Dried eye but no tear drop prescribed. Just clean. Why?

[novetan5]

I have one eye (right) which is quite teary. Went to checked with an eye specialist (an Oculoplastics) and was diagnosed with dried eye, but not serious. Due to dryness, hence the eye produce tears to compensate. He does not warrant the use of eye drops, but instead recommend eye wipes to clean twice daily the root of the eye lashes (top and bottom). I asked him whats the benefit of just wiping. He went round to talk quite long in circles with mind blogging explanation and by the time he finished I lost track what was he trying to say. Sometimes a good golfer can be a lousy coach.

I need to see him in 6 mths time. I’m just into two weeks of wiping. So still at a very early stage to see any results. Can someone explain in layman’s language whats the benefit of just wiping the root of the lashes instead of using tear drops. His an oculoplastic. So I take it that his method must be beneficial and knows his stuff well. But how does it works?

Tks

[novetan5]

No takers?

[Rebecca Petris]

Hi there,

I can't really answer this without making a lot of assumptions about what the doctor might have said. But here's my take, for what it's worth.

There's a lot of potential reasons for epiphora (excess tearing) - including "dry eye", which comes in so many ways, shapes and forms.

You didn't mention why you went to an oculoplastics specialist. They are the eyelid gurus - but more specifically, eyelid surgeons. They would tend to be the best ones to diagnose and come up with treatment options for an issue related to incomplete eyelid closure (which is sometimes part of the dry eye picture), and also related to blocked tear ducts (a non-dry-eye reason for tear overflow, that is, a drainage failure! - but people who have this might or might not also have dry eye, so occasionally it gets overlooked).

When the dr talked about cleaning the eyelid margin area, and went into a long explanation, I am guessing (you could call their office to confirm, as it will be in your chart) that they were talking about MGD, or meibomian gland dysfunction, which is basically inflammation of the oil glands at the base of the lashes. Those glands secrete oil which becomes part of the tear film and keeps the natural tears from evaporating too quickly. When the oil gets too thick to secrete and do its job properly, the tear film doesn't work well. That's actually quite a common part of the dry eye picture.

Lubricating eye drops can be helpful for symptom management of pretty much any kind of dry eye (the point being, keep our eyes comfortable). It's not necessarily medically necessary though, depending on the specifics. So I imagine that your dr's point was, don't just dump drops in, do something to treat the disease that is really more of the root of the problem. These things aren't mutually exclusive. If you do have MGD, then daily cleansing really is important! If your eyes are over-tearing, then using drops to decrease these "reflex tears" may also be important for your comfort!

Next time you visit this dr, you might ask if they have a patient handout about blepharitis/MGD and if not, perhaps suggest that they get one. It's a lot of information to absorb in one sitting.

[novetan5]

Hi there,

I can't really answer this without making a lot of assumptions about what the doctor might have said. But here's my take, for what it's worth.

There's a lot of potential reasons for epiphora (excess tearing) - including "dry eye", which comes in so many ways, shapes and forms.

You didn't mention why you went to an oculoplastics specialist. They are the eyelid gurus - but more specifically, eyelid surgeons. They would tend to be the best ones to diagnose and come up with treatment options for an issue related to incomplete eyelid closure (which is sometimes part of the dry eye picture), and also related to blocked tear ducts (a non-dry-eye reason for tear overflow, that is, a drainage failure! - but people who have this might or might not also have dry eye, so occasionally it gets overlooked).

When the dr talked about cleaning the eyelid margin area, and went into a long explanation, I am guessing (you could call their office to confirm, as it will be in your chart) that they were talking about MGD, or meibomian gland dysfunction, which is basically inflammation of the oil glands at the base of the lashes. Those glands secrete oil which becomes part of the tear film and keeps the natural tears from evaporating too quickly. When the oil gets too thick to secrete and do its job properly, the tear film doesn't work well. That's actually quite a common part of the dry eye picture.

Lubricating eye drops can be helpful for symptom management of pretty much any kind of dry eye (the point being, keep our eyes comfortable). It's not necessarily medically necessary though, depending on the specifics. So I imagine that your dr's point was, don't just dump drops in, do something to treat the disease that is really more of the root of the problem. These things aren't mutually exclusive. If you do have MGD, then daily cleansing really is important! If your eyes are over-tearing, then using drops to decrease these "reflex tears" may also be important for your comfort!

Next time you visit this dr, you might ask if they have a patient handout about blepharitis/MGD and if not, perhaps suggest that they get one. It's a lot of information to absorb in one sitting.

Tks Rebecca. That was indeed very informative. What u said does make sense. Let me read up on MGD.

Just back track to answer your pt. I went to a GP which is my good friend and he recommended me to see an oculoplastics. The dr. use something sharp trying to poke thru the base of my eye (near the nose side) and can't go thru. So it concluded my tear duct is actually blocked. Hence tears overflow. He don't recommend to create an artificial duct to drain the tears cause the hole may be accidentally created too large to drain away the tear. And since I hv dry eye syndrome, it may further create more tears. That is totally not resolving the problem and may create more problem.

[paras1234]

Hi Rebecca,
Thanks for posting this . Can you help us with facebook groups and medicines helpful in subsiding neuralgic pain?

Thanks

[Rebecca Petris]

Whoops! So sorry, I just saw this. Have you found the corneal neuralgia Facebook group?