does cause determine treatment?

[namoomoo]

Can anyone tell me whether the cause of dry eye will determine the treatment? Are there general treatments like drops/plugs etc and then specific treatments depending on why you have dry eye? I am confused about how to find out the cause, and if I need to in order to get the right treatment.

[Rebecca Petris]

Can anyone tell me whether the cause of dry eye will determine the treatment? Are there general treatments like drops/plugs etc and then specific treatments depending on why you have dry eye? I am confused about how to find out the cause, and if I need to in order to get the right treatment.

Absolutely.

Well let me qualify that. Identifying the actual exact "cause" is ideal... not always possible. What's essential (in my opinion) is to identify the type(s). Is it your lacrimal (moisture producing) glands that aren't functioning fully, due to auto-immune disease? Or is it your meibomian (oil producing) glands underperforming or getting blocked up, due to blepharitis, rosacea, drug side effects, or something else? If it's both (not uncommon) probably one is primary and one is secondary. You have to figure out which is primary and tackle that... patiently.

Broadly speaking, I think that MGD is more "treatable" in the sense that you can get the oil flowing with careful maintenance of the oil glands. By comparison, with aqueous deficient dry eye it's more about palliative measures to protect your eyes from damage and keep you comfortable (drops, plugs, protective eyewear). The confusing part of course is that no matter what the cause, you're still hurting and still need protection and palliative measures so drops are essential to most people in any case.

How to pin it down?

Well, if you're lucky - or you live near a really good specialist - or you're willing to travel - you'll get one of the docs that really, really knows his/her stuff. If you're not/don't/aren't, you'll probably have to shop around for a suitable doctor who knows how to do very thorough testing and has a broad understanding of all the different treatments.

You can also learn from experience based on what works: I don't mean what makes you feel better right now, but things that give you noticeable lasting improvement. Frankly, so much of dry eye (unless it's auto-immune) is from MGD that I think personally it makes sense to go ahead and start working on the MGs with good lid hygiene, heat, and Omega 3s - like Dr. Latkany's home eye spa routine. Assuming you're careful and don't overdo it, it can't hurt - at worst it will be a good preventive.

[sazy123]

Hiya

The cause does effect what treatment will work and what wont.

I.E. Due to the fact that i think my cause is underperforming MGs, as in my MGs are not producing 'enough' oil, as a result of contact lenses and medication interfering with the singals telling my eyes to produce oil i am quite limited in what treatments will help other than as pallitive care.

But everyone is different, and if you have blocked MGs due to inflammation etc then hot compresses etc will probaly be of more benefit for long term improvement.

I do think finding the cause is important but if that is not possible trying all the mainstream treatments through trial and error is often what has to be done.