Unilateral symptoms/signs

[Alix]

Just when I thought things couldn`t get worse, the burning sensation in my left eye is so bad now, that I am seriously considering taping it shut and wearing an eye patch just until I get my sclerals. I can barely keep it open.

The TBUT has been slightly lower than the right since the summer but now the difference between the right and left in terms of burning /redness is huge.

I don`t have any history of eye injury/surgery so I do not understand how or why my symptoms can be so much worse in one eye.
The gland loss is the same percentage in both eyes and the conjunctival chalasis looks the same as well.

Does anyone else have one eye that is significantly worse than the other?

[deep_dry_eye]

This sounds like a classical mismatch between clinical signs and symptoms (i.e., equal clinical signs, but vastly different symptoms).

It sounds like it could be a nerve issue. Have you tried Prokera? Other options include autologous serum as well. The goal of these treatments are to enhance growth factors onto your ocular surface to heal/regrow your nerves.

[Alix]

This sounds like a classical mismatch between clinical signs and symptoms (i.e., equal clinical signs, but vastly different symptoms).

It sounds like it could be a nerve issue. Have you tried Prokera? Other options include autologous serum as well. The goal of these treatments are to enhance growth factors onto your ocular surface to heal/regrow your nerves.

Yes possibly, it is very frustrating and confusing. The last doctor I saw said more oil was coming out from glands in the left eye than the right which is strange.

As far as I know Prokera is not available in the UK, and even if it was I am not prepared to pay thousands of pounds for something which doesn`t have a 99% success rate. Same for serum drops they are not available/too expensive in the UK.

I am waiting to get my sclerals but I am not sure how to handle the pain in my left eye. Thankfully with the holiday season coming up, wearing an eye patch is doable as I don`t need to go into work.

[deep_dry_eye]

Yes possibly, it is very frustrating and confusing. The last doctor I saw said more oil was coming out from glands in the left eye than the right which is strange.

As far as I know Prokera is not available in the UK, and even if it was I am not prepared to pay thousands of pounds for something which doesn`t have a 99% success rate. Same for serum drops they are not available/too expensive in the UK.

I am waiting to get my sclerals but I am not sure how to handle the pain in my left eye. Thankfully with the holiday season coming up, wearing an eye patch is doable as I don`t need to go into work.

Unfortunately , none of the treatments we have will have 99% success rate. It is very unfortunate that cost denies you access to medical care. In Canada, Prokera costs 1.5k CAD which includes all followups. Perhaps you should consider flying to Canada for vacation + Prokera treatment.

Sclerals are not necessarily a good option, they will help you symptomatically , but may not help you clinically. Sclerals (especially big ones) may cause more partial blinking issues (i.e., your eye lids will be unable to make full contact during blinks).

[Guest]

Check and see if the side that’s worse is the side you’re sleeping on. It could be mechanical irritation from rubbing that eye on the pillow when you sleep.

[TARYN]

Alix, It sounds like you need a solution since the burning is so bad that you are considering taping your eye shut. When I had the burning and redness years ago, no local doctor was helping me so I finally sought help from Dr Tseng who is a little over a 2 hour plane ride away. As I said previously the surgery which included excising the conjunctival folds from the chalasis and placing amniotic membrane on that area solved the problems of redness, inflammation and burning immediately. More recently I had a similar surgery on the other eye to get rid of a pinguecula that was causing problems with my tears. That surgery was also successful. I am wondering if you called Dr Tseng's office he might be able to recommend a doctor near you that might be able to help you if traveling to see him is out of the question. Good luck

[Alix]

Thank you all for your thoughts.

@deep_dry_eye My main issue is meibomian gland atrophia so not sure it is worth the time and expense involved in getting prokera.
@Dowork123 I am going to make a concerted effort to sleep on my right side only to see if it changes anything.
@TARYN I am based in the UK - there is limited knowledge/interest in dry eye here. I am going to ask about CCH surgery at my next hospital appointment.

I am now using Ikervis twice a day instead of once as prescribed, to see if it has any impact.

[Topher3]

are sclerals actually okay for people with minimal oil over the eye? Dr Korb in one of his conferences said that with minimal oil the sclerals friction can warp the cornea and or cause serious damage? I understand how it prevents the water layer from evaporating and working in a way as the oil and also comes out over the cornea and doesn’t touch it.But I’m talking about where it sits in the eyes could get seriously irritated? I’m not sure though that’s just my thoughts/questions

[Alix]

are sclerals actually okay for people with minimal oil over the eye? Dr Korb in one of his conferences said that with minimal oil the sclerals friction can warp the cornea and or cause serious damage? I understand how it prevents the water layer from evaporating and working in a way as the oil and also comes out over the cornea and doesn’t touch it.But I’m talking about where it sits in the eyes could get seriously irritated? I’m not sure though that’s just my thoughts/questions

Yes there is a high drop out rate for the reasons you outlined but I am using them to deal with the burning as nothing else has worked so far. Yes they are only ******g the problem to some extent as the burning will come back each time I take them out but it is affecting my quality of life, so I don't have much choice. I am running out of options.

As I have a lot of gland loss due to contact lens use, I am going to use the sclerals as a temporary measure until/if the Ikervis starts working.

[Topher3]

Alix yes for sure good idea! I really hope it helps you. A good way to tell if sclerals could be useful is if you put 5 eyedrops in each eye and then close your eyes. If the burning stops the sclerals should help, as that’s texhnically the same thing that’s happening.

[Alix]

Alix yes for sure good idea! I really hope it helps you. A good way to tell if sclerals could be useful is if you put 5 eyedrops in each eye and then close your eyes. If the burning stops the sclerals should help, as that’s texhnically the same thing that’s happening.

Thank you! I will post feedback once I get them and use them for a while.

[TARYN]

Alix, Have you tried Patanol eyedrops? Before I had the CCH/AMT surgery, the only thing that would help with the burning was Patanol eyedrops followed by cold compresses.

[Alix]

Alix, Have you tried Patanol eyedrops? Before I had the CCH/AMT surgery, the only thing that would help with the burning was Patanol eyedrops followed by cold compresses.

Hi At the hospital earlier this year I was given Opatanol, which I believe is the same thing, and used it for one month, but it didn't do anything.....
I'll try cold compress again.

[TARYN]

Yes the Patanol didn't help that much until I used a cold compress for about 15-20 minutes after I put the Patanol in my eyes. For some reason the combination helped with the burning.

[Guest]

Yes the Patanol didn't help that much until I used a cold compress for about 15-20 minutes after I put the Patanol in my eyes. For some reason the combination helped with the burning.

I’m assuming you put your compress in the refrigerator not the freezer correct? That’s an important note to make, don’t put it in the freezer, it’s too cold. But a cold compress is really helpful with eyelid irritation. Good luck! Latkany said in his findings, a cold compress 3x a day was more effective at relieving dry eye than of drops 4x a day.