Any advice please

[lemonjelly]

Hi

I'm writing on behalf of my Mum. She's 80 and has had severe dry eye/blepharitis problems since radiotherapy on her face early last year. She's under the hospital who treat her with antibiotics and steroid drops. As soon as she stops the steroid drops, the inflammation comes back.

She's on her third 'cycle' of this now. She's on antibiotics and her eyes are just awful. She's been back to the GP who has changed her antibiotics and said the only thing she can do is hassle the hospital for a further appointment. She's got one in ten days time ... I can't believe she has to wait this long. She is suffering.

What I'd like to ask is ... what is the issue with dry eye? Is it just poorly understood even by the 'experts'? Mum is under the care of the consultant and seems to think she's good but I have to question, if it keeps coming back is she that good? My sense is that the antibiotics won't do an awful lot without something to treat the inflammation. I know she can't stay on the steroids forever but so far there has been no discussion about any alternatives.

I don't go to the appointments with her. She's very independent and placing her faith in the doctor but, like I say, I feel that she's not getting the right treatment. I'm not a medic but from all I've read, I just feel that she's being let down. There has been no attempt to discuss the radiotherapy as the root of the problem. It just seems crazy to me.

I'm encouraging her to try omega 3/find another doctor but it's an uphill task. The consultant had no knowledge of this for dry eye. And I've just been reading about phospholipid drops. I've never heard of these ... surely these should have been suggested at some point? She has meibomian gland dysfunction.

Can you anyone comment?

Thanks

[Angela810]

Hi there,

I am so sorry to hear about your mum. I guess her immune system is down after the radiotherapy and that is causing the dry eyes maybe? I hope it gets better with time.

Please ask your doctor to prescribe optimmune or ikervis which should kill the inflammation and can be used long-term unlike steroids. These drugs are more expensive than the standard drugs for eyes so doctors don't just hand them out, you need to ask - persuasively! Make sure to explain in detail how her quality of life is affected which should hopefully prompt them to prescribe it. These will definitely increase her tears. Also for daily eye drops that are preservative free and on prescription ask for - hypo-forte, hylo-tear, vismed gel or vismed eye drops. All of those contain sodium hylauronate which are really soothing.

Has she tried warm compresses and squeezing the glands after with a cotton bud to express oil?

Please keep taking omega 3 from fish oil. Eating oily fish or supplements. This one is good:

http://www.barebiology.com/products/...ega-3-fish-oil

I personally did not find that antibiotics helped me at all and they are not a great idea for general health anyways.

Do keep us posted as to how she gets on.

I hope she gets better soon. x

[meibomian]

Hope you mom is feeling better with her eyes. Dry eyes related to radiotherapy can be very difficult to manage. It may be helpful to get a better understanding as to why she's in such misery with her eyes. Is it due to the loss of corneal nerve endings (neurotrophic keratitis/ulcer)? Is it due to loss of meibomian gland - lots of vascularization around the lid margin with very little oil flow upon compression. Is it due to a lacrimal system obstruction - see my other posts about this issue. Or is it due to a lack of tears? May help to narrow down the cause to better alleviate the problem. Can't comment on your mom directly without seeing her, so her situation may be completely different than what I'm thinking. But I hope I've provided a little insight into thinking about eye inflammation in general.