Confusion re: tear quality

[fernellen]

I am feeling liquid on my eyes; not necessarily soothing; retaine about 1/2 hour ago. Morning routine at 6 included Xiidra and Lotemax; what’s going on?

[Guest]

Not really understanding what you're asking...

[fernellen]

I suspect it is the tear quality as I still feel pain even though I am blinking a lot especially in the afternoon. Frustrating. I feel like the solution is far down the road

[Guest]

What's your entire routine look like? Do you have MGD? Are you treating that also? How's your diet? Any supplements you take and all meds please? Maybe I can assist or at least get you going into a good direction.

[fernellen]

5:30-Warm compresses; eye wash; just introduced homemade tea tree oil in coconut oil solution until I get commercial formulation;
6:00-Lotemax; rest with eyes closed for 5 minutes
6:20-Xiidra; rest with eyes closed for 10 minutes

today i I listened to radio for an hour with eye madk

eyes were “wet” feeling so I put in soft contact after putting in a drop of Systane in both eyes at about 8:00. I have one that brings my vision to about 20/25in both eyes. Other eye had cataract and prk surgery

removed contact at 11:15. Little twinge;

have not not gone out in wind. I do not run the ac in the house

i have high hopes for the Xiidra. I am scheduled for a corneal bandage in a few weeks

evening—

6:00 - warm compresses and lid scrub
8:00- Lotemax
8:15-Xiidra

today I am not eye drop mad. Yesterday I could not get enough drops. The pain was so bad.

[Guest]

The only thing I could see causing the issue is the addition of tea tree oil. Possibly got into the eye yesterday. How long have you been on the steroids? Steroids always make me feel better...so that could be the wetness.

Whats your concern though? You're concerned that your tears are too watery? Sounds like you improved from yesterday are you just trying to make sense of all the moisture?

[fernellen]

Yes. I am trying to improve the tear quality

[Guest]

Ok how hot is your compress? I use a laser thermometer and realized I was going wayyyyyy too hot, then I pulled back and got way too cool. So I got the laser thermometer out and make sure I apply it between 45-50C max. 50C may even be too hot for most but it really helped that glue like substance out. Now that my oils are pretty good again, I hang lower around 45C.

Just trying to theorize here..your compress was possibly off (too cool) and so you're having reflex tearing cause your oil functions low? No clue but possibles

as a general rule I try to measure everything...including my food on a food scale. That way I'm not having different results andvwondering why. Everything is militantly controlled.

[Hokucat]

Hi fernellen. Sorry to hear about your recent bout of suffering when you had been doing well for several years...saw some of your other posts. I was also so bad off for an extended period where my husband was basically operating as my caregiver, and he also had to operate like a single parent for my kids. So it's fortunate your daughter can help you out during this tough time.

Sounds like you are being treated for MGD. Do you know what the status is of your meibomian glands, as I read you had gland expression? For example, are many glands blocked where no oil is coming out, is the oil coming out thick, etc.? Do you know your TBUT and Schirmer scores? It sounds like you still have some days better than other days, so perhaps look into diet changes, doxycycline, IPL, Lipiflow, etc. to unblock and improve the consistency and quality of your oils.

Do you know the possible cause of your MGD? That can help determine optimal treatment options. Mines is likely Sjogren's Syndrome, plus reduced blinking from excessive use of the computer and long commutes to work. I have MGD and aqueous deficiency. It got to the point where almost all my glands ultimately got blocked, many with scar tissue. What helped was unblocking my glands first with probing (because of the scar tissue in my case), and then finding the right diet changes so my glands functioned better from the inside out. For me, using multiple OTC and rx drops had only made my eyes feel worse. I also wear scleral lenses to help with the remaining dryness, since several glands had atrophied.

It might help to keep a daily journal of everything you eat and drink, meds/supplements taken, exercise, how eyes felt that day, etc. to really see a pattern of what makes you feel better or worse. That's how I found the diet that helps (or was not good for me), what drops and supplements had no impact or made me feel worse, etc. trying only one change at a time for at least a week, by being very methodical and controlled approaching this. Especially if you have some days better than others, there must be an underlying reason. Something similar to Dowork's philosophy where he says everything is militantly controlled :-)

[fernellen]

Thank you all. This misery is a result of missed dry eye diagnosis prior to cataract surgery. Right now I am drinking a fair amount of water, but not eating very much due to the pain. Good news. Morning blood pressure is 116/74 so no meds. I will take it in afternoon when pain ratchets it up. Blood glucose 140; will wait on that as well.

i believe I am experiencing reflux tears. Better days than others is relative. I have ordered moisture chamber glasses.

what I would like besides no pain is less light sensitivity as ability to go out to do chores like bank and grocery.