filamentary kerastitis - possible solution?

[ok45sg]

"Subsequently, friction cause by blinking and/or movement of the eye develops between the palpebral conjunctiva and the injured epithelium and produces the filament core. Further frictional stress is exerted by the eyelid, and the core then entwines with mucin, conjunctival epithelium, fiber of DNA from postlesional nuclei, and inflammatory cells, thus building up the filament."
http://iovs.arvojournals.org/article...icleid=2185853

On the result indicates that filaments are built up from the friction of blinking or moving the eyes, so is keeping the eyes closed part of the solution?
Exploring as Acetylcysteine 5% (strength used) eye drop - is expensive - used to break down the mucus plaque.

Any comments, appreciated.

[LaDiva]

I had this and it is miserable. I used Acetylcysteine for awhile, but it provided only very temporary relief. My filaments went away after I started doing hot compresses and expression three times a day, wearing goggles and after getting plugs. (Also using eyedrops regularly.) For me, getting rid of filaments meant working on the overall health of the eye with dry eye treatments and being consistent about those treatments. I think if you can improve the environment of the eye you will notice a difference, but it will take awhile. Everyone is different though. Best of luck to you.

PS- Keeping my eyes closed always makes my eyes feel better, but we must sometimes use your eyes, so I would consider the things mentioned earlier. If you are already doing them, try more. If more doesn't work, try less, but give it a good amount of time to see if it helps. Drops do help reduce friction.

Sorry. I always fail to notice this section is for Docs and patients and I am far from being a Doc. Anyway, this is my personal experience and what worked for me. I no longer have filaments, and the eye surface has completely healed. Hope the same will be true for you.

[ok45sg]

Thanks for your response LaDiva and I am happy for you re the healing of your filamentary keratitis condition. However, I reckon you still am a DES patient.

To clarify, I am caregiver to a DES patient, and we are in the tropical Singapore where it is 80% humidity, I doubt if moisture chamber glasses is needed in this climate.

As for gland expression, I read an article which warns against excessive expression: http://dryeyezone.com/encyclopedia/mgcare.html

Instead of expensive compounded Acetylcysteine 5%, how about using sodium chloride 5%? - which is OTC.
http://www.amazon.com/Akorn-Sodium-C...ct_top?ie=UTF8
I got the idea after I came across the research.

Anybody tried that?

[ok45sg]

Will this work to flush out the filaments? Using saline solution in an eye cup and put it to your eye for a few minutes?

[LaDiva]

Everyone has read that article on expression. I think the tone of the article is over-kill, although you do need to be careful. If your patient has oil problems, you need to be doing something to encourage the oil to flow, even if it is just putting a warm compress on the eyes two or three times a day. There are ways to express the glands where you are not pressing on the globe of the eye. Filaments literally peel off of the eye. I used to pull them out with my fingers (which is a bad idea), and some of them were like rubber bands. Rinsing with saline doesn't work very well, or at least it didn't for me. Still, it is probably better than nothing. Even though your patient lives in 80% humidity, he or she still might benefit from plugs. I hope a doctor will answer your questions. What does the doctor in Singapore say?