What can I do next ?

[dominorose]

Hi there,

Still struggling with MGD, hitting the 20 months mark soon, let's celebrate! Joking.

So, I had an appointment post ****** probe with my doc yesterday, and well... "Medical symptoms" are improving: TBUT on the left eye is still 4, but am now at 8 for the right one. What I don't get is how my BUT could be higher on my WORSE eye? This is nonsense. Physical symptoms are the same. I had 10 horrible days just after the intervention, couldn't open my eyes at all, but it didn't last hopefully.

My doc told me we had tried everything he had to offer (doxy, azyter, cyclosporine, castor oil drops, and probing), so next step is scleral lenses in may.
I feel devastated. I am so afraid I won't be able to tolerate them as I am VERY sensitive...

According to my doc, all my lower MG's are open but the meibum is too thick. The upper MG's tend to atrophy and are all plugged. According to what I've read, the upper atrophy could be related to my low estrogen levels. Anyone here facing the same issue?

And what can I do for the meibum quality ? I already use my blephasteam goggles twice a day, take 100mg of doxy, use cyclosporine... I don't know what to do and am really afraid about this atrophy thing
I'm thinking about trying autologous serum, but not sure it could work for me. Any reviews on this?

Thanks

[MGD30]

I'm in a very similar situation as yourself, MGD, although I'm getting close to 30 months and my glands arent closed up, and I dont think I have any hormonal issues. I've tried all of the same drops and medications as you without any success.

Do you know what caused your MGD? I think mine was caused by working in front of a computer which in turned caused me to blink only partially. Are you in front of a screen a lot? Have you had a meibography to see exactly what shape your glands are in?

Here are the only things that have helped me; intesive blinking exercises; Lipiflow to remove the hardened oil, although my oil is still thick, its nowhere near as bad as it was before; more blinking exercises and warm compress to keep the oil from hardening again; I also use moisture chamber glasses, night time gogles, and humidifiers at home and office and avoid computers once I'm home. I still take fish oil and eye drops daily although I cant tell if they are helping or not.

Since my oil has somewhat improved, my next step is to deal with the nerve pain (theres a good thread on the front page right now discussing this, coneal neuropathy) through different drugs. So far these drugs have not worked, but I'm still trying different ones. My next steps after this will be taking time off from work and scleral lenses. I hope the lenses work for you.

[xpro]

Hi there,

Still struggling with MGD, hitting the 20 months mark soon, let's celebrate! Joking.

So, I had an appointment post ****** probe with my doc yesterday, and well... "Medical symptoms" are improving: TBUT on the left eye is still 4, but am now at 8 for the right one. What I don't get is how my BUT could be higher on my WORSE eye? This is nonsense. Physical symptoms are the same. I had 10 horrible days just after the intervention, couldn't open my eyes at all, but it didn't last hopefully.

My doc told me we had tried everything he had to offer (doxy, azyter, cyclosporine, castor oil drops, and probing), so next step is scleral lenses in may.
I feel devastated. I am so afraid I won't be able to tolerate them as I am VERY sensitive...

According to my doc, all my lower MG's are open but the meibum is too thick. The upper MG's tend to atrophy and are all plugged. According to what I've read, the upper atrophy could be related to my low estrogen levels. Anyone here facing the same issue?

And what can I do for the meibum quality ? I already use my blephasteam goggles twice a day, take 100mg of doxy, use cyclosporine... I don't know what to do and am really afraid about this atrophy thing
I'm thinking about trying autologous serum, but not sure it could work for me. Any reviews on this?

Thanks

Have you ever had pets in your life?

[JJdryeye]

I tried the serum drops and they didn't help me, but they must be helping some people as a lot of people do them, worth a shot, we all react differently. I hope you find your answers.

[No tears in ATL]

Serum is worth a shot, especially if they are affordable to you. It didn't work long term for me, but helped when I was going through awful flareups and needed some moisture on the eye surface (couldn't do regular drops). It did not affect tear breakup time or anything like that, though. More of temporary band-aid. There are others who swear by them, though.

[dominorose]

Thanks for the feedback. I don't know what other options I have if serum or sclerals don't work...

[xpro]

Wash your hair and face every single day with tea tree shampoo. There should be enough tea tree in the shampoo that your skin should feel a cooling effect. Let it sit for a few minutes before rinsing. You will feel worst initially as the mites are dying and infecting your skin and meibomian glands. You should start seeing some improvement after the 2-3 week mark. But continue to use the shampoo.

[dryeyehealth]

I am in the same boat. I am relatively young (less than 30) and my dry eye symptoms had a sudden onset 4 years ago and have not diminished. This is what I have tried so far: Lotemax eye drops, Restasis, Azasite, Lotemax drops, Azithromycin, hot compresses, cold compresses, humidifiers, meibomian gland massage, changing all my hair products and using no skin products or eye make-up, puntal plugs, acupuncture, a 3 month course of doxycycline, Lipiflow, a 3 month course of Plaquenil, a long course of C-Dexameth drops compounded without preservatives, serum tears, meibomian gland probing, and tear duct cauterization. Finally I had surgery to correct conjunctivochalasis on both my eyes in January 2015. Nothing has helped. I have had work ups by internists, rheumatologists, neurologists (autonomic neuropathy?), gynecologists (hormone imbalance?), endocrinologists (thyroid?), and many, many ophthalmologists. All tests including lip biopsy for Sjogren's came back normal or negative. I tried PROSE and could not tolerate them at all as my eyes are very, very sensitive to anything. I would say that the tear duct cauterization was the most beneficial but it has caused my allergies to increase and irritate my eyes. I would caution you about the PROSE as it is a very expensive and long period of fitting and testing and if you don't tolerate anything in your eyes it might not be successful. I can only sympathize.

[Faith1989]

I'm in the same boat. I havent tried as many things as you dryeyehealth but almost. Now to bring some positivity to the thread I have improved. I am still struggling but am way better than I was a few years ago. The only thing I can attribute to my success is I drastically changed my diet, have gotten meds for depression, and have been on restasis for a long time. I still use Lotemax when I need it. I need to go back to the tea tree because xpro is right and it does help if you have rosacea. I really believe things will get better for you. It took me like four years to get to a state where I can work full time and live my life (to a point)

[LaDiva]

I completely agree with Faith. It took four years to get back to "better", and I am now at five years and holding. I am not where I was before dry eye, but can at least function. I don't have photophobia or mucous strings and can sometimes wear just plain glasses as opposed to goggles. I would say that I clawed my way back to being better. The key is to be a robot with compresses, expression, diet, drops, whatever the things are that help. You've got to do them every day, week after week after week for a long time. It is a royal pain, but unless you have other underlying health problems, you will improve. Best wishes to you Domino. Keeping you in my thoughts.

[Faith1989]

I am trying to go VERY low to no sugar at all. It's only been a few days but I've noticed less lid redness. I've never actually stuck to it for more than a week or two. I can't seem to stick to it. I LOVE my high sugar fruits like bananas. I'm only eating berries and have reintroduced eggs. I have also been using tea tree shampoo on my eyes and face. I feel like if I tell people on here I'm going to actually do it I will lol I know that seems weird.
Dominorose, have you tried any extreme diets?

[dominorose]

I am trying to go VERY low to no sugar at all. It's only been a few days but I've noticed less lid redness. I've never actually stuck to it for more than a week or two. I can't seem to stick to it. I LOVE my high sugar fruits like bananas. I'm only eating berries and have reintroduced eggs. I have also been using tea tree shampoo on my eyes and face. I feel like if I tell people on here I'm going to actually do it I will lol I know that seems weird.
Dominorose, have you tried any extreme diets?

I will try the Clean gut diet by alejandro junger in june, yes! I cant go too low carb as I do weightlifting 5 days a week though, so I will still eat quinoa, sweet potatoes and rice I think...