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  • Things have improved - what's working....

    Hello Everyone,

    Here is my first post here about 9 months ago:

    http://www.dryeyezone.com/talk/showthread.php?t=2027

    In summary, I had RK 18 years ago and my eyes have felt scratchy and looked bloodshot ever since. Now in the last few months, I have improved significantly. I would say that my problem is approximately only half as bad.

    Here is what I am doing. I finally found a doctor willing to try different things. I had over the years always used my "highly acclaimed" refractive surgeon for help with solving my "dry eye" problem. Typically he would recommend drops such as systane etc. and the eye scrubs. Nothing really worked. I started to become more persistent about the problem and he prescribed some steroid drops. I knew this wasn't going to solve the problem. I tried the drops, but had little affect on my eye comfort. Finally, he threw up his hands and said there was nothing more that he could do, and offered a referral to a doctor at the Stanford Medical Center in Stanford CA.

    My new doctor was completely different. Instead of constantly denying that my problems were related to my RK surgery, he started trying things. His initial examination convinced him that my basic problem was that my meibomian glands were plugged up. He said my eyes looked fine, but my tears were bad. First he offered me the standard eye scrub and hot compress regimen. This has never worked very well for me but hey, I decided to give it a fresh try thinking maybe I just had not been diligent enough in the past. Sure enough my eyes got WORSE. Then he said to stop the scrubs and compresses and put me on DOXY pills. Things started to get a little better, but not much, maybe 20% better.

    I started at this point to notice that when I pressed my lids, I would get some cloudy stuff coming out of my lids and I found that with a little practice, I could get it to come out quite easily. In fact, I have come to recognize a little itch on my lid that seems to come when stuff is getting backed up. When the cloudy stuff would come out, I would notice that my eyes would start feeling a bit better after a few minutes. I was on to something I figured. Even though things were feeling somewhat better, I was still suffering a significant amount of pain and irritation.

    Now for the thing that really made the biggest difference of all. I had heard this before, but never really listened. I STOPPED RUBBING MY EYES ENTIRELY. No touching beyond the VERY GENTLE cleaning and pressing of the glands. Previously, I had regularly splashed my eyes with cool water and would rub the eyes with the water and would further rub the eyes when I would dry them on the towel. BIG MISTAKE. While I was getting some relief from the water, and possibly rubbing some of the oils out of the glands, I was causing damage to my eyes. I wouldn't feel any pain during the rubbing, in fact it felt kind of good. One other thing that occurred to me was that I had been rubbing my eyes a lot during the lid scrub and compress regimens.....HMMMMM.

    Once I stopped the eye rubbing COMPLETELY, things started to improve significantly. The throbbing and aching stopped. The pain in my brow and cheek stopped. I think this is probably related to my particular surgery, where they cut 12 deep incisions into each eye. There is probably some sort of weakness there, I don't know. In any case, it is well known that rubbing your eyes is not good. I will attest to that.

    So in summary, here is what I am doing:

    1. I take the Doxy pills, 100mg day.
    2. I GENTLY express the glands in my lids when I start to feel my eyes drying and stinging. Usually some cloudy stuff comes out, things start to feel a little better. I make sure I only do this with cleaned hands.
    3. I let the shower spray rather forcefully on my closed eyes for about 5 minutes total every morning.
    4. I GENTLY wash my eye lids twice a day with OCUSOFT foamy eye soap. I figure keeping my eye lids clean can't hurt things.

    My eyes are feeling and look significantly better. I guess I would say they are at least 50% better and on some days, dare I say this, feel.........almost normal!!

    The next area that I will experiment on is returning to the hot compresses. This time I will start very slow and not apply any more pressure or rubbing on my eyes than is possible. Maybe this will help the glands even more than the hot showers. We'll see.

    I hope that somehow this will help someone else just as this site has helped me.

    Richard.
    Last edited by Richard_R; 23-Jul-2007, 13:11.

  • #2
    Thanks for the update. I have tried something for the last few days that sounds similar to your point about not rubbing eyes. I stopped doing my washcloth compresses (I usually rub my lids with the cloth at the end), and my eyes feel better. I'm going to do it much more gently in the future.

    I know I rub and mess with my eyes WAY too much. The biggest thing that starts it off are the mucous strings and clumps; they're SO irritating---I start digging around for them, and it's all downhill from there.

    C66

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    • #3
      Hi Richard,

      Very good news!!
      I am on doxy too. BTW, do you have any punctal plugs, upper/lower?
      How long have you been on doxy? Have you tried to stop it?
      I get very dry if I try to stop it. I am also taking NAC which helps too.
      All best !

      George

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      • #4
        Dear Richard,

        My eyes are feeling and look significantly better. I guess I would say they are at least 50% better and on some days, dare I say this, feel.........almost normal!!
        What wonderful news, and what a wonderful post!!! I am 100% behind you on the counterproductive potential of overmanipulating the lids in many cases where lids/MG health are central to the problem. I try to keep mine to a minimum as well. For a long time my routine was a Q-tip/Unisol lid wipe (I'd hardly classify it as a scrub) and a rice baggy. I've never done any heavy duty scrubbing or massaging and for me personally, this routine keeps the MGs in shape. In the last month or two I ditched the Unisol in favor of Ocusoft foam lidscrub (original formula) which I use briefly in the shower in the morning - originally as an experiment, but now as a habit. My eyes are quite sensitive to tap water so I get a teensy bit of irritation from my quick rinse but it does not last.

        The next area that I will experiment on is returning to the hot compresses. This time I will start very slow and not apply any more pressure or rubbing on my eyes than is possible. Maybe this will help the glands even more than the hot showers. We'll see.
        Fingers crossed. A good compress does not need pressure or rubbing. Using some kind of device that retains heat well is important too, in my view... If it doesn't retain heat well, then there is a tendency to get it too hot (another lid risk) and for example with washcloths many people redo it over and over because it cools quickly. Personally I think it's better to use something that doesn't have to get that hot initially but stays warm for plenty long enough. For me it's a rice baggy, many people like Dr. Latkany's 'eye spa pad', and there are so many more things - heat pads, microwaved potatoes, coffee cups, you name it.

        Thank you again for sharing about your progress and what you've identified as issues... much appreciated!!
        Rebecca Petris
        The Dry Eye Foundation
        dryeyefoundation.org
        800-484-0244

        Comment


        • #5
          Originally posted by GeorgeT
          Hi Richard,

          Very good news!!
          I am on doxy too. BTW, do you have any punctal plugs, upper/lower?
          How long have you been on doxy? Have you tried to stop it?
          I get very dry if I try to stop it. I am also taking NAC which helps too.
          All best !

          George
          For the doxy, my doctor has given me smaller tablets so that I can try to taper off. Instead of 2 50mg tabs/day, he is moving me to 4 25mg tab/day and is letting me reduce them slowly to see how things work. My next appt. is in 6 months.

          When I asked my doctor about trying punctal plugs, he said that he doesn't think they will benefit me because my problem isn't primarily with moisture but with a tear film that does not control evaporation. He believes that for me, it is important not to trap contaminants in my eyes any more than necessary. He also said that maybe we'll try later if other things don't work.

          If you can't tell, I really like my new doctor, he is more like my ally than my adversary.

          Richard.

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