how do you increase the thickness of the tear film?

[stella]

Any ideas - Ive just returned from the corneal clinic at the hospital where i had a 6 monthly follow -up
It went well ,and after examination and various drops (unknown) the ophthalmologist agreed with my optician that the tear film was intact , but she would prefer it to be thicker
At least i dont have any holes in the tear film now - and i would know that 'cause i have very few symptoms
(Wish to goodness everyone on this site could achieve an intact tear film - It makes a HUGE difference to your comfort)
However the thing to aim for as well as an intact tear film is a thick one -----
Any ideas on how to achieve this or go about it ???
The ophthalmo did suggest i use artificial tears regularly ,which i have not been doing at all - I have taken the attitude -- The less you put in your eyes the better and if i feel dry i yawn to produce my own tears and only use celluvisc(my drops of choice) if i have burning or foreign body sensation, which is hardly ever these days
Do Dr Holly,s drops increase the thickness?I know they claim to heal the tear film - I could not use them in the past - maybe now i could (I find i can use much more than i used to when i had holes in the tear film)

[indrep]

Stella,
The thickness of the tear film comes mainly from the Aqueous (water) layer of your tear film. The outer lipd layer is a monocellualr level and cannot be thickened. The base layer, the Mucin layer, is the mucous interface between the ocular surface and the aqueous. This thickness is determined by the goblet cell output of mucin. However it only accounts for about 7% of the tear thickness.

I'm guessing they wanted to see more aqueous on your ocular surface.

[stella]

Thanks for that Indrep - I never knew that
That must be why the ophthalmo wants me to use drops in my eyes even when i dont feel the need for them

[lasiksurvivor]

Correct advice

As illogical as it sounds, the eyedrops and warm compresses are designed to build your tear film layer up as previously described. It can take a long time but it's good to hear your tear film is in pretty decent shape already. Gradually as it improves, vision and comfort will improve also.

[calli66]

My ophthalmologist wanted me to use drops every hour. In my mind, and in my experience, that is counter-productive. Using more drops probably doesn't make the tear layer thicker.

I agree with what you said: "The ophthalmo did suggest i use artificial tears regularly ,which i have not been doing at all - I have taken the attitude -- The less you put in your eyes the better..."

Whatever you've been doing has made a positive difference for you in the past 6 months, correct?

I've been using FreshKote (originally a Dr Holly drop) for 3 months---usually 2-3 times a day, no more. They seem to be working pretty well. My eyes still have some "staining", according to my eye doctors, but it's sort of diffuse, not large problem areas. And my eyes feel pretty comfortable.

So I don't know how a person can "thicken" the tear layer. My personal goals are to "remain out of trouble," meaning not intentionally making my eyes more vulnerable to dryness or stress (too much computer, dry wind, staying up late, etc), and trying to deal with inflammation right when it begins by using compresses, good hygiene, rest, etc. Usually I can prevent the "crash and burn" phase.

I know my tear layer is thin---I just don't have the quantity needed. But it does function well enough most of the time.

Calli

[clairvoyant]

What is funny I think is that using more drops will cause a blepharitis flare (if this applies to you). For example, my eyes and glands felt pretty dry earlier. So I washed my hands, cleaned my glands via a q-tip, massaged them then bam they were back pumping oil out again. So I would defenitely say tears can be counter productive. I am trying to figure out the best way around this though. A nice short warm compress clears any crusting, so would a Q-tip but those are not always immediately accessable.


Also I am not sure about this but I am wondering if drops like celluvisc can actually aggravate the glands like ointments are postulated to and even more so if castor oil can, namely restasis.

It truly amazes me how many things factor into more dryness once the eyes are vulnerable aka car ac, blepharitis treatments, hygeine, facial anti-inflammatories or even washing your hands and touching your eyes(gotta be careful there too).

[rubyslippers]

It is confusing isn't it.

Some tell us that the dropping will make things worse and others tell us that dropping will actually help us heal.

I don't know which it is. I use drops when I am uncomfortable because for me, allowing the eyes to be too dry is a sure way to get a horrible case of pink eye. Been there and done that too often. The medications for the infection make my dry eye considerable worse for 3 months or so. I think we just have to follow our guts and do what makes most sense for us.

[lasiksurvivor]

I agree with Rubyslippers

Rubyslippers is right on in stating everyone is different and you have to experiment a bit to find out what works best for you. I had my first episode with really bad vision about 6 months after my Lasik and worked really hard with warm compresses and very frequent eyedrops (never liked celluvisic either) and finally started seeing better after about 8 months. I stopped doing anything for a couple of years and thought oh wow I'm healed. Summer of 2006 dry eye came back with a vengeance and nothing I did helped. Finally started using Restasis, Genteal moderate to severe eyedrops. and ointment at night along with eyelid scrubs, warm compresses and now two years later I'm almost back to "normal". Just be aware of the possible consequences of varying or stopping treatment.