Author: Board Members

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Solve the Dry Eye Mystery Before It’s Too Late!

The temperature’s dropping, and it’s time to cozy up with a warm cup of tea and a thrilling medical mystery. Imagine a case so perplexing, even Sherlock Holmes, Inspector Clouseau, and Kojak would be scratching their heads. Enter: the dry eye mystery that baffles the brightest minds.

But fear not, there IS one doctor-detective who cracked the case—and just in time.

A Doctor Who Solves Dry Eye Like a Pro

 Your Dry Eye Mystery Solved is not just a book, it’s an adventure filled with suspense, danger, and life-saving discoveries. Thousands of dry eye sufferers were stuck in a cycle of hopelessness until one doctor had an “AHA!” moment that changed everything.

While most “specialists” simply prescribe drops, warm compresses, and gadgets, none of these get to the root of the problem. But our doctor-detective saw the desperation in his patients’ eyes. He couldn’t sit back and watch them suffer any longer.

The Breakthrough Moment

After years of relentless research, one patient’s long-suffering led to a life-changing discovery. This breakthrough has transformed how we understand and treat Meibomian Gland Dysfunction (MGD). And who’s the genius behind it all?

Cue the drumroll… it’s Dr. Steven Maskin, ophthalmologist extraordinaire. And guess what? He solved the mystery that affects up to 90% of dry eye sufferers!

The Culprit Behind Dry Eye: MGD

What’s the big reveal? Brace yourself—it’s called periductal fibrosis. That’s the root cause of MGD, and Dr. Maskin’s discovery has been a game changer for those who once thought relief was impossible.

Want to Know the Treatment?

Dr. Maskin invented and patented a revolutionary treatment for MGD. The catch? We’re not revealing it here! Like any good mystery writer, we’ll leave you with some tantalizing clues. If you can’t wait to find out, go ahead and dive into Your Dry Eye Mystery Solved. Skip straight to Chapters 7 and 8 for the full scoop.

Get the Book – And a Special Offer!

Don’t miss out on this limited-time offer! Until November 9th, 2024, you can grab the audiobook at a whopping 60% off. Ready to solve the mystery?

Click here to purchase the audiobook at 60% off!

Or, if you prefer the written or kindle version, buy it on Amazon and start unraveling the secrets of MGD today!

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It was the end of 2022, the most hopeful time of the year–the Christmas season. Like most everyone, I anticipated the new year with hope. Hope for happiness, good health, change for the better, finally winning at Rummy 500 against my darling husband. But I sensed that I was going to come up dry on all four of my hopes. To borrow from Twas the Night Before Christmas, “When what to my wondering eyes did appear, but severe pain and dryness. I had hardly a tear!”

True Grit

I’d been living my life fully and, happily, minding my own business when, as the world celebrated the end of the old year and the beginning of 2023, I was bombarded with practically overnight sensations of sandpaper imbedded in my eyes. I’m guessing 36 grit! (Little did I know that I’d need a lot of grit, as well as determination, faith, a sense of humor, and yes, hope, to overcome this dilemma.)

Excelling at Lying

My former extremely mild Dry Eye symptoms transformed into a Dry Eye lifestyle of lying in bed with a cold, wet washcloth over my eyes for several hours a day. It was the only way I could achieve relief. I was severely fatigued, and my eyes were so uncomfortable that I was unable to read one page in a book, get on the computer for a minute, watch any TV, or even travel to visit friends and family. Except in one case. (I attended a reunion of friends I had planned though warned my hosts I would be horizontal most of the visit.) But the good news in all this was that I listened to every free legal thriller on Audible and can now wholeheartedly recommend anything by John Grisham or Michael Stagg.

Doctors No, No, and No

During the ten months of practically living as an agoraphobic with severe dry eyes, I visited three ophthalmologists. One even claimed to be a “Dry Eye specialist.” (I’ll call him Dr. #3. It turns out he devoted all of one whole day a week to seeing patients. Some specialist!) Their prescribed treatments were:

Dr. #1) Use warm compresses a few times a day (very short-term relief), followed by massaging the eyelids (no relief).

Dr. #2) Put in his own plug for punctal plugs, but Dr. #3 quickly put down the plugs. (“Only effective 10% of the time,” he said.)

Dr. #3) Prescribed RESTASIS three times a day (helped some), and on the next visit suggested Lipiflow (made things worse). He then suggested amniotic membranes. There was a pregnant pause before I realized he wasn’t going to explain what amniotic membranes had to do with Dry Eye, and I was too fatigued to ask.

“If I Only Had a Brain…”

Unfortunately, my normally inquisitive mind was losing its’ battery power regarding all things medical. I was too overwhelmed, too tired, and in too much pain to self-advocate. I went back home to the bedroom and my two Dry Eye besties: 1) Cold, wet washcloth and 2), Audible novel.

Hope Sneaks In

But then, hope sneaked into the bedroom wearing size 11 1/2 sneakers belonging to my husband.  Just by watching me suffer he had been suffering too but doing research online. “I think I found someone who can help you,” he cried out.

Dr. Un-Masking MGD (and Other Comorbidities)

The “someone” was Dr. Steven Maskin. At my first appointment, he shared eye-opening info – pun intended – with me. Through lengthy and extensive testing, along with decades of experience treating Dry Eye patients and doing research, he diagnosed me with conjunctivochalasis, Meibomian gland dysfunction (MGD), aqueous tear deficiency, lagophthalmos, and ocular allergies.

The conjunctivochalasis surgery was scheduled for the left upper eyelid a week later, and the right upper eyelid one week after that. (I now know what “amniotic membranes” are!) Dr. Maskin un-masked all my Dry Eye mysteries. The relief post-surgeries and Meibomian gland probing– a month later– was astounding and life-changing. Actually, life restoring!

Got Hope?

I am forever grateful for Dr. Maskin’s compassion, expertise, and knowledge-sharing. Not only did he fulfill my hopes for comfortable eyes, he also understands and believes in hope’s intrinsic value. This most important, uplifting, and life-giving word is in Dr. Maskin’s and Natalia Warren’s book title. Your Dry Eye Mystery Solved: Reversing Dysfunction, Restoring Hope. It’s also listed in the text as the number one guideline for managing Dry Eye: “Don’t give up hope!” To that I say, “Amen!”

 

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Shelley Hussey is a humor writer and speaker, and author of I’m Not OK, You’re Not OK, But That’s OK with God: Finding the Humor and Healing in Life. She recently joined the Not A Dry Eye Foundation Board of Directors.

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Q&A via ZOOM On

DRY EYE DISEASE
and MEIBOMIAN GLAND
DYSFUNCTION ISSUES

WEDNESDAY, AUGUST 23, 2023 7PM to 8PM EASTERN

SUBMIT YOUR QUESTIONS AND REGISTER

FOR THIS ZOOM EVENT AT

https://www.eventcreate.com/e/drmaskin

Steven L. Maskin, M.D. is an ophthalmologist who specializes in solving difficult Dry Eye, MGD, and ocular surface disorders. He is the director of the Dry Eye and Cornea Treatment Center in Tampa, Florida and founder of MGDinnovations, a bio-tech company focused on Meibomian Gland Dysfunction.

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Do you remember what happened when your doctor was searching for a reason for your chronic eye pain? Did you hear the word “neuropathic”? Maybe your doctor prescribed pain medication. Did you take it? And did the pain stop but then return when you stopped taking the pain meds?

If this scenario sounds familiar, it’s because some doctors, ophthalmologists and optometrists alike, are now saying “neuropathic eye pain” is the cause of mysterious eye pain in the Dry Eye patient. They refer to the phenomenon as “pain without stain.” They explain that it’s a problem with the patient’s nerves. So the brain “feels” pain even when there is nothing there to cause the pain.

Reasons to Doubt Neuropathic Pain Diagnosis

It may sound plausible, but in fact there are plenty of reasons to doubt a diagnosis of neuropathic eye pain. The reasons are numerous. For example, a doctor’s diagnostic techniques may be poor, so they miss a multitude of possible ocular surface comorbidities that might be causing pain or other discomfort.

Test results may be inaccurate so even something simple like aqueous tear deficiency can be easily missed. This can happen when a Schirmer’s test or fluoresceine clearance test (FCT) is improperly administered or too swiftly abandoned (as when a test is administered just once instead of several times in succession, as necessary). Or it can be because the challenge test for pain, instilling anesthetizing drops in the eye, doesn’t actually numb parts of the ocular surface that are diseased, sometimes severely diseased and highly sensitive. So the eye will never go numb with topical eye drops.

It can be due to a reliance on fast and easy but not specific tests. An osmolarity test, for example, may indicate that tear osmolarity is sub-optimal, but what does that actually mean? Is a specific disease indicated? Maybe it is because of aqueous tear deficiency, but maybe it’s because of something else! Similarly, MMP-9 testing may indicate some level of inflammation, but why? What is underlying this positive test for the presence of inflammation, if, in fact, it is accurate?

Successful reversal of neuropathic eye pain

In his recently published paper, Dr. Steven L. Maskin describes three patients who had been diagnosed with ocular neuropathic pain by other doctors. The usual treatments were prescribed, but the patients didn’t improve. When they finally saw Dr. Maskin, and had all of their comorbidities diagnosed and treated with targeted treatments, these patients finally found relief for their debilitating and painful symptoms.

Now, I will admit much of what Dr. Maskin writes is way over my head with technical and medical words I don’t always understand.  But that said, I am sure the doctors who need to read this will understand it. And if they do, they will get better at diagnosing and treating these types of patients with massive, chronic pain. If your doctor gave you a diagnosis of neuropathic eye pain, maybe you could take a copy of Dr. Maskin’s article to them and see what they think about it.

A summary of the full article in plain English is available here, at the National Library of Medicine Pub Med.

If you want to take the deeper dive into patient’s situations, the diagnosis/treatment details and yes, all of the medical terms you can find it here. 

The good news is there are better ways to diagnose and treat patients with chronic ocular surface pain. You can learn even more about these better approaches in the book Your Dry Eye Mystery Solved: Reversing Meibomian Gland Dysfunction, Restoring Hope.

If you think you would like to connect with one of our Patient Advocates to sort things out, at no cost to you, via email or by telephone just fill out this short form here.

Henry Harlow,
Dry Eye Patient
Patient Advocate, Not A Dry Eye Foundation

 

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“Review of Literature on Intraductal Meibomian Gland Probing with Insights from the Inventor and Developer: Fundamental Concepts and Misconceptions”

https://pubmed.ncbi.nlm.nih.gov/36789289/ 

For the full article with a PDF download available just click this link now.

Reading research is something of a challenge for a non-scientist, non-medical person like me.  What I do first in reading an article of this type is to read the abstract.  The abstract is at the beginning of the article.  It gives sort of the bottom line of the research.  Sort of like what some call an Executive Summary.  You can see the whole abstract further below. But first a bit of “my take”.

My biggest takeaway from the abstract, was to give me greater assurance that my decision to have Meibomian gland probing was a good one.  I only wish I had learned about it sooner than 10 years plus into my Dry Eye Disease.  Then to be honest, I probably would not have done it 10 years ago.  At that time the science on the procedure was very thin indeed.  I would not have been convinced then.  I certainly would not have been desperate enough.  After all Restasis was doing well for me in the beginning or so I thought.

The bad news I did not know, and my three well-meaning eye doctors did not tell me, was things were getting worse in the background as time marched on.  Their “standard care” was covering the core problem with some symptom relief while the core of the problem, Meibomian gland dysfunction, continued to get worse.  Thus, I was one of those, as referred to in the study, who was doing worse in spite of doing a great deal of standard care over the 10 years before I learned about Meibomian gland probing.  My story is not an uncommon story.  Here is the abstract and see what you think.

Abstract

Obstructive Meibomian gland dysfunction (MGD) affects millions of patients around the world. Its effective treatment with intraductal Meibomian gland probing (MGP), was first reported in 2010. Since then, MGP has provided relief to thousands of patients globally suffering with refractory MGD. The purpose of Meibomian gland probing is restoring the integrity of the gland’s central duct by entering the gland through the natural orifice, releasing fixed obstruction thought to be periductal fibrosis, thereby establishing and/or confirming the patency of the duct, and concurrently equilibrating intraductal pressure as well as promoting gland functionality with meibum production. There may or may not be immediate secretion of meibum upon successful restoration of ductal integrity depending on the gland’s state of function and degree of atrophy. One double-blind placebo-controlled study has been conducted and, with the accumulated evidence of over 12 other peer reviewed articles in the scientific literature, overwhelmingly indicates that MGP is a safe and effective treatment for the MGD patient refractory to prior standard care and as a first-line treatment. This paper describes relevant fundamental concepts, dispels commonly held misconceptions, and provides an objective review of the current understanding and effectiveness of MGP for the treatment of obstructive MGD. Our analysis will better equip clinicians to draw informed conclusions about both subjective and objective findings reported in MGP studies and researchers to design future robust studies that provide meaningful results.

After reading this post maybe you have further questions.  Great!  That is what we are here for.  To get them answered at no cost to you by a patient advocate via email or by telephone just fill out this short form now.

Henry Harlow

Patient Advocate Volunteer

Not A Dry Eye Foundation

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Send your questions and comments to blogger@notadryeye.org.

Subscribe to our blog to keep up with Not A Dry Eye.

 

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Your Dry Eye Mystery Solved: Reversing Meibomian Gland Dysfunction, Restoring Hope.

This important new book about Dry Eye and Meibomian gland dysfunction (MGD) is a must-read for anyone seeking information about these diseases and commorbidities.

By renowned ophthalmologist Steven L. Maskin, MD.

With Not A Dry Eye Foundation’s co-founder and chair, Natalia A. Warren, MBA, MHA.

Published by Yale University Press, June 7, 2022.

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For information about where you can buy Your Dry Eye Mystery Solved: Reversing Meibomian Gland Dysfunction, Restoring Hope

In the USA visit: Yale University Press

In the UK, Europe and Overseas visit: Yale University Press UK

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A Trove of Information

This ground-breaking book contains a trove information about Meibomian glands and MGD. You will learn about the structure and function of Meibomian glands and discover how MGD develops, how it progresses, and how it can be reversed. You will learn how to decipher puzzling symptoms and Dr. Maskin’s meticulous approach to diagnosis.

Praise for Your Dry Eye Mystery Solved: Reversing Meibomian Gland Dysfunction, Restoring Hope

One chapter is devoted to common ocular surface and systemic comorbidities. In others you will learn about conventional and newer treatments for MGD, including Dr. Maskin’s own break-through treatment, Meibomian gland probing. Here, he explains why Meibomian gland probing effectively treats MGD and provides step-by-step instructions for correctly administering the treatment.

Throughout, the co-authors dispel myths about Dry Eye and MGD while portraying the devastating effect MGD and comorbidities can have on patient lives.

Uncover the Mystery 

“Our collaboration represents the intersection of a doctor’s quest to uncover the mystery surrounding a common but enigmatic eye disease, and his patient’s harrowing journey with a painful, incapacitating disease,” writes Dr. Maskin in the prologue. “We hope our joint effort will shift conventional thought about MGD, its diagnosis, and treatment toward a new paradigm based on clinical evidence that reveals the true nature of this disease, and we offer this book as a beacon of hope for patients needlessly suffering with inadequately diagnosed and treated MGD.”

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For information about where you can buy Your Dry Eye Mystery Solved: Reversing Meibomian Gland Dysfunction, Restoring Hope

In the USA visit: Yale University Press

In the UK, Europe and Overseas visit: Yale University Press UK

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Send your questions and comments to blogger@notadryeye.org.

Subscribe to our blog to keep up with Not A Dry Eye. It’s FREE!

 

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Anyone who used Restasis® between May 1, 2015 and July 31, 2021, may be eligible to receive money from a class action lawsuit over the price of the eye drop.

Attorneys have reached a proposed settlement with Allergan, the maker of Restasis. The lawsuit is on behalf of both consumers and third-party payers.

The defendant denies any wrongdoing. Notably, the lawsuit has nothing to do with the safety of Restasis.

“Consumers” includes anyone who purchased Restasis for their own use, in a pharmacy or online pharmacy, in one of some 32 states and the District of Columbia. Click here to learn if you are eligible.

Other restrictions apply.

You may ask to be excluded from the class action, but must do so by objecting to the class action by June 7, 2022.

Allergan has agreed to pay $29,999,999.99 into a fund to settle all claims and attorney fees.

Claims must be submitted online or postmarked by August 11, 2022.

For more information, visit www.restasislitigation.com or call 877-868-6810.

More About Restasis and Allergan

Since Allergan’s patent protection for Restasis ended several years ago, several companies have entered the Dry Eye market with drops that contain cyclosporine, the active ingredient in Restasis. These newer drops have different formulations than Restasis. Sometimes the concentration of cyclosporine is different and sometimes the vehicle, the liquid in which cyclosporine is suspended, is different. A generic version of the drug is also now available. For information on effectiveness, check the medication’s product information sheet. You can find the product sheet for Restasis here.

Allergan tried to delay competition for Restasis by selling its Restasis patent in 2017 to the Saint Regis Mohawk Tribe in New York. Attempts to protect the patient failed when in 2019, the U.S. Supreme Court rejected Allergan’s argument that the sovereign status of the tribe shielded the Restasis patent from U.S. Patent and Trademark Law.

Reference

Allergan loses Supreme Court fight to shield Restasis patents with Native American tribe
April 15, 2109
View the full report.

 

Support Not A Dry Eye Foundation. When you shop at smile.amazon.com, Amazon donates 0.5% of your purchase.

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For Dry Eye patients wearing a face mask that doesn’t fit properly can be challenging. That’s because each exhalation that blows over the eyes speeds up tear film evaporation. Then the thinner layer of tear film doesn’t protect the eyes well, so the exhalation feels like a fan blowing at full strength.

It’s a vicious cycle.

If you wear glasses to protect your eyes (or for vision), not only do your eyes feel bad, but your glasses fog up. They get foggier, and your eyes get even more uncomfortable, when you walk down the frozen food aisle of a supermarket.

How to Wear a Face Mask When You Have Dry Eye

Thankfully, we found a simple solution courtesy of a video by Dr. George Yang, a double board certified New York surgeon. Dr. Yang recorded the video for medical and nursing students, but Dry Eye and MGD patients can learn from it too.

In the video, Dr. Yang shows how to get a better fit when wearing a surgical mask. We tried his simple technique with three face masks, all with the metal strip that hugs the nose: procedural masks from CVS, KN-95 (the Chinese version of the N-95), and Dr.K Mask from V-Zero in Korea. (We didn’t have an N-95).

His technique worked with each mask. The masks hugged the nose and cheeks, preventing exhalations from reaching the eyes.

Watch Dr. Yang’s video: Surgeon’s Tips: Stop Fogging & Improve Seal on Medical Face Masks

Note: if you can get them, V-Zero brand Dr.K Masks  get high marks for comfort.

Wear to Buy Surgical Masks

Not all face masks are made alike, and by now you may have a preferred style and vendor. There are plenty available online: Walgreens, Amazon, and other retailers like 1000bulbs.com.

One great source is Project N95. “Project N95 is a national non-profit working to protect people and their communities during the COVID-19 pandemic and beyond.” Project N95 sells only reliable, high-quality masks that meet required standards. Masks come in a variety of styles and sizes at a variety of price points.

Preventing Air Flow with 7eye Glasses

If you can’t get a good seal between your mask and your face, 7eye glasses may be a solution. 7eye Dry Eye glasses have silicone eye cups that retain moisture and protect the eyes from wind and drafts.

Learn more about 7Eye eyewear.

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Subscribe to our blog to keep up with Not A Dry Eye. It’s FREE!

 

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In a previous blog I described ways to direct focus away from the frustrating and painful symptoms of Chronic Dry Eye. This time I’m writing about my experience over the past two years practicing Tai Chi.

Tai Chi is an ancient Chinese exercise created as a fighting art that dates back over 700 years. Although still considered a martial art, today it is no longer practiced for self-defense.

Tai Chi for Dry Eye

There are many styles of Tai Chi; the most notable are Yang, Chen, Wu and Sun. These different styles all consist of a series of exercises that focus on slow movements. The movements are accompanied by deep breathing and the gathering of Qi (pronounced chee) considered the universal life force that present in all living things. Tai Chi can improve strength, flexibility, mood and overall health and reduce inflammation, chronic pain and stress levels. Considered mediation in motion, Tai Chi can also improve concentration, memory and the ability to focus, relaxing both the mind and body.

As a student of Tai Chi, and now an instructor, I have found that focusing on the slow movements of this exercise have reduced my Dry Eye induced anxiety and pain levels. Combined with daily eye care management and an excellent eye doctor, my Dry Eye symptoms, and all the anger and anxiety that goes along with this disease, have significantly decreased. I’m now living an almost normal life again.

Tai Chi might not be for everyone. (You should always check with your doctor first before starting any new exercise program.) Still, I would highly recommend it to anyone who suffers from chronic pain, depression, or anxiety. (If you’re staying at home during Covid-19, there are plenty of Tai Chi videos online.) Even if you don’t have these concerns and just want to feel better overall, you might try this ancient exercise. It helped me tremendously.

Susan Howell, Dry Eye Patient

Read Other Blogs by Susan Howell

Susan Howell’s Story of Hope

There’s Something in My Eye

Managing Dry Eye Today and Every Day

4 Steps for a Better Life with Dry Eye

A Stye in my Eye

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Send your questions and comments to blogger@notadryeye.org.

Subscribe to our blog to keep up with Not A Dry Eye. It’s FREE!