Inflammation

[farmgirl]

Why experts only put plugs in after the inflammation is under control -
happen to find one video (SOE 2017, training program for doctors) with 3 experts/professors from Spain, USA and Italy.
from 50:35 - about 3 min.

https://www.youtube.com/watch?v=YC3QgyodyMw

I seriously don't think that I can agree with the woman who says that she removes the plugs from Sjogrens patients and they do much better. In the beginning for me (Sjogrens) the plugs were the only thing that made an appreciable difference and I would never voluntarily get them out unless they were presenting some kind of noticeable problem.

[MGD1701]

found another one The pathophysiology of Dry Eye - Finding the targets”

from Dr. Michael E. Stern
ImmunEyez, LLC. Irvine, CA, USA. Adjunct Assistant Professor, Baylor College of Medicine.Houston, TX
2019 April

so much important info - something I have been curious about and eager to learn.

https://www.youtube.com/watch?v=EEXg_clEz-0

[MGD1701]

I am still very happy to find the re-confirmation:
*Doctors can not detect the inflammation from the slit lamp and
no redness does not mean no inflammation
from Dr Michael Stern's above video, The pathophysiology of Dry Eye - Finding the Targets

I first read/learnt *this from Dr Korb partner, Dr Caroline Blackie old article and other experts.
These helped me figure out how to better control the inflammation and
I have improved red (inner) lid margin at least 90%. My secret weapons

Moisture glasses: to avoid the environmental stress - most important

Saline rinse to remove dead cells etc.

Tea tree oil (TTO) + jojoba oil on lashes before bedtime
despite I dont have any typical demodex signs. Doctors also confirmed I did not have demodex.
My last grittiness was almost 2 month ago. I am pretty sure such grittiness is demodex inside m. or s. glands.

BlephEx
to remove years of sticky biofilm which HOCL spray can not achieve

NatraSan (pure) HOCL Spray I have found almost 2 years ago, of course, to control bacaterial overgrow.

[quattroboy]

This is interesting after nearly 18 months of LASIK dry eye and visiting various doctors the Scleral lenses specialist I went to see performed an InflammaDry test.

No one else has actually tested me for inflammation, well guess what a strong positive!

To be honest, I'm not surprised, I've suspected it since last summer.

So I've decided to restart Ikervis, which I stopped the beginning of January on the advice of my regular doc, which I have a lot of respect for.

When I saw him on Monday he wasn't convinced but confirmed my staining had returned to the inner corners of my eyes, which again the lens specialist showed me on his screen. Again a first, actually seeing the results of their observations and testing on the screen for yourself.

Not only had the staining returned but Lacrimal glands appear to have shrunk again! Again they looked better in January. Inflammation setting in again?

At the moment trying to avoid steroids again.

So I have inflammation markers and staining despite using PRP drops from Alio at Vissum.

The lens specialist suggested the Makuka honey drops to see if they help in the short term control the inflammation, novel but I'll give it a go despite they sting like made.

Seeing the lens specialist again on the 3rd to discuss using scleral lenses. He'll test again.

[MGD1701]

Dr Stern also mentioned in this video that Lacrimal gland can die so he told
ophthalmologists that they should treat patients early and ''a few actually listened'', if I understand correctly.

[Milo007]

This is interesting after nearly 18 months of LASIK dry eye and visiting various doctors the Scleral lenses specialist I went to see performed an InflammaDry test.

No one else has actually tested me for inflammation, well guess what a strong positive!

To be honest, I'm not surprised, I've suspected it since last summer.

Did you have any signs of inflammation in your ocular surface or the inflammadry gave a strong positive result despite no obvious signs of inflammation?

By signs of inflammation I mean redness of the inside of the eyelids or the eyeball surface.

Also did you have any symptoms such as burning or uncomfortable blinks?

There must be something that hints towards the presence of inflammation without performing the inflammadry test.


What were the symptoms that made you suspect the inflammation was returning again?

[quattroboy]

Did you have any signs of inflammation in your ocular surface or the inflammadry gave a strong positive result despite no obvious signs of inflammation?

By signs of inflammation I mean redness of the inside of the eyelids or the eyeball surface.

Also did you have any symptoms such as burning or uncomfortable blinks?

There must be something that hints towards the presence of inflammation without performing the inflammadry test.


What were the symptoms that made you suspect the inflammation was returning again?

Yes the inner corners of both eyes get red, after a full day in the office.

The inner corned of my left eye mostly has blood viens showing.

And yes I have the symptoms which seem to tally with the location of the staining on the inner whites of my eyes.

[Milo007]

Yes the inner corners of both eyes get red, after a full day in the office.

The inner corned of my left eye mostly has blood viens showing.

And yes I have the symptoms which seem to tally with the location of the staining on the inner whites of my eyes.

Sounds like a have a lot of inflammation then. No surprise my lipid secretions are so highly variable.

[MGD1701]

How to check lacrimal function? I thought about this last night and now happened to find the answer:

''Dr. Laura Periman believes that
tear osmolarity testing is foundational in determining the health of the lacrimal functional unit
in her dry eye patients, establishing the disease severity and tracking dry eye patient's response to treatment over time.''
2017 Jan.
https://www.youtube.com/watch?v=nbA1DCxkGjg
---------------------
forgot to add: and to check the tear lake height which Dr Periman does, from her various articles.

[Milo007]

How to check lacrimal function? I thought about this last night and now happened to find the answer:

''Dr. Laura Periman believes that
tear osmolarity testing is foundational in determining the health of the lacrimal functional unit
in her dry eye patients, establishing the disease severity and tracking dry eye patient's response to treatment over time.''
2017 Jan.
https://www.youtube.com/watch?v=nbA1DCxkGjg

Isn't it so that tear film hyperosmolarity can also be due to increased evaporation due to a compromised lipid layer?

[MGD1701]

Isn't it so that tear film hyperosmolarity can also be due to increased evaporation due to a compromised lipid layer?

Yes, but the higher tear osmolarity one has, higher salt contents as well, which is an indicator of the level of inflammation, I guess.
Dr Stern also mentioned this.

[Milo007]

Yes, but the higher tear osmolarity one has, higher salt contents as well, which is an indicator of the level of inflammation, I guess.
Dr Stern also mentioned this.

Yes hyperosmolar tears results in the release of inflammatory cytokines and chemokines. So chronic tear film hyperosmolarity will always be accompanied by inflammation.

It would be very useful if you have some informational sources on the detection of scar tissue over and inside the meibomian glands. I mean if it's possible to guess if meibomian glands have developed scar tissue without actually probing them.

[MGD1701]

Just wanted to add
some experts do mention, ''If you (doctors) look for it (the inflammation),
you should be able to find it (the inflammation).
Perhaps it depends on how knowledgeable doctors are?

The problem seems to be most doctors still consider redness = inflammation so if
they do not see redness, they consider there is no inflammation?
but do they check the lid (margin), lashes (for demodex) or/and
perform objective testings such as, MMP-9 or osmolarity etc.

[MGD1701]

Hey Milo
Do you know baby shampoo is bad for the goblet cell? recently study shows. I have heard/read it from two different doctors from USA. You can easily get such report/article with google.
It removes the natural oil too - I have posted a video some time ago.

[Milo007]

Hey Milo
Do you know baby shampoo is bad for the goblet cell? recently study shows. I have heard/read it from two different doctors from USA. You can easily get such report/article with google.

Damn I have been using it daily as an eyelid scrub!

Thanks for sharing the information.

How do you know I use baby shampoo?