Can someone explain my eye report a bit better?

[Guest]

Hi, was wondering if anyone could explain the scientific lingo below a bit better for me? At my last eye check up this was reported:

- There are diffuse punctate epithelial erosions (?!)
- Tear film assessment showed the following; tear meniscus height was almost 0 in both eyes, the tear break up time was 1-2 seconds in the right but 0-1 second in the left, the tear quality appears to be poor, and Oxford ocular surface staining causing lissamine green and fluorescein staining was grade 3 in the right and grade 4 in the left. (this is scaring me too)
- Tear osmolarity was increased in the left in particular to 310, while it was 306 in the right.

In October a different assessment showed no lissamine green staining and TBUT of 6, but this latest report has got me really down, and matches my feeling that things are worsening again.
I'm just hoping it can't get worse, and am desperate for hope it can get better. I spend hours with my eyes shut some days and they still burn

Background - MGD (and maybe aqueous deficiency) started in July after using the computer way too much. No gland blockage, and minimal gland dropout, but cloudy oil. I was feeling a tiny bit better in October. I even got some oil coming out after using the heat pad on my eyes and thought I was on my way up. This month its all gone downhill again - maybe the colder weather, or starting AD's (which I've just stopped as can't bear the thought they might be making my eyes worse).

It's a daily struggle not to fall into the pit of despair - I can't work, use moisture chamber glasses all the time, have lower plugs and am two months into restasis, which I thought was working, but am not so sure now. I probably take way too many different oil tablets too.

Lena

[farmgirl]

Hi Lena:

I would conclude from that report that your eyes are dry, quite dry and as a result you have some dry spots on your corneas. Obviously this report is worse than the first but don't despair I wouldn't necessarily conclude that you are getting a lot worse. Dry eye is a very variable disease and typically you will have some days better than others and some times of day you will feel better than others, at least that has been my experience. Some of the difference could be accounted for by at what time of day you saw the Dr and relate to what had been going on that day prior to your appointment. Did you see the Dr first thing in the morning after you were rested or at the end of the day. Had you slept well the night before. If it was first thing in the morning and you had corneal erosions perhaps they had occurred during the night and the eye had not yet recovered - short story it is a result of dry eye.

Having said that I had erosions every time I went to any eye doctor but in the 4 years that I have been using serum eye drops I have never presented with erosions since so that is one thing that I highly recommend you get using IF they are available where you live.

As regards the tear osmolarity I have never had that test preformed but online it says:

Each of the above methods provides a numeric osmolarity measurement. The higher the measurement, the “drier” the eye. It’s measured in milliosmoles per liter (mOsmol/L), such that a reading of:

• 316mOsmol/L and higher indicates dry eye (hyperosmolarity).⁶ (I’ve taken readings as high as 360mOsmol/L, although I’ve heard anecdotally of a reading higher than 400mOsmol/L, which would be like shaking salt directly into your eye!)
• 290mOsmol/L to 316mOsmol/L suggests borderline or intermittent dry eye.
• 290mOsmol/L and below is healthy and normal.

My conclusion based on that would be 'borderline or intermittent' dry eye but not severe.

Personally I found that 2 plugs was not sufficient, I am quadra plugged and that has been a game changer for me. I would recommend that you try getting quadra plugged. Keep using the moisture chamber glasses and for sure outside so they will need to be sunglasses.

If you are using oils make sure they are quality oils. PRN oils were recommended for me by one eye doctor. There are cheaper oils out there but there is something about the way these oils are made that make them superior for eye health, they are not regular old fish oil.

Colder weather for sure makes dry eye symptoms worse as hot air circulating + low humidity = drier eyes. If you must use a computer, keep it to the minimum and take frequent breaks. Check out things that you can do to minimize computer related problems, there is a lot of info out there. Stay off your tablet, cell phone, video games and TV as much as possible they are all really difficult for your eyes to tolerate. TV is better because you can at least close your eyes for a lot of it and just take peeks.

Stay strong and stay the course because most people find over time what works and does not work and hopefully you will arrive at a place where you can at least work and function day to day.....F/G