Eyes still dry!

[lizzyk]

I had my lower puncta cauterised a few months ago and have had permanent plugs inserted last week at the top, so i am completely blocked. BUT i am still having to use drops and my eyes are still sore and dry, can someone please tell me what is wrong, i am at the end of my tether as i expected to have lots of lovely tears keeping my eyes moist!

[LaDiva]

Hi Lizzyk,
My eyes are quadra plugged like yours, and I still have dry eyes. They are better than they were before they were plugged, though. I have ocular rosacea and mgd, so the oil and inflammation are part of an on-going problem in causing dryness. I wear goggles, and still use eye drops as well. It took awhile for my eyes to heal after getting the plugs, so hopefully you will continue to heal and improve. Best wishes.

[tealeaf]

LaDiva,
Are your dry eyes due to lasik as well?
I am currently plugged at the lower tear ducts and eyes still dry (have marginal improvement). How do you decide when to proceed with plugging the upper tear ducts? How long do your TBUT and Shirmer tests improve after being quadra plugged?

[LaDiva]

Hi tealeaf,
I had PRK about seven years ago, and had "dry eyes" well before that. (My eyes never bothered me though- they didn't hurt.) My eye doctor told me I was an ideal candidate for PRK even though he knew I had dry eye, so go figure. I read all of the stuff before hand about how surgery could cause dry eye, but chose to focus on the "you are an ideal candidate" statement. I have tear deficiency, ocular rosacia and mgd. If you decide to have the upper ducts plugged, talk to your eye doctor first, as mine told me the top plugs would probably have to be surgically removed if ever need be. The bottom plugs are apparently very easy to remove, but not the top. I do not know how much improvement in TBUT, but the doctor said the surface of my eye has healed. That blue dye they put in your eyes no longer "sticks" to my eye like it used to, so the dry spots are much better or gone. I had IPL three years ago. At the onset my TBUT was 3, and when done it was 7. Still not good. The eye doctor said the low TBUT was mostly due to the poor quality of oil produced by the glands. My left eye feels pretty good now (too wet sometimes), but the right is still not great.

[tealeaf]

LaDiva,
Thanks for your reply.
Same here, I told my eye doctor I have dry eyes and still I was considered the ideal candidate for lasik

Your doctor mentioned once plugged on upper tear ducts, removal has to be done surgically, however, there were people in this forum who managed to have their upper permanent silicone plugs removed at the clinic, thus I am confused.

With lower plugs, I can really feel tears slightly well up in my eyes, blinking is more comfortable and eyes in the morning feel much better. However, as I am constantly in aircon environment (be it in office or in the mall), the tears in my eyes feel cold and dry. I have MGD as well, am doing warm compress and lid massage/scrub. I reckon the cold and dry feelings in my eyes are due to either poor quality tears or MGD. Well, is a dilemma, if I have upper plugged, the insufficient oil may not be able to cover the increased tears!! urrrgghh

[lizzyk]

Thanks LaDiva. I had the plugs removed yesterday as they actually seemed to make my eyes feel slightly worse. The optom i saw told me my tears break up in 3 seconds even when the plugs were in, normally it would be 12 seconds, some of my glands are blocked, (contrary to what someone else told me a few weeks ago!) so he is going to put me in contact with someone more senior to see what can be done. I just wish i could get all these so called experts to agree what is wrong and tell me how to make it better - i would just about consider anything at the moment!
What is TBUT?

[LaDiva]

Hi lizzyk,
Tear break up time. Mine was originally 3, and ouch, ouch, ouch. That is really tough. I am sorry! Are you using warm compresses? I have to use them three times a day, and then do gland expression, otherwise all of the glands become blocked.

[lizzyk]

Hi, i used a bag that heats up in the microwave for a while, 10 mins at a time, followed by massage but it seemed to make my eyes worse, or maybe i wasnt using it often enough? 3 times a day seems a lot, how long do you leave the compress on for?
My regime at the mo is cleaning my eyes every morning with Ilast hydraclean, (though i dont have crusting) and constant application, (every 30 mins at least) of hyloforte eye drops. my eye rims get inflammed and sore and i seem to have a lot of little raised white bumps where the eye lashes grow out. My vision often gets smeary/greasy. I had lasik 13 years ago and have used drops since then but my real problems probably started in earnest about 5 years ago, i do not know why! Its so frustrating!

[Faith1989]

Ladiva is your TBUT higher now? Or is it still 3? Mine is about 3-5 as it fluctuates each time. I'm doing the rosacea diet and hoping my TBUT will increase even slightly.

[cathy8889]

My eye rims get inflamed a lot during day, I have been doing 3-4 hot compresses a day, lasting between 5-10 minutes, and expression with cotton wool bud, that coupled with doxycycline is helping me a lot. I started doing hot compresses in May but stopped in mid June before I knew I had mgd. I'm going to carry on doing 4 a day even if my eyes are feeling ok. I thought it would be too much for my eyelids and they be red raw but they've been ok touch wood, I've been making sure that the compress isn't too hot.

I use this thera pearls eye mask, it's great because you can clean it before and after use http://www.butterflies-eyecare.co.uk...AEYESSENT.html I felt that hot compresses made of non wipe able material Were carriers of bacteria, you can't be washing them all the time, too much faff.

Before the hot compresses and doxy I was putting drop in 2-3 times an hour, it's a lot less now.

Hope things improve x

[LaDiva]

Love reading your posts, Cath. Our common British roots use wood for luck, but in GB I guess folks touch, and we knock! Sounds like you have a good regimen, lizzyk, and you too Cath. It takes awhile to get the blocked pores moving again, and you are right about not stopping. If I skip one treatment during the day, I have a problem. I think you can probably do compresses as many times a day as you like, as long as they aren't too hot, or irritating your eyes. I use Rebecca's rice baggie, which I love. 35 seconds in the microwave, I let it cool a little, and then 5-6 minutes on the eyes. It took me a long time to get the inflammation down; months. I think mine was quite bad for a couple of years, but after doxy, diet changes, compresses and plugs, I am better. You may consider plugs again farther down the road when some of the inflammation dies down. Faith, I am not sure what my TBUT is now. After IPL it was 7, but I think it is better than that now as I am plugged. The left eye is in pretty good shape by the feel of things, but the right is still not comfortable, and there are still oil problems and some inflammation. Cath, I wash the covers to the rice baggie regularly. I have several covers, so can swap them out.

[cathy8889]

Hi la diva, lol I can't say anything without touching wood (or my head!), I'm glad I'm not annoying, sometimes I feel I repeat myself in diff threads but if it can help someone a bit I don't care lol. i will look at Rebecca rice bag too, it's great that's it's removable.

I was just wondering la diva how long did you have mgd symptoms before you started on doxy and hot compresses. For the last two years I have had to use ointment at night for dryness but last year has been the worst and it's effected me in day too. How long did you take doxycycline for? I'm to take 100mg each day for a year, I hope that can cure it. I just don't know how I've got it. I keep worrying thinking I've given it to myself by using lacrilube every night and clogging up my pores.

Did you ever try restasis too? I've been told that and plugs are next stage if doxy doesn't work but I don't know how long to give it.

Sorry to ask so many questions la diva it sounds like we had similar problem and symptoms and you're treating them in similar way.

Cath x

Love reading your posts, Cath. Our common British roots use wood for luck, but in GB I guess folks touch, and we knock! Sounds like you have a good regimen, lizzyk, and you too Cath. It takes awhile to get the blocked pores moving again, and you are right about not stopping. If I skip one treatment during the day, I have a problem. I think you can probably do compresses as many times a day as you like, as long as they aren't too hot, or irritating your eyes. I use Rebecca's rice baggie, which I love. 35 seconds in the microwave, I let it cool a little, and then 5-6 minutes on the eyes. It took me a long time to get the inflammation down; months. I think mine was quite bad for a couple of years, but after doxy, diet changes, compresses and plugs, I am better. You may consider plugs again farther down the road when some of the inflammation dies down. Faith, I am not sure what my TBUT is now. After IPL it was 7, but I think it is better than that now as I am plugged. The left eye is in pretty good shape by the feel of things, but the right is still not comfortable, and there are still oil problems and some inflammation. Cath, I wash the covers to the rice baggie regularly. I have several covers, so can swap them out.

[tealeaf]

My eye rims get inflamed a lot during day, I have been doing 3-4 hot compresses a day, lasting between 5-10 minutes, and expression with cotton wool bud, that coupled with doxycycline is helping me a lot.

Cathy, how do you know if your eye rims are inflammed? Are they very red? I can't really tell. I even have my husband looked at my eye rim and he said the same as his ... Do you used sterilised cotton wool bud or the normal one?
Does doxycline help in MGD? I am thinking to ask my opth. for it.

I thought it would be too much for my eyelids and they be red raw but they've been ok touch wood, I've been making sure that the compress isn't too hot.

Do you feel the difference after each warm compress? I can't seem to notice the difference

[tealeaf]

Ladiva is your TBUT higher now? Or is it still 3? Mine is about 3-5 as it fluctuates each time. I'm doing the rosacea diet and hoping my TBUT will increase even slightly.

Faith, what do you eat with the rosacea diet? though I have no rosacea, but am willing to try if the diet helps in improving my eyes.

[LaDiva]

Hi la diva, lol I can't say anything without touching wood (or my head!), I'm glad I'm not annoying, sometimes I feel I repeat myself in diff threads but if it can help someone a bit I don't care lol. i will look at Rebecca rice bag too, it's great that's it's removable.

I was just wondering la diva how long did you have mgd symptoms before you started on doxy and hot compresses. For the last two years I have had to use ointment at night for dryness but last year has been the worst and it's effected me in day too. How long did you take doxycycline for? I'm to take 100mg each day for a year, I hope that can cure it. I just don't know how I've got it. I keep worrying thinking I've given it to myself by using lacrilube every night and clogging up my pores.

Did you ever try restasis too? I've been told that and plugs are next stage if doxy doesn't work but I don't know how long to give it.

Sorry to ask so many questions la diva it sounds like we had similar problem and symptoms and you're treating them in similar way.

Cath x

I had to quit Doxy, Cath, as it caused yeast problems, so now I am taking Minocycline, 50 mg daily. I don't know how much it helps. I think the key items for me are diet, compresses, stress levels and hygiene, but I don't dare quit taking it either. I used Restasis for years until my tear film got bad. It caused quite a bit of inflammation the last year that I used it, and so I quit. I am not sure Restasis helps if you are plugged.