Computer/Reading Routines and Using Drops

[mgd_sufferer25]

Hi everyone,

I suffer from MGD and wanted to hear about people's routines for performing visually demanding tasks (reading, computer work, etc) to minimize strain, and whether the routine is effective for you. I've been having strain lately, which has made my office job a lot more difficult.

How often do you take breaks? How long does each break last and what's the time between breaks? How often do you use drops and how long do the drops keep your eyes moist?

My ophthalmologist informed me that my meibomian glands are quite blocked, despite frequent compressing and hygiene on my part, so I imagine that since my own oils aren't coming out nicely I'll need to rely more on artificial tears.

Thanks so much for sharing your experience!

[Hokucat]

Hi there. Have you looked into scleral lenses? These are nickel-sized dome-shaped contacts that keep a layer of saline over your eyes. I wear them 12 hours a day, and these have helped me and others be more comfortable and for a longer length of time when using the computer, read, etc. You may not need to use drops while wearing the lenses...I don't, but some people still need to. But these lenses definitely are an integral part of managing my dryness. I've only had experience with Boston Prose Scleral lenses, but there are other doctors who are skilled at fitting sclerals who are mentioned on other threads on this website, so would look for a recommendation if not Boston PROSE, because experience in fitting the lens is key. Here is the link at least to Boston PROSE so you can get some overview of sclerals, as well as their locations:
http://www.bostonsight.org/PROSE-tre...y-Eye-Syndrome

Periodic forced blinking exercises may also help. Also if you do not currently wear contacts, Genteal Severe Gel gave me some longer lasting comfort than regular drops when looking at the computer.

[Hokucat]

One more thing. I also have MGD, and eyes were so dry for several years I had to quit work, could not read, use computer, watch TV, drive. etc., basically was home bound. I had several meibomian gland probes, which relieved the dryness some but only for a few days, likely because my glands would quickly get blocked again because my meibum oil was thick like Crisco oil. Ultimately for me, my major breakthrough to improve the consistency of my oils on-going was making some simple changes to my diet, see my post if you are interested:

http://www.dryeyezone.com/talk/forum...evere-dry-eyes

However, I think first having the probing procedures to unblock my glands subsequently allowed the new, better oil I was generating from changing my diet to flow through. The more standard treatment like hygiene and compresses didn't work for me either. My thinking is, if the glands are blocked solid with a bunch of old thick/dried up meibum, it would be difficult for good oil resulting from diet changes or any other treatment to push through.

Good luck to you. Things will get better

[ehsan372]

Hi there. Have you looked into scleral lenses? These are nickel-sized dome-shaped contacts that keep a layer of saline over your eyes. I wear them 12 hours a day, and these have helped me and others be more comfortable and for a longer length of time when using the computer, read, etc. You may not need to use drops while wearing the lenses...I don't, but some people still need to. But these lenses definitely are an integral part of managing my dryness. I've only had experience with Boston Prose Scleral lenses, but there are other doctors who are skilled at fitting sclerals who are mentioned on other threads on this website, so would look for a recommendation if not Boston PROSE, because experience in fitting the lens is key. Here is the link at least to Boston PROSE so you can get some overview of sclerals, as well as their locations:
http://www.bostonsight.org/PROSE-tre...y-Eye-Syndrome

Periodic forced blinking exercises may also help. Also if you do not currently wear contacts, Genteal Severe Gel gave me some longer lasting comfort than regular drops when looking at the computer.

Hello
I have some qustion
Do you test punctal plug?
How much pay for sceral lens?
Sceral lens make huge diffrence for your dry eyes?

[Hokucat]

Hi ehsan372. Yes, I have lower punctal plugs, That was one of the first things I got at the beginning of my dry eyes. It didn't seem to help much as I went through several years of debilitating dry eyes when nothing seemed to help, but now that I am much better, it may be helping keep some moisture in my eyes.

The Boston PROSE scleral lenses can be expensive. I think initial fitting and lenses were ~$7,500, then as one needs updates each lens is ~$1,000, However, the PROSE providers are used to working with insurance companies, and mine was almost totally covered. It was considered a medical necessity for me. There are other scleral lenses and doctors I've read about in this forum, who people have recommended that others have been extremely happy with, including the price being half or even one-forth than the PROSE lenses. Just know it's important to go to a doctor who has a lot of experience fitting scleral lenses, and who has a track record of success with this.

Yes, the scleral lenses make a big difference for my dry eyes. Daily functions I previously couldn't do I now can, like using the computer, reading, watching TV, etc. Not only do my eyes feel soothed while I'm wearing the lenses, they also feel better when I'm not wearing them, likely because the lenses bathing my eyes with saline during the day helped the surface of my eye heal. I think of it as similar to putting lotion on chapped skin every day to get soft, smooth hands. However, for several years my eyes were sooo dry, I could not tolerate the edge of the lenses laying on the dry white part of my eye, it was so uncomfortable. Once my dry eyes got better from a few diet changes, I revisited the sclerals and they helped improve my condition even more. Don't get me wrong, I still have dry eyes, but it is manageable now. For example, I rarely use eye drops anymore, which I consider a significant benchmark.

Like for many of us, often it is a combination of things that's the solution. Hope I answered your questions!

[ehsan372]

Hi ehsan372. Yes, I have lower punctal plugs, That was one of the first things I got at the beginning of my dry eyes. It didn't seem to help much as I went through several years of debilitating dry eyes when nothing seemed to help, but now that I am much better, it may be helping keep some moisture in my eyes.

The Boston PROSE scleral lenses can be expensive. I think initial fitting and lenses were ~$7,500, then as one needs updates each lens is ~$1,000, However, the PROSE providers are used to working with insurance companies, and mine was almost totally covered. It was considered a medical necessity for me. There are other scleral lenses and doctors I've read about in this forum, who people have recommended that others have been extremely happy with, including the price being half or even one-forth than the PROSE lenses. Just know it's important to go to a doctor who has a lot of experience fitting scleral lenses, and who has a track record of success with this.

Yes, the scleral lenses make a big difference for my dry eyes. Daily functions I previously couldn't do I now can, like using the computer, reading, watching TV, etc. Not only do my eyes feel soothed while I'm wearing the lenses, they also feel better when I'm not wearing them, likely because the lenses bathing my eyes with saline during the day helped the surface of my eye heal. I think of it as similar to putting lotion on chapped skin every day to get soft, smooth hands. However, for several years my eyes were sooo dry, I could not tolerate the edge of the lenses laying on the dry white part of my eye, it was so uncomfortable. Once my dry eyes got better from a few diet changes, I revisited the sclerals and they helped improve my condition even more. Don't get me wrong, I still have dry eyes, but it is manageable now. For example, I rarely use eye drops anymore, which I consider a significant benchmark.

Like for many of us, often it is a combination of things that's the solution. Hope I answered your questions!

Tanx for reply
Your answers is good
I dont have hope for cure dry eye.

[Hokucat]

I didn't have hope I would get better for several years, but I did. You can too.

Ultimately I had to be my own advocate and take a VERY methodical approach. initially, I saw several ophthalmologists who all just gave me the standard treatment without really knowing the cause of my dry eyes. Frustrated, I started doing a lot of research on the different causes of dry eyes, pressed doctors to help find the cause of my problem by asking a lot of questions and challenging them, listened closely to their observations, went to doctors where others have had success with similar issues, and did research on and pursued treatments that addressed my problem, I also kept a detailed log of all the treatments (dates, dosage or procedure, doctor, whether helped or not), and a log on the impact of diet changes.

So the above approach is how I got better. I narrowed my diagnosis to MGD, possibly caused by Sjogrens, an auto-immune condition, but no tests have ever showed I had any auto-immune disease. When I pursued expressing and probing procedures to clear my meibomian glands, it helped some for a few days, but then eyes would be really dry again. I asked if I had any oil in my glands when the doctors did the procedures, and they said it was very thick like Crisco oil.

So I was determined I needed to change the consistency of my oil, if I wanted long-term improvement. I started making diet changes, but only one thing at a time, and would test each food for at least a few weeks. If my eyes felt better while on that food, I would stop the food for a few weeks to see if my eyes got dry again, and if it did, eat the food again to make sure that food was indeed helping me. If a food didn't make my eyes didn't feel better, I stopped eating it, and then moved on to the next food. Using this method, I found fresh lemon juice with green tea for me did the trick. Also helpful for me is fresh parsley juice and a small portion of beef, but the beef is not as healthy so I limit that. For someone else, it might be other foods. I do think I have some auto-immune or unhealthy gut problem, and given lemon and green tea are anti-oxidants and both known to kill bad bacteria, it may be helping eliminate the bad bacteria in my gut where autoimmune and other illnesses start. Some of my doctors now agree that is a real possibility, at least for my situation.

The scleral lenses do not address the cause of my dry eyes, but have been a great help managing my symptoms and giving me comfort, which is important as well. And NONE of my doctors recommended these to me, I researched and pursued getting these lenses myself. So my point is the two biggest things that personally gave me on-going relief are these lenses and the lemon/green tea, neither which was prescribed by any of my doctors. So being your own advocate can be key.

So please do have hope. Being in this forum and asking questions is definitely on the right track!I

[Klee]

Can i ask is it hot tea? How many cups a day and how much lemon. Decaf or regular tea. Thanks.

[Hokucat]

Hi Klee. I drink two cups a day. Yes, it is hot regular (caffeinated) green tea. I steep the tea for several minutes or push the tea bag with my spoon at least 100 times to get the tea really strong. Then right before I drink it, I squeeze the juice of 1/6 slice of a medium/large lemon into the tea and also drop the lemon rind in..If you add the lemon juice too early before drinking, I've read the heat weakens the lemon's nutrients. I also like to add a slice of crushed ginger which has anti-inflammatory properties, and sometimes a handful of goji berries. Sometimes if its late in the day and I didn't take my 2nd cup of green tea, I substitute chamomile tea instead. I think the main thing for me is I take the green tea/lemon combination at least once daily, otherwise, my eyes start to get a little dry after several days without it.

Good luck to you!