to schedule a consultation with Dr. Artola there. I saw him yesterday but prior to my visit I researched everything related to blepharitis and DY condition as well as the tests normally required before treatment.

I was fully prepared to keep my visit from becoming another waste of money and as soon as I saw Dr. Artola I mentioned to him that I suffered from what it had originally been diagnosed as psoriasis, later dermatitis, along with blepharitis and DE but I had not yet received an in-depth examination from any of the doctors I had visited in the past.

Before I could begin talking about the tests I was interested in getting, Dr. Artola interrupted me to say he would not give me any of them. "If you have dermatitis you should see a dermatologist because that is the cause of the problem".

After I recovered from the shock of hearing this I said to him that my dermatitis was in remission while my dry eye was bothering me a lot at the moment. He said he could treat me for DE but he would do it without giving me any tests because they would be useless. I then explained to him that when tears are not produced in sufficient amount, if that is my problem, it can happen for a variety of reasons that need to be looked into. Tears can also be deficient in oil or mucin, which in my opinion, warranted a medical study, but he said he wasn't going to go about it "the American" way and asked me to go someplace else.

I presume Dr. Artola would have wanted me to be one of the patients that would have payed 130 euros to go home with a new brand of eye drops. He must have known there was no way in hell he was going to pull that one on me and opted to move on to the next patient.

He did refer me to an eye specialist in Spain, Juan Murube del Castillo, he said would be the one I should see if I want to try a different approach.

Have any of you heard of him?

Ariel

[Gretchen]

Hi Ariel -

Are you sure that you have dermatitis and not rosacea? These two diagnoses are often related. When my dry eyes began, I was diagnosed with perioral dermatitis. This was later revised to rosacea. And now I know that my condition is MGD resulting from ocular rosacea. It is a very common cause of dry eye and posterior blepharitis.

That said, it sounds like these doctors are pretty obnoxious. I hope that you find a dry eye competent eye doctor who can help you. Look for a corneal specialist. They are usually the most versed.

Common treatment for ocular rosacea/MGD/posterior bleph are as follows:

1. Oral doxy - 50mg - 200mg
2. Azasite
3. Omega 3 supplementation
4. hot or cold compresses
5. Restasis
6. Topical erythromycin (sp?)
7. IPL (very new in US, hard to find here, possible impossible in Europe, pm Sazy for more info on this)

I am not sure which of these are available to you in Spain however. These are all treatments that are trial and error. Some work for some, others for others and all to varying degrees. But usually your condition can improve so stay positive.

Good luck,
Gretchen

[Ariel]

Hi Gretchen,

Thanks for your reply. It looks like for most of us finding a "real doctor" is the first challenge. Many people here have the ability to spend time and money on it. If you check some of the forums in other countries with poor economies people have limited means to find the right help so they don't talk about doctors in different parts of the world or expensive medications, they just suffer and share their feelings of impotence with each other. It is very sad.

In my case. I'm still waiting to get properly tested so that a reliable diagnosis can be made. I don't know if this is a medical fact but I'm beginning to think there are different kinds of dry eye. Whether they are a chronic condition or not may well depend on the cause.

I think it would be a good idea for me to find out if I have psoriasis, dermatitis, or rosacea. I saw a dermatologist twice. The first one said I had psoriasis, which my father does have all over his hands. I only had a few skin patches around my nose that were slightly lighter in color. Pinkier as when you have a cold. The second one said I had dermatitis caused by stress. Stress is my last name so I thought he may be right. He prescribed acupuncture and a topical ointment. I was tested by neither doctor and I think that knowing what my skin condition really is should be the first thing for me to do. Right now my skin is normal so I imagine it isn't possible for me to do it.

Is MGD caused by rosacea different than MGD caused by something else? I would like to know if we're all stuck with it as a chronic condition. If there are people for whom it has vanished it would be good to know what the origin was in their case. Unfortunately, as someone else mentioned in another post people who get well leave the forum and we don't hear about it. As far as I know, there is on medical data about the evolution of DE which different causes.

Today, for some reason, I don't have dry eye. Is it normal for it to disappear completely all of a sudden for no reason? In the last few days I've increased my daily intake of canned tuna and raw salmon and I'm complementing my diet with fish oil and Omega 3. I'm using over the counter eye-drops and hot compresses every now and then but they don't seem to help. A few months ago wet plaster fell into my eyes and even though I rinsed my eyes very thoroughly the burning pain didn't go away. It was then that I went to the emergency room where they discovered some cornea abrasions and eye-lashes pointing inwards towards the eye. This is how my eye problems began.

How are you dealing with you DE? Have you suffered from it very long? Have the symptoms varied in intensity? You seem to be very focused on doing what you need to do so I hope your condition is improving.

Thanks again for your input.

Ariel
PS. If you prefer, you can send me a pm.

[sazy123]

Hey,

I did not have the same experience when i went to the vissum institute.

I think the only test he did was mucous test though, piece of paper on white of eye.. that revealed normal levels.

Serum drops really help healing of cells on the surface of the eye, so if you have mucous deficiency they will probably help. Not so much for ocular rosacea causing MGD IMO. They didnt help me. But they may help because they are supposed to be anti inflammatory.

[Ariel]

Sazi123,

In Spain Autologous Serum normally comes in a 20% concentration. Doctors most often prescribe it without specifying the strength and that is what you get. I had to fight long and hard to get a lab to prepare in a higher concentration. This was "and odd request" for them so they did it as a "special favor".

If it weren't for SAAG I wouldn't have know about the possibility of getting Autologous Serum in different concentrations. I'll soon be getting it in 100% now. The 20% Serum I got at the Vissum center didn't do anything for me, although I heard that it might have worked better if I had been taking cyclosporine with it.

[Ariel]

Sazy-- what is a mucous test?