Enjoy the sun. Have a good summer!
Diana Adelman
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Many of you read our last blog post, Sue VandePanne’s Story of Hope, and some of you sent in questions. Sue answers some of these questions below.
Why do you say over and over again that we need to keep looking for a doctor if we have Dry Eye?
It’s important to look for a doctor who can diagnose all of your conditions and treat them. Although everyone with Dry Eye has some form of the disease, all of our specific conditions aren’t the same. If your specific set of conditions aren’t diagnosed, then you probably won’t be treating the conditions you have. And there are many conditions that only a doctor can diagnose and treat.
Conjunctivochalasis (loosening and wrinkling of the clear tissue that covers the white part of the eye and the inner part of the eye lid) is one of these. You can’t see it in a mirror. And there’s no over-the-counter treatment.
What condition does a wet contact lens treat? Does it hurt when you take them out or put them in?
It doesn’t hurt when I take the contacts out or put them in. I developed dry spots on one of my cornea so my doctor put in a bandage contact lens. That contact protected my eye from the environment and stayed in for two weeks. While it was in, I used antibiotic drops to prevent an infection. Because my eye felt much better with the bandage lens, my doctor suggested that I should try daily disposable contacts – the wettest available – to see if those would work for me long term. My optometrist suggested Dailies Total 1 because they have so much moisture in them. He said people that could never wear contacts can wear these. So nine months ago I started using them and they have been a life saver. There are days, especially when I’m outside, that my eyes still bother me. But I’m so much better overall.
Why don’t you try scleral lenses?
My doctor feels I should wait on scleral lenses. They may be in my future. For now they’re on hold… But we will see what the future brings.
Sue VandePanne
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It’s been twenty one months since I developed this horrible Dry Eye disease. Back then my symptoms were unbearable. My eyes were scratchy and gritty. I could hardly keep them open they hurt so much. It felt like I had foreign objects in my eyes. There were days I didn’t want to get up in the morning and I couldn’t wait to go to bed at night. Actually that was true on most days!
It all started two weeks after cataract surgery. I’d experienced severe eye pain for no apparent reason in past years. But it always went away after a few days. Not anymore. After seeing six eye doctors, I was scared this was going to be my new normal. It was hard just to keep searching for the right doctor. How do you keep searching for the right doctor when your eyes feel so bad? I even felt as if I was going to lose my sanity.
Although we live in Michigan, my husband and I are snow birds, spending our winters in Florida. So in January 2015, I was very lucky to find Dr. Steven Maskin in Tampa, just over an hour away from our winter home. He was the first doctor who understood my symptoms, diagnosed a variety of conditions, and knew what to do about them. The first thing he did was check for infections – which I had. He probed my meibomian glands, and with that I finally had some relief. He also cauterized my upper and lower tear ducts because my tear film was aqueous deficient. But I needed even more treatment. Because there were wrinkles and heavy red veining on the surface of my eyes I had surgery – amniotic membrane transplants – in both eyes.
We ended up spending a hot summer in Florida as I underwent treatment. And for nine months I made weekly trips to Tampa. Although it was a long nine months, I was grateful to finally be in the care of a doctor who could help.
My meibomian glands were the biggest challenge. Although after probing they produced oil, the oil wasn’t making its way to the tear film. So I continued to experience discomfort and a variety of troublesome symptoms. But Dr. Maskin was not going to give up on me. He was determined to get me to a place where I would be comfortable. He gave me eye injections for inflammation and he used larger probes and dilated my meibomian glands to improve the flow of oil.
In the fall of 2015 I wanted to return home to Michigan to see my family which I hadn’t seen in months. Dr. Maskin tried a bandage contact lens in my left eye, the worse of the two. When it helped tremendously, Dr. Maskin suggested that, while home in Michigan, I should find a doctor who could fit me for contacts – the wettest ones that are comfortable. The contacts would work as a bandage to protect my eyes.
At first I didn’t believe that contacts could improve my eye comfort. I had tried contacts when I was younger and my eyes just couldn’t handle them. So I didn’t think they would work now. But I decided to follow Dr. Maskin’s advice. It turns out the contacts are a life saver for me. I found a wonderful optometrist in Michigan who found a pair of contacts, Dailies Total 1, that would work for me. Because I have astigmatism, I still have to wear glasses to correct my vision. But now I put the contacts in first thing in the morning, and take them out when I go to bed each night. Thankfully my eyes feel normal and comfortable most days.
Although I don’t think much about my eyes anymore, certain environmental conditions can change that – sand or dust blowing in the air; riding a motorcycle or a motorboat. Going to the beach is still a bit concerning. But most of the time my eyes are pretty comfortable.
I wanted to share my story because I know many of you are experiencing horrible symptoms and wondering if life will ever be normal again. All I can say is keep searching for the right doctor. They are out there. You just have to find them. I did. And now I function normally (mostly) and once again enjoy life. Yes, it took time and perseverance. And at times I never thought I would get better. But I did. I got much better.
Unfortunately, there’s no quick fix for Dry Eye. It takes time and energy to find the right doctor. And you have to make a commitment to stay the course and get better.
I truly believed my case was hopeless. I felt frustrated, desperate, and wasn’t sure for a few months if I even wanted to wake up in the morning. But…here I am writing this, feeling blessed. There are many treatment options out there for everyone with Dry Eye. Explore them all and hope for the best. Keep searching for the right doctor and you will find help. Nothing lasts forever!
Sue VandePanne
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Lately we’ve been getting a lot of questions about getting to and from medical appointments, because driving with Dry Eye can be really hard. Sometimes driving is completely impossible, but you still need to see your eye doctor. And sometimes your doctor is so far away that driving just isn’t an option.
The most obvious solution is asking for help from your family, friends, or neighbors.
As with the 24 hour vet near me, these policies typically itemize covered treatments, deductibles and lifetime or per illness maximums. The cost of a pet health insurance policy will vary based on the amount of coverage, the type of coverage, the species and age of the pet, and even what breed of animal.
But even when they want to help, life can get in the way and they just aren’t available to drive you there and back. And what happens if your doctor is hundreds of miles away or on the other coast? You still need to get there. But how?
Travel and transportation issues are faced by many Dry Eye sufferers. Here are a few resources for patients in the U.S., where there are both government programs and volunteer organizations, that can help with travel and transportation.
Let us know about travel and transportation services in your area. We’ll share the information on our website. Write to blogger@notadryeye.org
A program administered by the Federal Transportation Administration is available wherever public transportation services receive federal funding. You’ll need to contact your local public transportation service to learn if it’s available in your area. You may also need to undergo screening to qualify for the program. Note:
• You don’t have to be disabled to qualify.
• You can use this service for transportation anywhere within the service area, and not just for medical appointments.
• Once you qualify, you can use the service in any other location in the U.S., wherever it’s available.
• Door to door service is provided.
• The cost to passengers is usually minimal.
• Passengers can travel alone or bring others along for the same fare.
All states, territories, and the District of Columbia provide non-emergency medical transportation to Medicaid beneficiaries. Check your benefits or contact your Medicaid administrator for more information.
This non-profit organization provides referrals and information about charitable, long-distance, medically-related transportation.
For example, depending on your needs and qualifications, you may be referred to Mercy Medical Angels, a non-profit that provides ground and air transportation services and assistance.
Volunteer pilots, receiving no compensation for their services, provide transportation at no cost to passengers. Commercial and corporate aviation services are available. This non-profit is funded by donations from individuals, corporations, and other organizations that cover the costs of air travel.
For more information about any of these services see Travel and Transportation Assistance.
View more tips for coping with Dry Eye and MGD.
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Dry Eye symptoms can flare up periodically or persist for a prolonged period of time. Sometimes important and necessary treatments, like topical medications or surgery, trigger new types of discomfort. With proper care and treatment, all of these symptoms eventually subside and flare-ups can become less frequent.
During times of prolonged discomfort or sudden flare-ups, it can be difficult to find relief while waiting for treatments to take effect or healing. And when there is pain and other discomfort in the eyes, literally everything else recedes into the background. It can even be very difficult to just get through the day.
Some doctors prescribe anesthetizing drugs, like Lyrica, that can mask these symptoms. These drugs may help temporarily. But unless the underlying conditions are treated, symptoms will return. And masking symptoms will not only mask the symptoms from you, but from your doctors as well. Because if you can’t feel it, you won’t report it to your doctors. They won’t be able to treat what they don’t know about, especially if something changes or a new condition crops up. And that could be a problem.
Temporary relief can sometimes be achieved with distractions that direct the mind toward something other than the symptom. This works because the mind is able to really focus on only one thing at a time – whether it’s a sensation or a thought. The object of the mind’s focus will be the one that’s the most prominent, while everything else recedes into the background.
Here are four distractions to help you get through the day.
The sensation of ice on the skin near your eyes is particularly helpful during acute episodes of pain or other discomfort. Here’s what you need.
• Ice cube
• Clean, thin cloth, like an old T-shirt
Wrap one layer of the cloth around the ice cube. Hold the cloth, with the ice inside, to your eyebrow or cheekbone until you feel the coldness of the ice. Leave it there for a few seconds until your eye symptom subsides. Then pull it away. Keep touching the wrapped ice to different spots on your eyebrow or cheekbone as soon as you feel the symptom return.
The cloth shields your skin while absorbing the melting ice. You can try a paper towel, but the paper tends to rip when it gets wet. A thick cloth insulates the ice too much and you won’t feel the cold enough.
Never touch the piece of ice inside the cloth to your eyes, eye lids, or inside the eyes. Cold is the enemy of meibomian glands. It’s best to leave these glands at their normal temperature unless you’re doing a warm compress.
If you’ve noticed that your eyes feel better when you eat, you’re not alone. All of the sensations in the mouth – taste, temperature, texture – are great distractions that help to deflect focus from the symptoms in your eyes.
So eat something. Then keep eating.
Try to find something that doesn’t have too many calories and is generally healthy, especially if you’re going to eat for a long time.
One favorite is popcorn. Skip the fat and calories in the pre-packaged microwaveable bags, and make your own air-popped (if you have an air popper) or microwave popcorn.
Microwaving your own popcorn is the easiest thing in the world. Here’s what you need.
• Popcorn, any brand, any kind. Or try organic.
• A brown paper sandwich bag
Put enough popcorn into the sandwich bag to cover the bottom. Fold the opening down two or three times. Place the bag in the microwave with the folded side down. Push the popcorn button. Wait till it finishes popping.
You can eat it plain, or you can add salt or butter. Look for butter from grass-fed cows that is higher in Omega 3 fatty acids. Or try butter-flavored olive oil that mimics the flavor of movie theater butter, with the added benefit of being lower in Omega 6’s.
Activities that require some mental focus, but low visual focus, are great distractions. Try listening to music, audio books, talks shows… whatever interests you.
Crossword puzzles are one of the best distractions, but you will need a friend to read the clues, tell you how many letters are in the word, and which letters are already there. You’ll have to think about the clue, count the letters, and maybe visualize the word. The harder the crossword puzzle the more your mind will be distracted.
If you’re able to watch television without too much discomfort, this may be an option for you. But if not, you can try just listening.
Some movies and television shows are easier on the eyes than others.
Avoid dramas, especially if you cry easily at movies, because emotional tears exacerbate Dry Eye symptoms. Staying calm is also important. So it’s best to avoid horror movies, thrillers, or anything with suspense.
Comedies can help keep your mind distracted without exacerbating symptoms the way dramas and other genres can. Comedies might even help you find the humor or irony in your own situation.
Just be sure to blink and take frequent breaks if you’re watching TV or a movie.
These simple techniques distract the mind from Dry Eye symptoms and help you get through the day. Depending on your specific condition, some may work better than others. So try them, and see which ones work best for you.
View more tips for coping with Dry Eye and MGD.
How do you manage your symptoms? Send your tips and comments to blogger@notadryeye.org and we’ll share them with our readers in future blog posts.
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Three years ago I suffered with symptoms of severe Dry Eye. My eyes constantly felt dry, irritated, and gritty, and were sensitive to light. On Schirmer tests, where a score of 10 is normal, one eye scored an abysmal 0 and the other eye fared hardly better with a whopping 1. My eyes were so uncomfortable that they interfered with my work and social life. Making matters even worse, no doctor I saw was to be able to diagnose my conditions or relieve my symptoms.
As an Asian with a double fold in the upper lid, I have approximately 60 meibomian glands in each upper lid and 20 in each lower lid. But back then I had only 3 meibomian glands opened and functioning in each eye. (You need about 10 working glands to feel comfortable). Contributing to my extreme discomfort, Dry Eye had caused superior limbic keratoconjunctivitis (SLK) and conjunctivochalasis in both eyes. SLK caused extreme pain in the upper half of the eye every time I blinked. Conjunctivochalasis made my eyes feel raw. The wrinkled conjunctival tissue harbored bacteria that caused recurring pink eye and eye pain. Needless to say, I was miserable. As my eye discomfort consumed my life, I became depressed and began to lose hope.
Then in 2014 I was finally diagnosed with all of these conditions and began a treatment plan that started with cautery of the tear ducts to retain moisture in my eyes. A few days later I had amniotic membrane transplant (AMT) surgeries for SLK and conjunctivochalasis. After recovering from the surgeries, I had meibomian gland probing to clear the glands of any obstructions. Soon after these procedures, my eyes began to feel moist and comfortable. I’ll never forget the first moment I felt wetness in my eyes and shouted out to my husband “I have tears, I have tears!”
Two years have gone by since the initial treatments. I still see an ophthalmologist in Tampa and another in Seattle where I live. And my eye health continues to improve. In April 2016, I underwent meibomian gland probing again for the third time – something I have been doing about once a year. And I’m happy to report that after my last probing I had more than 50 glands opened in each eye, a truly remarkable outcome especially considering how few were functioning just a few years ago. Plus my Schirmer tests scores have improved considerably, increasing from 1 to 22 in one eye and from zero to 16 in the other. If anything, one eye feels a little too wet.
As I sit at my desk and writing this, my eyes feel quite comfortable. Admittedly, sometimes they are a little too wet and sometimes they are still a little uncomfortable. But I could never have imagined a day like this three years ago, at a time that I was so miserable that I thought I would rather die than live like this. Instead I am grateful for having found help. And with help, my hope was restored.
Although currently there are no cures for Dry Eye Syndrome, with correct diagnoses, effective treatments, and life style change, it’s possible to get Dry Eye symptoms under control and manage them successfully. My eyes are a testament to that possibility as I continue to remain hopeful and work on reaching the next level of comfort for my eyes.
Diana Adelman
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Some people have no problem asking for help.
Maybe they recognize that we live in an interdependent society where everyone relies to some degree on others. So they already know that no one can exist without help. Or maybe they know that asking for help isn’t a sign of weakness. It’s simply an expression of need.
Somewhere along the way, we’ll all need someone else’s help. And asking for help is a skill that can be learned. Here a few practical tips that can help you when you need to ask for help.
For those suffering with extreme Dry Eye symptoms, the thought of developing a support network can seem daunting. It may even seem like it’s too late to start. You might have become isolated when your eye discomfort prevented you from leaving the house and taking part in normal daily activities, limiting your interactions and access to others.
Even if that’s the case, it’s never to late.
Start with basics. Make a list – even if it’s just in your head – of the people you know who you think you can reach out to. Write down their contact information (so you don’t have to look at a screen): name, phone number, and when is a good time to call. Then give them a call. You might not need any help just yet, but let them know you might ask in the future. If you give them a brief update about your eye condition and tell them how difficult it has become for you to do x, y, or z, they might even offer to help you with x, y, or z.
Then add neighbors to your list and give them a call. Or if it’s appropriate, ring their door bell.
When you initially make contact, try not to burden these people with all of your problems. They need to know what’s going on with your eyes, but for now everything else is just noise. Focus on the condition that’s driving you to ask for help – the discomfort in your eyes. Later, when you are better acquainted, and if there’s an appropriate time and place, you can share more.
You never know when you’re going to make a new friend. At the bus stop. At the grocery store check out line. While taking a walk.
Introduce yourself. Be friendly and you will make friends.
Neighbors who are friends can be especially helpful once they learn that you need help, because neighbors are right here. They don’t need to drive long distances to get to you. And because helping each other is something that neighbors already do.
But remember to be a friend as well. Listen. Be positive. Have compassion. Help out when you can. Friendship is a two-way street.
Asking for help is not a job interview, a date, or a movie audition. You aren’t being rejected if someone says they can’t help. They just can’t. Accept it, ask if you can ask for help again in the future, and move on. And don’t ever make anyone feel guilty for not being able to help. You’re requesting help, not demanding it (see #10 below).
Even if you have a BFF who’s always available, others might want to help. In fact, for some people being asked to help is an honor. Asking different people for help is a way of nurturing your support network, which is important because you never know when your BFF will suddenly get a new job or have her own medical emergency. Or one person in your support network may feel they can help sometimes, but not always. So ask around.
Apps like the one provided by CaringBridge can help you organize your support network. CaringBridge is a non-profit organization that provides an online scheduling app so everyone in your network knows when you need help and can volunteer their time when they’re available. This way you don’t have to call everyone in your support network individually to let them know you have another appointment with your doctor.
Depending on your country, state, city, province, or local laws and regulations, there may be programs that you can take advantage of without even having to be officially disabled. In the US, for example, there is a federal transportation program that provides door to door transportation services for people who qualify. If you qualify, you won’t have to drive yourself or ask someone in your support network to drive you shopping or to your next local doctor’s appointment.
Whether it’s volunteers who drive people to the grocery store or pilots who fly patients to medical appointments on the opposite coast, you may qualify for any number of programs offered by volunteer organizations in your area. These can help you resume some aspects of a normal life, or even save you thousands of dollars. It may be worth while to do some research, or ask someone in your support network to do the research for you.
Look for support groups in your area, not just for Dry Eye, but for other conditions or disabilities you may have. You might find people who have had to overcome similar obstacles who can give you advice on overcoming yours.
If you need a ride to the doctor for an appointment on Wednesday at 2:00 p.m., say exactly that. Don’t make anyone guess what you need. Don’t assume that anyone knows what you need. If you need to go shopping, or need help opening that new sports water bottle, or you just want to talk to someone, say so. Don’t beat around the bush. Just ask.
Consider how well you know someone. If it’s the first time they’re helping or if you don’t know them that well, you don’t want to scare them off with something that’s emotionally charged, too negative, or alarming.
But don’t be afraid to say what you’re feeling. Just try to do it in a positive or objective manner. Most people prefer to be around others who have a positive attitude. And when we’re struggling with Dry Eye, the more supportive people we can gather and keep around ourselves, the better.
After all, we’re all struggling with something. Whether it’s a medical condition or something else, life happens to everyone. It’s how we approach it that matters.
So stay positive. It will help your relationship with your support network as much as it will help you.
As noted above, even though what’s going on with your eyes may seem insurmountable, everyone has their own problems that to them may seem insurmountable: medical conditions, problems at work, family issues, or whatever else. The list goes on and on. So have as much compassion and empathy for others as you would want others to have for you. In other words, practice The Golden Rule.
When you’re listening, one thing you’ll probably hear is advice for treating your eyes. This advice can sometimes be exasperating. Most people who are themselves unfamiliar with Dry Eye won’t be able to give you very good advice. But they might still try. Be patient with them too.
How to respond when someone offers advice about Dry Eye
Some animal trainers say that when they’re giving an animal a command they aren’t really giving a command. They’re making a request and giving the animal the option of filling that request…or not. If the animal does what it’s asked to do, there’s a reward at the end in the form of food or something else the animal likes, like a belly rub.
It’s a good approach and one that can easily be adapted by anyone asking for help. First, remember that you’re making a request, not a demand. Then always give the option of saying no without guilt. And the reward at the end (no, not a belly rub) can be a sincere, heartfelt “Thank You.” Because who doesn’t like to hear “Thank You?”
Whether it’s a doctor, a mental health professional, attorney, local government representative, nurse, or other professional, don’t hesitate to ask for help when you need it. Waiting too long can make things worse or make problems more difficult to solve. Professional help can sometimes be expensive, so it’s important to be mindful when seeking this help. But if you need professional help, by all means seek it out. Remember that asking for help isn’t a sign of weakness. Asking for help is just an expression of need.
If you are having suicidal thoughts because of your eye pain or discomfort, seek help immediately from your primary care or eye doctor, spiritual advisor, mental healthcare provider, a trusted family member or friend, or a suicide prevention hotline.
Send your comments to blogger@notadryeye.org
Research on contact lenses and Dry Eye Syndrome has recently been in the news. One study examined the role of the lipid layer in tear film and how that might impact contact lens design. The other looked at the microbiome in the eyes of contact lens wearers.
It’s a known fact that contact lenses can contribute to Dry Eye symptoms and it’s not uncommon for people who wear contacts to stop because of the discomfort they feel. In fact, Dry Eye is the most common cause of contact lens intolerance, with about 50% of the 30 million contact lens wearers in the US switching back to glasses.
One Stanford researcher, Saad Bhamla, a postdoctoral scholar in bioengineering, who stopped wearing contacts as a student when they became uncomfortable, decided to do something about it. He and other researchers at Stanford looked at the role of the lipid layer in tear film and determined that it has two primary functions. One is strength. The other is liquid retention. They are using this new understanding of tear film in designing a new kind of contact lens that helps with tear film stability.
Sounds promising. Right?
But even these new and improved contact lenses could, like all other contacts, stress meibomian glands and interrupt the blink feedback loop.
And then there’s the question of the eye microbiome.
Last May, researchers at NYU Langone reported that the microbiome in the eyes of contact lens wearers is more like the microbiome of the skin than the eyes of those who don’t wear contact lenses.
Reporter David McNamee wrote:
The team found three times the usual proportion of the bacteria Methylobacterium, Lactobacillus, Acinetobacter and Pseudomonas on the eye surfaces (conjunctiva) of contact lens wearers than on the eye surfaces of the control group.
The study’s senior investigator, NYU Langone microbiologist Maria Gloria Dominguez-Bello, PhD., said that putting a contact lens in the eye is, “not a neutral act.”
And Dr. Jack Dodick, the study’s author, professor, and chair of ophthalmology at NYU Langone, explained:
A common pathogen implicated has been Pseudomonas. This study suggests that because the offending organisms seem to emanate from the skin, greater attention should be directed to eyelid and hand hygiene to decrease the incidence of this serious occurrence.
And Dry Eye symptoms are only exacerbated when there’s an infection.
So if you’re going to wear contact lenses, be sure to practice good hygiene, rule out aqueous deficiency, and have your meibomian glands monitored periodically with meibography to be sure they’re healthy and doing their job well.
Send your comments to blogger@notadryeye.org
References
Alterations to the eye microbiome of contact lens wearers may increase infections
McNamee D.
Medical News Today
31 May 2015
View the full report
Instability and breakup of model tear films
Bhamla MS, Chai C, Rabiah NI, Frostad JM, Fuller GG.
Investigative ophthalmology & visual science
2016 Mar 1;57(3):949-58. doi: 10.1167/iovs.15-18064.
View the full report
New insights into human tears could lead to more comfortable contact lenses
Medical News Today, Adapted Press Release
29 March 2016
View the full report
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This true story is the first in our series Stories of Hope. These stories, about people who have triumphed over their Dry Eye symptoms, will inspire you and give you hope. In this story, William Cravey tells us about his wife who had suffered with Dry Eye since before 1997 and how she finally was able find relief.
In 1997, my wife’s Dry Eye symptoms were so bad that she finally had to stop working and go on long term disability. Eventually she qualified for Social Security Disability. Over the years she had suffered miserably and said it felt like “having sand in her eyes 24/7/365.” We tried every treatment we could find and she had to use artificial tears every 5 minutes to get relief.
Eventually she became chronically depressed and sleep was almost impossible. It affected every aspect of our life together, including our relationship. We often cancelled plans because she could never predict how she would be feeling that day. The pain and discomfort was tearing our relationship apart and finally we divorced. But I continued to support her and eventually we remarried.
My wife’s ophthalmologist finally prescribed autologous serum tears (eye drops made from her own blood) which reduced her pain significantly. Thankfully, we were able to get them locally, but then our local supply suddenly stopped and I began to search for another source in Florida.
I found two. One was in Tampa, Dr. Steven Maskin, and the other was in Miami. I contacted Dr. Maskin’s office to see if we could obtain the drops from him. We were told that he could help and prescribe serum tears, but that as per Florida laws, he would have to examine her first.
My wife made an appointment and after seeing Dr. Maskin, a treatment plan was established. It basically entailed resurfacing her eye. It sounded scary and we were both a little hesitant at first. I spent many hours researching both the procedure and Dr. Maskin, a truly gifted physician. We chose to go forward and scheduled the first surgery. We were both surprised that it was a little uncomfortable but definitely nothing to fear.
The surgery (conjunctivoplasty with amniotic membrane transplants) to resurface her eyes has been completed. Already the pain from the dry eyes is almost gone, her vision is better, and her depression is lifting. She returned to her original ophthalmologist, who examined her eyes for the first time after the surgery, and who had done some partial resurfacing but never a complete resurface. She was amazed. She said to my wife, “If I weren’t looking at you, I wouldn’t believe it’s the same eyes.”
We are still waiting for my wife’s insurance to approve the meibomian gland probing procedure, but even with the resurfacing procedure alone, the results were beyond our wildest expectations. We expect my wife will have her meibomian glands probed soon and, once completed, I will provide an update on her progress.
We are extremely pleased with the outcome. I just don’t know why these treatments and their effectiveness are not better known. If you have Dry Eye and your current treatments are ineffective, I suggest you get evaluated by another physician that is familiar with these conditions and treatment options.
William Cravey
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Even if you have an excellent doctor treating you for Dry Eye or meibomian gland dysfunction (MGD), there are lifestyle changes you can make to help improve your symptoms. These range from getting a good night’s sleep to washing your hands before touching your eyes. Some lifestyle changes can be hard to make. But when the discomfort from Dry Eye or MGD takes over your life, even small changes can add up to make a big difference. Remember, you can play a big part in managing Dry Eye and MGD symptoms.
If you have aqueous deficiency, MGD, or sleep with your eyes opened (nocturnal lagophthalmos) moisture chamber goggles can help to prevent your tear film from evaporating. Choose goggles that block out light or clear ones that you can see through. Be sure to wash them every day according to the manufacturer’s directions. If your goggles are uncomfortable, contact the manufacturer. If the pair you have is under warranty you should be able to exchange them for a more comfortable pair.
Introducing bacteria to the eyes only exacerbates symptoms. So wash your hands right before you touch your eyes for any reason, even when you’re just putting in an eye drop. And blot them dry them with a fresh, clean, low-lint paper towel. Keep a roll of paper towels on your bathroom counter or wherever you take care of your eyes most often so they are always within reach when you need them.
Some foods are known to cause inflammation such as foods that contain high levels of Omega 6 fatty acids. This includes chicken and turkey. Inflammation is not always a bad thing – it’s how the body fends off disease. But chronic inflammation, which is associated with MGD, is the last thing you want to increase when you’re trying to improve eye comfort. Some experts recommend eliminating dairy, sugar, and wheat. But without actual food sensitivity testing, you might be eliminating some foods unnecessarily while not eliminating foods that cause your inflammation. For more information, see our page on food sensitivity testing.
Allergens cause allergic reactions and inflammation, and inflammation is the enemy of the meibomian gland. See tip #3 above. Eliminating allergens completely can be very difficult. For example, dust is almost impossible to completely eliminate or avoid. And it can be extremely difficult, and even heartbreaking, to eliminate it if the allergen is a beloved pet. But the more you can avoid allergens, the less you will exacerbate any symptoms.
Adding Omega 3 to your diet helps to offset the inflammatory effects of Omega 6’s. You can either increase the foods that have a beneficial Omega 3 to Omega 6 ratio or take a good Omega 3 supplement. If you choose to take an Omega 3 supplement, be sure it’s tested for contaminants.
If you’re used to wearing eye makeup, stopping can be very hard. It might take some extra courage to go out without any on. But tiny particles of eye makeup can flake and fall into the eyes. Powders can rim the eye lid margin, the site of the opening of the meibomian glands. Makeup brushes, sponges, and mascara tubes harbor bacteria. And we don’t even want to imagine the colonies of demodex mites in there, so on to the next tip.
Eye tissue is restored when we sleep. When we don’t get a full eight hours, the cells don’t have time to regenerate and we end up exacerbating any eye discomfort. Eight hours is usually recommended. So put on those moisture chamber goggles and go to bed early.
Doctors can’t help if they don’t know what’s going on. So if you’re not getting better, or you’re experiencing some new symptom, don’t delay and make an appointment. Some doctors will communicate via text or e-mail once you’ve established a doctor/patient relationship. They may even take your call, especially if you’re experiencing acute symptoms. So if you’re experiencing something new, or something you’re pretty sure shouldn’t be happening, let your doctor know. The sooner the better, and before it gets worse.
Managing Dry Eye and MGD symptoms can be challenging, but remember that every little thing you do can add up to help a lot.
View more tips for coping with Dry Eye and MGD.
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