Eyelid inflammation

[brd888]

I think my dry eye symptoms may be caused be inflammation of the eyelid. I have mild dry eye, and after a recent exam the Dr said my eyes look okay but inner eyelids look like a contact lens abusers!
I think the inflamed cells are causing the discomfort rather than a lack of oil from MGs. Aqueous tears are abundant.
I also point out that i suffer discomfort at night with eyes closed too.
Any thoughts on this speculation?
Thx
Bruce

[odydnas]

My inner eyelids are covered in blood vessels...is this an indication of inflammation of my eyelids?

[Justin]

Check out my post found here.

http://justinbazan.wordpress.com/2007/08/04/89/

[brd888]

No lenses

Dr Bazan,
Yes but I should point out that I don't use contacts. My innder eyelids look nowhere near as bad as the photo on the link.
My eyelids are mostly healthy looking pink but the blood vessels are prominent. To be more accurate the Dr said the lids look typical for someone using contacts every day - do you think this "inflammation" is causing my dry eye symptoms or vice versa?

Regards,
Bruce

[Justin]

I think you glanced over the important part. It does not have to be from a CL.

"Giant Papillary Conjunctivitis (GPC) is an immune-mediated, inflammatory disorder that is a response to the presence of an irritant. That irritant can be an allergen, a contact lens, an ocular prosthesis, an exposed postoperative suture (stitch), a contact lens solution or even the dirty deposits of bacteria and buildup that accumulates in and on a contact lens. Basically something interacts with the inside of your eyelid to the point where it becomes irritated and bumpy, leaving your eye very uncomfortable."

In your case, it may be that the lack of lubrication is causing your own lid to have a frictional irritant effect on itself. Have you ruled out other sources of irritants, especially allergens? Also, keep in mind that pic shows a very prominent example. I did not mean to imply that was your eyelid.

The inflammation and the dry eye should not be thought of as mutually exclusive. The are intimately linked and because of this it is hard to say if one was causative of the other.

I assume you are being treated, would you care to share your Tx regime?

[brd888]

Regime

Hello,
My current treatment consists of a heat compress and lid massage which I do around 5:30pm daily (although I often get lazy and dont bother). I use Nutratear or Clinitas ultra 3 drops whenever eye feels dry. As I am having a period of difficulty I have re-started taking Doxycycline for the last 2 weeks.

Also I have been using the heat for about 4-5 minutes. I read last night it should be 5-20 minutes. My meibomian glands do not have blockages and meibum definitely gets out. My condition is moderate but persistent.

Thanks for listening,
Bruce.

[Justin]

Hi Bruce, Thanks for sharing your tx regime.

I want to make it a point that if you waiting for your eyes to feel irritated to use the artificial tears, you have waited to long. Try to identify what triggers you to feel symptomatic and use them before you feel the need to. For example, many pts will use ATs when they sit down at the computer. It helps to keep their tear film optimally functional under stressing conditions. If they didn't they would feel sympomatic and have to use them anyway. Except now the damage may have been done and they are treating the symptom, instead of preventing the problem.

Consider using a nutraceutical tear film enhancement instead of the doxy. One might conclude that if the doxy works, you might benefit from eating a few fortifeye or biotears everyday. Talk it over with your eye doc.

[skygoddess]

Dr Bazan,
Thanks for the tip about not waiting to use drops till you feel dryness
Seems so obvious. but I am guilty as charged .
I wait till they feel dry, then I get upset because the drops do not seem to be effective.
I guess instead of chasing the perfect drop maybe I should just try staying on a schedule with the 10 or so bottles I already have!
Any thoughts on dosing frequency?

Thanks a million for your time,
I hope you know how much we appreciate it.

[Justin]

You're very welcome. The schedule can vary dramatically for individuals. For those lucky enough to have mild symptoms as little as 4 drops spaced throughout the day may be sufficient. Others know a more frequent schedule. One might try every 2 hours and adjust accordingly. The discipline it takes to maintain adequate compliance is something many of us cannot easily maintain and we end up waiting till our eyes are bothering us.

What tips do you guys have for keeping on schedule?