RCE and/or nighttime Dry Eye?

[Giacomo]

I owe my discovery of RCE to Rebecca and Aidan. A big shout-out to them with thanks. (I know Rebecca has an upcoming Happy Hour on nighttime Dry Eye). For a long time, I thought i had DRY EYE Syndrome (or as DR Hagan on Med Help has called it Ocular Surface Disease). BUT I do not have dry eye symptoms during the day as many/most people complain about. I kept researching “dry eye only at night” and came up with nothing that helped. I was waking at 4 AM or 7 Am with the feeling that sand paper was rubbed across my eye. Then on a Dry Eye happy Hour a few months ago, Rebecca mentioned RCE and I realized that was certainly what I was suffering from. I still use an assortment of drops both Muro 128 and moisturizing /refreshing drops during the day AS A PRECAUTION, and at night before bed, I use Muro 128 ointment AND another like Artelac Nighttime Gel or Vita Pos (both European products, I believe). Since starting this routine, I have not had erosion episodes upon waking. TG ! The purpose of this post to is dive deeper into the action of a hypertonicity solution like Muro 128 (or the cheaper version by AKORN on Amazon) and moisture retention products like lubricant drops. The former is meant to draw out corneal edema (swelling) while the lubricant/refresher drops ADD moisture to the cornea. To a layperson, they would seem to work at cross purposes. By adding lubricants, am I perhaps worsening the corneal edema? Any insight much predicated.

[DryEyeHelp1985!]

I may be able to help because I had / have RCE. And, I have used muro and lubricants together. I got my first erosion in December of 2019. Second in January 2020. After thatt, I started Muro and had no recurrences for about three months.. After 3 months and a small recurrence, I added moisture goggles to help prevent another RCE. Recently, I have used muro and gel together. I haven't had any erosions doing that but I have been able to feel my eyelid pretty much constantly.

I think there is more to my RCE personally than one thing, such as corneal edema. That might be your case, too. If so, you may have to carefully balance your risk factors

For instance, the initial factors in my RCE were:

- History of trauma
- Slight map dot fingerprint dystrophy


However, I believe I may have developed blepharitis, MGD and dry eye as a result of the moist, humid environment I keep my eye in at night (i.e., moisture goggles and muro / lubricants)

So, now I have the additional factors of

- MGD
- Blepharitis
- Dry eye

Ironically, I think I was overzealous in trying to prevent future RCEs and essentially gave myself MGD, blepharitis and nighttime dry eye, leading to an increased chance of RCE, even when I think my basement layer has actually healed and strengthened by this point.


My thought is a singular factor such as corneal edema is something to watch out for; however, I also need to make sure I am taking care of the MGD, blepharitis and dry eye. I guess my point is, you may be worsening the corneal edema by using a lubricant. However, if your case is multifaceted, you don't want to focus on preventing one thing (corneal edema) at the expense of others (MGD, blepharitis, dry eye.)

Now I am dealing with the blepharitis and my eye feels much better. I plan to go off Muro and strictly use a polymer based gel at night, with moisture goggles. If my eye continues to feel good, I am going to slowly reduce the amount of gel and see how things go.

Do you have map dot fingerprint dystrophy? Did you injure the eye?

Thanks.

[Giacomo]

Thanks of all info above. I am curious about your experience with solutions vs gels vs ointments. I believe solutions are the most “liquid”, then gels, and finally ointments which can be sticky. I was using ointments at night but have switched to gels. I found the ointments actually irritating the cornea. Question for you: you mention Muro 128. Did you use the ointment or the solution? Also to note: the ointment is preservative free but the solution is not !!!! While the preservative is not BAK, we are led to believe that we should avoid all preservatives. I have found, and use sodium chloride 5% solutions that are preservative free. One such product is AEON by Rayner which also contains sodium hyaluronate. Here, in Europe, I have other options. I also have had success with Thealoz Duo gel. Which gel are you using or will you use?

[DryEyeHelp1985!]

I used the Muro 128 ointment. As far as gels, I use Genteal.

I feel like something like the Muro is actually swelling my eyelid. I had no eyelid swelling until after RCE. After that, the eyelid is swelling. None of the 8 optometrists / ophthalmologists I have seen has ever tried to figure out WHY my eyelid is swelling. It's beyond frustrating. I see an ophthalmologist Tuesday and am going to simply demand he tries to figure out the WHY of why the lid is swelling. It's mind numbing to me how indifferent all the doctors have been to conditions like this. It's something they don't know, so it's like they don't care to even try to figure it out.

[Giacomo]

Have you checked if genteal tears is preservative free? I have seen web pics where boxes display preservativecfree and other pics don’t.