Inflammation

[MGD1701]

DryEyeCoach's Twitter

inflammation of the surface of the eye may occur along with dry eye.
If left untreated, this condition can lead to pain, ulcers, or scars on the cornea, and some loss of vision.
However, permanent loss of vision from dry eye is uncommon.''

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earlier post on Red Eyes: painful, with discharge, loss of vision

with pictures etc By Dr de Benito-Llopis, UK shared that she always asks three things when patients present with red eye –
‘Is it painful?’
‘Do you have discharge?’ and
‘Do you have loss of vision?’

A guide to what needs to be referred into ophthalmology, Nov. 2018
https://www.youtube.com/watch?v=5ZSLr1VcR04

Untreared dry eye Consequences
http://forum.dryeyezone.com/forum/dr...e-consequences

[MGD1701]

Demodex - Tea tree Oil

more #9
http://forum.dryeyezone.com/forum/dr...cating-demodex

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from DryEyeCoach, including the image
''Tests are performed to pay special attention to the surface of the eye.
A drop of *yellow or green dye may be placed in the eye to look for damaged areas from inflammation.''

*fluorescein & lissamine green (one of them is late stage indicator so I think MMP-9 is more useful)
One of these dyes is a must, ideally two dyes plus MMP-9
Normally doctor should wait for 2-4 min for the dyes, per TFOS 2017 report too.

[MGD1701]

BlephEx is effective/economical to control inflammation (remove years of sticky biofilm for example).
pure Hypochlorous Acid (like Avenova or NatraSan spray which I have found more than 1.5 years ago - out of curiosity),
helps to control bacteria but it can not penetrate - with more learning now I beleive so.

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From DryEyeMaster, Dr Periman twitter
''New paper describing how to diagnose ocular rosace......''

[MGD1701]

DryEyeCoach twitter today

''Dry eye can be associated with inflammation of
the surface of the eye,
the lacrimal gland,
or the conjunctiva''

[Milo007]

DryEyeCoach twitter today

''Dry eye can be associated with inflammation of
the surface of the eye,
the lacrimal gland,
or the conjunctiva''

The picture is that of chemosis of the conjunctiva which is inflammation induced by an allergic reaction.

[MGD1701]

This is my believe/understanding too, with more learning.

DryEyeCoach twitter today

''Nov. 2017
Most people do not realize that dry eye is considered
by experts to be an inflammatory process.
This means that treatments may require a focus on inflammation,
even when there are no visible signs of inflammation around the eyes or eye''.

Now I recall, experts do treat the inflammation, even MMP-9 is negative.

[baggs.barron]

This is my believe/understanding too.

DryEyeCoach twitter today

''Nov. 2017
Most people do not realize that dry eye is considered by experts to be an inflammatory process.
This means that treatments may require a focus on inflammation,
even when there are no visible signes of inflammation around the eyes or eyelids.''

Therefore, eyes should not be scratch if it is itching, giving some warm compress may lessen the itchiness.

[MGD1701]

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[MGD1701]

Twitter from Optometrists, 3/19

Red eye diagnosis

[Guest]

Demodex - Tea tree Oil

more #9
http://forum.dryeyezone.com/forum/dr...cating-demodex

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from DryEyeCoach, including the image
''Tests are performed to pay special attention to the surface of the eye.
A drop of *yellow or green dye may be placed in the eye to look for damaged areas from inflammation.''

*fluorescein & lissamine green (one of them is late stage indicator so I think MMP-9 is more useful)

When you say, lissimine green and flourescin staining are late stage diagnosis, I believe MMP9 is better. I’m not sure that’s the way to look at it. One diagnostic test isn’t better than the other per say. Each one will give you different information that all adds up to a diagnosis. What’s weird is my MMP9 on my left eye was weak and I’m my right eye was strong when I first got tested. But the left eye hurt more. Doesn’t make any sense, but I assume there’s more to the story than MMP9 in my case. Honestly, I think for me, the issue is the floppy eyelid not spreading tears properly. So again, I think every single test is important to achieved the correct understand of the disease process that’s occurring.

I had all three done at my exam. I think all three helped to determine my problem. I know you say a schirmer is inaccurate, and it probably is. But even a “failed” schirmer tells you something. My schirmer was 3/4 in each eye respectively. But when he did the tear wash, he said, you have tears. I put in 50 microliters and recovered more. So that told him I don’t have a true aqueous deficiency. That it’s most likely a side effect of the inflammation. That’s useful. Every test is a clue in my opinion. That’s why all these doctors that don’t do these tests really can’t help you.

I remember in the beginning I saw a local dry eye doc and asked about the dyes. Lissimine green was something g I wanted put into my eye because from my understanding, it helps give further info. When I said this to her, she said, I can add the due but it will just tell me you have dry eye. Lol! She had no clue how to use the dye. She had no clue that the dye could help her because she didn’t even know what she was looking for.

[MGD1701]

Just added * to make it clear:

fluorescein & lissamine green (one of them is late stage indicator so I think MMP-9 is more useful)
*One of these dyes is a must, ideally two dyes plus MMP-9 (in order to detect inflammation.)
Normally doctor should wait for 2-4 min for the dyes, per TFOS 2017 report too and
examine lid (margin), lashes (for demodex) and lift the upper lids.

[MGD1701]

All experts in USA I know look for inflammation on the first visit and treat. One professor says, ''If doctors control inflammation, they could turn that patient around.''Why bother? Maybe he cares for his reputation, patients and results and loves his job then he feels rewarding and is successful too?

They only put plugs in when the inflammation is under control - if doctors do not check inflamamtion and want to put plugs in (specially on the 1st visit) - I would look for more knoweldgeable doctors.

You are lucky if your doctors treat the inflamamtion, as most do not. No knowledge, no time, dont care or ....?

Normally, redness indicates inflammation but no redness does not mean one has no inflammation.

[MGD1701]

In case someone are curious.

''Demodex may be beneficial to humans

by Katherine Mastrota,MS, OD, FAAO, March 2018

Conclusion:
Eradication of demodex is most likely impossible and may be ill-advised.
The goal for those living with demodex should be to maintain homeostatic balance
by using proactive rather than reactive lid hygiene.''

https://www.optometrytimes.com/dry-e...eficial-humans

[MGD1701]

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

[MGD1701]

So happy to find this interesting/informative lecture

Pathologic Targets for Therapies in Ocular Surface Inflammation
by Dr. MICHAEL E. STERN.ImmunEyez, LLC. Irvine, CA, USA.
Adjunct Assistant Professor, Baylor College of Medicine.Houston, TX, USA., 2018.03

https://www.youtube.com/watch?v=TvtcrrIc-4w