Confused about next steps...

[unicorn]

Since stopping all drops over two months ago (on the advice of my ophthalmologist), I haven't seen any improvement in my symptoms or level of pain (nor have I worsened, to be fair). Eyes 'seem healthy' with no corneal staining - nothing to really explain how bad my symptoms are. I do have MGD but it's mostly described as 'mild'. (Perhaps it's 'non-obvious'?)

He now says the only thing he can offer me is pain relief - probably Gabapentin - and I have an appointment at the hospital next Tuesday to discuss this with another ophth who apparently has more expertise in this area.

However, this is a very big step to take, and I'm still not convinced it's the right one - Gabapentin does not come without side effects, even if it works.

Today I was at my optometrist for a check up. He's not convinced about the Gabapentin either. He thinks the type of pain I experience is in line with chronic friction from dry, inflamed lids & lid margins - and that this would also explain the follicles under my top eyelids (which he doesn't think were caused by the contact lenses I used to wear - in direct contradiction of the ophthalmologist). In fact, my optometrist is suggesting that using a soft 'bandage' lens might actually improve my pain by reducing the friction on the lids.

So: where do I go from here? I'm very torn, and getting very anxious about the situation. I have been reading about long-term contact lens wear causing MG atrophy/dropout and am also getting my knickers in a twist about this, so to speak

I know there aren't going to be any easy answers. I've been dealing with this for nearly two years and it isn't getting any better. Just desperate for some relief - but very scared of doing the wrong thing.

[glimmer-of-hope]

Since stopping all drops over two months ago (on the advice of my ophthalmologist), I haven't seen any improvement in my symptoms or level of pain

Just wondering why your ophthalmologist told you to stop using eye drops (preservative-free artificial tears, right?). What’s his deal? I’m not sure how stopping using eye drops can improve dry eyes… Did you ask another doctor what he/she thinks about this?

[Almondiyz]

I don't understand why your doctor had you stop all eye drops. Have you ever worn "Soft Bandage Contact Lenses?" I've worn two brands: ACUVUE® OASYS & AIR OPTIX®

Soft Bandage Contact Lenses are just a larger size contact lens that you keep in your eyes 24 hours a day. The first brand I had were ACUVUE® OASYS, it has a very high water content & it literally evaporated on my already painful dry eyes & I couldn't tolerate them even with using preservative free drops. When I had the Acuvue's removed by the doctor, I had to soak both my eyes in preservative free saline in little eye cups for about 15 minutes before they peeled off.

I was fitted AIR OPTIX® which has higher oxygen permeability was a tiny bit better than the Acuvue's but I still needed to keep inserting drops in my eyes.

My eyes were so dry that I just kept my eyes closed for the duration I had to wear them. I wore swim goggles with drops in my eyes when I HAD to see.

I have MGD & Ocular Rosacea & had corneal abrasions on both eyes from my DRY lids scraping my DRY eyeballs! I got corneal abrasions from blinking, plus my eyes don't completely shut, so a lot of damage occurred during sleep even when I wore masks at night. (I later went to putting cellophane over my eyes with nighttime ointment then a mask. Waiting on my Tranquileyes mask/goggle to arrive any day)

Wearing the Soft Bandage Contact Lenses made my eyes feel so much more dry!

Why is your doctor taking you off lubricating eye drops? Irritation? Sensitivity? Or just because he/she feels people shouldn't use drops long term?

[glimmer-of-hope]

Bandage contact lenses

Almondiyz,

That’s interesting… I actually have positive experience with bandage contact lenses.

How long did you wear them?

My doctor inserted them to help my RCE to heal, I had them in my eyes for about 5 days and it was so much better with them and I could sleep at night without pain! I was using preservative-free eye drops during the wearing but didn’t use them more often than usually.

Then, when my doctor removed them she didn’t have to soak my eyes in saline like you described she just easily take them out with a pair of tweezers (or something like that I can’t see well without my glasses But it wasn’t painful and it was quick.

So probably depends how long you wear them… ?

[bakunin]

My case is very similar unicorn.
More than 2 years.. symptons far worse than signs. I will try Omega 7. I really don't know what to do anymore. Last year I was better due to AC broken at waork and wearing moisture chamber glasses outdoor.

Yes, I though about asking some anesthesic eye drops, t use in special moments, but I think it would be very difficult to a doctor agree with that idea.

wish you the best

[unicorn]

Just wondering why your ophthalmologist told you to stop using eye drops (preservative-free artificial tears, right?). What’s his deal?

He thinks my eyes have become 'sensitized' - through what he called 'multiple trauma'. This included long-term contact lens wear, the allergy to the contact lens solutions I developed, then the multitude of different eye drops, steroids, etc that I was using. He says he has seen a couple of people with similar histories to mine who improved when they stopped using anything in their eyes. More detail in this post: http://www.dryeyezone.com/talk/showt...light=unicorns

My level of dryness is 'mild' (clinically), my symptoms are much worse. I haven't improved or worsened since stopping the drops. I am certainly not advocating this approach for most 'dry eye' patients. I don't have any dry spots, staining, or erosions. Drops never improved my symptoms, anyway.

I used to wear Acuvue Oasys as my regular contact lens. They were very comfy. My probs began when I became allergic to the lens solution (Opti Free). My eyes went downhill from there and haven't (yet) recovered.

[Almondiyz]

glimmer-of-hope,

I started wearing soft contact lenses in early my 20's back in the 1980's.
I reflect back to those years & realize I was never able to tolerate contacts because of dry eyes. I was constantly using rewetting drops.

March 2013, my sudden eye problems.
Long story short, I wore the soft bandage contact lenses for about a total of three months. It was horribly painful. I had to wear swim goggles for a complete seal/fogged lenses around my eyes.

[glimmer-of-hope]

Long story short, I wore the soft bandage contact lenses for about a total of three months. It was horribly painful.

That’s what I was implying – that it depends how long you wear them (I’m talking about the bandage therapeutical contact lenses). I think 3 months is just too long and no wonder it did more harm than good. In my case it was only a few days.

[Almondiyz]

He thinks my eyes have become 'sensitized' - through what he called 'multiple trauma'. This included long-term contact lens wear, the allergy to the contact lens solutions I developed, then the multitude of different eye drops, steroids, etc that I was using. He says he has seen a couple of people with similar histories to mine who improved when they stopped using anything in their eyes. More detail in this post: http://www.dryeyezone.com/talk/showt...light=unicorns

My level of dryness is 'mild' (clinically), my symptoms are much worse. I haven't improved or worsened since stopping the drops. I am certainly not advocating this approach for most 'dry eye' patients. I don't have any dry spots, staining, or erosions. Drops never improved my symptoms, anyway.

I used to wear Acuvue Oasys as my regular contact lens. They were very comfy. My probs began when I became allergic to the lens solution (Opti Free). My eyes went downhill from there and haven't (yet) recovered.

What does your doctor think about Serum Drops? Just a bit of info. If you can't use generic eye drops, why not from your own body?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772389/
http://hospital.blood.co.uk/library/pdf/eye_drops.pdf

[Almondiyz]

That’s what I was implying – that it depends how long you wear them (I’m talking about the bandage therapeutical contact lenses). I think 3 months is just too long and no wonder it did more harm than good. In my case it was only a few days.

Three months because the short time wasn't helping. I know some patients that wear Air Optix (one pair approved for 30 days 24/7 use) brand bandage lenses all the time because they're prone to RCE. But they can tolerate them because they have their own tears more stable lipid layer. I had no other choice. Wore them, a bit of healing, then relaspe. I didn't wear them three months without removal. I went once a week to replace the bandage lenses but my healing was so slow. I had a lot of stuff going on with my eyes.

[glimmer-of-hope]

Three months because the short time wasn't helping. I know some patients that wear Air Optix (one pair approved for 30 days 24/7 use) brand bandage lenses all the time because they're prone to RCE. But they can tolerate them because they have their own tears more stable lipid layer. I had no other choice. Wore them, a bit of healing, then relaspe. I didn't wear them three months without removal. I went once a week to replace the bandage lenses but my healing was so slow. I had a lot of stuff going on with my eyes.

Oh, I see, thanks for the explanation.

For me it wasn’t a miracle cure either. I still suffer from RCE…

[unicorn]

What does your doctor think about Serum Drops? Just a bit of info. If you can't use generic eye drops, why not from your own body?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772389/
http://hospital.blood.co.uk/library/pdf/eye_drops.pdf

Thank you. However I don't know of anyone in the UK that's actually managed to be prescribed these drops - even with severe dryness. My eyes are only 'mildly' dry, clinically.

When I wore contacts (the Oasys) I never felt my eyes were dry, never used rewetting drops, etc. But there was probably mild, symptomless dryness there. I actually felt better in lenses - days when I didn't wear them, my eyes would feel kind of tired and groggy by the end of the day. So maybe in some way they were actually helping me. I never wore them overnight, so not technically a 'bandage' lens. This isn't what my optom is suggesting - he's just suggesting going back to wearing them 6-8 hours a day or so to see if it helps the pain.

I went for a Lasik consultation in 2006 and was told my eyes were a little dry, but not so dry they wouldn't operate. Fortunately I thought better of it and didn't do it...