Allergy, Dry eye, both? possible Neuralgia?

[farmgirl]

I am not sure what you mean by 'bumps on the episode eye lid' Also allergy meds can dry eyes. Hopefully with forest fire season over that should help a lot. If I had to live that close to smoke I would not have been able to go outside, the pain was debilitating.

Also be aware that saline can disrupt the tear film even though I personally do use it for an eye drop since I have become hyper sensitive to everything that goes into my eyes. I would follow that flush with an artificial tear drop. For what it is worth I cannot even tolerate the non preserved saline that is used to fill scleral lenses I have to use the nebulizer type.

Regarding the Dry Eye docs I will tell you that these guys are recommending some tests that I have never heard of (that's a good thing). Be wary of lipiflow treatments there is not much positive about it on this forum and it is pricey. having said that there is recently one member MGD1701 has stated in a post that it helped him/her, so it is a crap shoot. Lipiview is OK as it is just a test and not so pricey.

My opinion, I would give them a go.....F/G

[DryGuySmb2]

Sorry my phone must have snuck the "episode" part into that. I meant to say the bumps on the inside of the eyelid. Both the doctors I've seen have said that they have seen papillae, or bumps on the inside of my eyelids which is a clear sign of allergy. The one doctor who I thought was a real arrogant, you know what, thought it had to do with the whole eye problem and sometimes I think it might as well. The Doctor I am currently seeing doesn't seem to think too much of it and is more concerned about the Dry eye itself. He just told me to take allergy medication for it and up artificial tears. I was wondering if you had had any experience with it since you were saying that you had allergies to a lot of chemicals.

I'd noticed the Lipiflow as well and was a bit off put by it. It seems like they try to make it the biggest selling point and as the doctor I am currently seeing has remarked, the lid margin disease is hardly even worth noting on my case. But the fact that they seem to also market a lot of other treatments including Autologous serum tears and oral anti inflammatories piqued my interest. I think I'll try to make an appointment with them tomorrow if I can.

Does anyone discuss dry eye stuff with their primary care provider? I've been having a lot of pain crop up in my face recently in points which I always attributed to my supposed autoimmune arthritis, but the pain is much more severe and there has been a lot of burning associated with it. I've been thinking of getting an appointment with him because of this and some problems I've been having with the Zyrtec I've been taking and seeing if he has any ideas. I just don't want to overload him with all the problems I've been having. Although he is much more personable and caring than the eye doctors I have been into.

Thanks a ton for keeping up with this thread! I have been so happy to be getting advice and talking to someone else about this, it means a lot!

[Hokucat]

You're very welcome Guy, I hope some of those things help you.

I took a quick look at the Empire Eye link. They seem to at least have some of the lastest treatments like Lipiflow, autologous serum tears (made from the serum in your own blood), amniotic membrane, etc., which is good. Some in this forum have had success with serum tears and amniotic membrane helping their pain and healing the surface of their eyes, so if you go here, these treatments would be readily available. The unknown would be how good the doctors are.

Recommendations on a good dry eye specialist could be invaluable. Perhaps start a new thread in this forum entitled "Looking for dry eye specialist in or near Montana". Also maybe try calling this forum's Dry Eye Shop to see if they have a doctor they highly recommend based on your history, especially since they are located in Washington, which is relatively close to Montana. Rebecca and her team are always very helpful. They might also have some product recommendations to help your condition.

And yes, it's a good idea to discuss with your primary care doctor. I often discuss my dry eye condition with my primary care physician. I especially discuss it with my rheumatologist because of my likely Sjogren's Syndrome. He runs even more detailed labs and tests on me than my primary care, and is constantly checking my joints, bones, lympnodes, other organs and overall health, as he says often one can get more than one autoimmune disease and other illnesses..like he says getting rheumatoid arthritis along with Sjogrens is common. So my rheumatologist has really evolved into my "super" primary doctor, and says he serves that role for many of his patients. Are you seeing a rheumatologist for your supposed autoimmune arthritis?

Guy, I hope you find some relief soon. Hang in there.

[farmgirl]

HI Guy, I am glad that you feel this dialogue is helping, that's what the forum is all about and why I keep lurking. Besides I am still finding out more years later and recently discovered a study on some work being done with stem cells and lacrimal glands that I intend to take to my specialist the next time I visit at the end of the month. It was a link by another poster, so we are still always learning and trying new things ourselves.

Hokucat, I notice that you have 'likely Sjogrens' have you ever had a lip biopsy? That is how I was diagnosed because often the blood markers are negative but you manifest the disease. I understand that the lip biopsy is the kinda 'gold standard' for diagnosis because if you actually do have Sjogrens it will manifest itself in the salivary glands which they can see with a microscope then you know for sure....no more guessing. I highly recommend it for your own sanity, then you know exactly what you are dealing with.

Personally guy I don't think my primary care giver even knows that I have dry eye, mostly because I started using him after I had been seeking treatment from specialists for my eyes. I have no other symptoms like the associated arthritis so the only time I have seen him for my eyes is last summer with the smoke incident. Whether or not you involve your primary care giver would totally depend on how the problem has evolved I guess and I suspect many keep theirs in the loop.

When I hear of random pain in the face I think of trigeminal neuralgia type problems. My son suffered a lot with that and recently they discovered that he had an abscessed tooth. Touch wood he is much better now but still takes the pain medication 'just in case' until the abscess is finished treatment and everything settles down. I would see my dentist about that first of all to make sure it is not coming from your teeth.

I think the dry eye guys will know more about the bumps on the inside of your eyelids but that would sure make me wonder if something was amiss. I have a great intolerance to anything in my eye but it manifests more in sore, red, burning eyes and resolves as soon as I quit putting the offending stuff in them. If you have allergies that manifest in something like bumps I would suspect that they are systemic, like to foods of which dairy and gluten are always the first suspects. I'd start keeping track of what I eat vs. how I feel on any particular day if that is the case......good luck, keep us posted.....F/G

Oh, by the way, did your eyes improve any after the forest fires were brought under control and the smoke dissipated?

[farmgirl]

Hi Guy: I see that MGD1702 started this post which you might find interesting since you think you may have allergies affecting your eyes.

http://www.dryeyezone.com/talk/forum...ular-allergies

[DryGuySmb2]

Hokucat:
I'll have to do a post looking for a specialist, unfortunately Montana and Idaho are pretty remote, I live in one of the bigger "Cities" that basically either has a LASIK clinic that looks at everyone as dollar signs, an old Doctor who from the sounds of it should have retired years ago and the Opthalmologist I am currently seeing, who I am very indifferent about. I do have some money in a credit for plane travel I could use to go to Seattle, but my insurance doesn't cover that part of Washington and money is wearing thin. So the Idaho specialists may be my only hope. Maybe Oregon, I think I have coverage there?

The Rheumatologist I was seeing was very aggressive in her treatments and I stopped seeing her. I didn't feel comfortable going on such medications without a proper diagnosis. It was a very much treat the symptoms and not find the cause type situation. It's good to hear that your Rheumatologist is working out well for you!

Farmgirl:

I did not unfortunately have any relief from the burning when the fires stopped. I have only gotten mild relief from allergy meds and the Lotemax I have been taking. It was a pretty terrible sensation on the bottom of my lower eyelid, almost towards the bottom of the eye. a very gritty irritated sensation that just burned like crazy all the time.

I have never really had any dental problems in the past and the burning correlates to spots on my head that were already in pain. Honestly the burning started more so when I went off of the Maxitrol drops in the beginning. Trigeminal Neuralgia is almost exactly the type of pain I would describe it as, but it mainly feels as if it is coming from within the eye itself.

As for the bumps, I have had allergy problems in the past, but have never had them in my eyes before which makes me very suspicious. I guess allergies can grow over time. I definitely have increased mucus strands when I am not on any allergy medications I have noticed.

[DryGuySmb2]

Just an update, I'm back to talking to my mom and we are going to go see the Dry eye doctors in Coeur D'alene! A little piece of hope has opened up, I just need to make an appointment. Any reccomendations on things I should ask them over the phone?

[farmgirl]

Good luck at your appointment Guy, keep us posted.

To answer your specific question, I can't really think of anything, hopefully they will do a thorough history so I would make myself some notes to be sure I didn't forget anything and I would also write down any questions I had to make sure that I covered off everything and didn't remember the important stuff on the way home. And don't be like me and forget to look at your notes until you are in the car after the appointment...lol

[DryGuySmb2]

I was thinking of taking my notebook into the appointment, with the timeline of events and all the stuff I've tried and all the questions I have.

I am very interested in serum tears at this point and will probably be trying to get a reccomendation for those.

[DryGuySmb2]

Had the appointment, some promising stuff and some daunting things as well. First off my glands and everything look fine so there is no MGD going on. There is definitely an inflammatory component going on as I tested positove for inflammatory markers. My symptoms are wildly out of control for the signs, but the Optometrist likes to look at symptoms. She wants me to use Restasis 4x per day and to ask for Lotemax gel to use at night or when I'm having a rough day. She wants me to go back to a Rheumatologist and see if they can help. I asked about Neuralgia and she said she starts to worry with highly symptomatic people, but since there is an inflammatory component to my tears she would like to try anti-inflammatory treatment first and that we would cross that bridge if we get there. She said that with all the stuff that has happened to my eyes the coals are still burning.I have a good feeling that I could get Serum tears from her if I send her some literature on how it can help Nerve growth, so I may do that in the future. She said she would pass her notes along to the Opthalmologist who I see this Monday.

Fingers crossed it's not Neuralgia, but I am a bit worried about that to be completely honest, especially with how hard it is to treat.

[MGD1701]

Hi DryGuySmb2

Thanks for sharing.

Inflammatory markers:
Do you mean dr use the InflammaDry Test, which commonly used in USA, for you or just with slit lamp?
Did dr say if bacterial or demodex and recommend you lid cleanser?

I dont have inflammation issue for a few years. I'd suggest you focus on diet to improve
such as the combination of Omega 3 + GLA works better than alone. Many new studies on this too.
Avoid sugar, processed food etc.

[farmgirl]

Hi Guy: Like MGD that was my question as well, how did the Dr test for inflammatory markers? I have never heard of that. Sounds like it was a worthwhile visit, I am so happy that you went.

BTW I do not tolerate gels so if you wake up red and inflamed be aware. Is there a compounding pharmacy in your area set up to do the serum drops because that can be an issue.....F/G

[DryGuySmb2]

It was the Inflammadry test that they used to check for inflammation.

As far as bacterial/demodex nothing. Lids are clean, no signs of MGD. Just inflammation and Aqueous deficient, but not severely by any means. She did say that plugs may be an option in the future as well.

At this point I may want to seek treatment for the pain, it is ever present and has only died down a little since it started. I can't deal with it to be honest.

[MGD1701]

Hi DryGuySmb2

Thanks. Did dr identify source of inflammation if not bacteria, demodex??
I envy you to be able to conduct such InflammaDry Test - we dont have it yet.

[DryGuySmb2]

She thinks it's from my unknown autoimmune arthritis