Dry Eyes

[Maydup]

Does anyone have any tips for coping with dry eyes?

I have seen a specialist at the hospital and had every type of drops going but i fear I will just have to live with it now. After a year of it, its really getting me down now.

I use liquid eye drops when I need them and wear sunglasses whenever I'm out doors, but I'm inside today and its really bad.

Any suggestions?

[Sqad]

York 113 Ophthalmic ABer is your man.

[SeaJayPea]

Try bathing your eyelids for five minutes using water as hot as you can bear it. The idea is that the oils that come from the lids to lubricate the eye get gummed up and the hot water melts the gunge and allows the oil to flow. Seems to work for me.

[Maydup]

Thanks SJP - I'll try that in the mornings perhaps.

I have been bathing them with a warm flannel and washing with cotton buds using a bicarb dilution. I do this morning and night, but I'll try making the warm flannel hotter and leaving it on for longer.

[ruthandsam]

I would take a trip to your ophthalmic optician and get their advice. I have the same problem due to some medication I'm taking/age which came to light when I had a trial for contact lenses. He showed me how to stimulate the tear sac in my lower eyelid (sounds horrible) but it really did work.

[Maydup]

Thanks R and S. I have another appointment with the Ophthalmic specialist at the hospital but its not until December (since I only saw him last week) so I might take your advice and pop into the optician in the meantime.

The GP did describe massaging the corner of the eye, but I haven't a clue what I'm doing to be honest and cannot seem to gain any benefit.

[york310]

The key aspect to the management of dry eyes is identifying the underlying cause. Dry eyes could be an issue with poor tear volume and production or poor stability due to problems with aspect of different constituents of the tear film layer leading to excess watering or rapid evaporation. Problems with dry eyes can have numerous factors including age, environmental issues, systemic conditions, medications, eye lid anomalies, contact lens use, smoking etc.
Eyelid disorders such as blepharitis or meibomiam gland dysfunction(MGD) are conditions which benefit from the hot compress, massage and lid hygiene routine on a regular basis and there are over the counter products designed specifically for these tasks. Try googling EYEBAG, BLEPHACLEAN and LID CARE WIPES.
There is also a wide variety of artificial lubricants available for different aspects of dry eye problems. Some people find the basic ones such as hypromellose work reasonably well whereas other require more modern lubricants such as hycosan or optive. Using drops regularly throughout the day require preservative free options due to toxic affects of certain preservative found in some drops. Some people need more greasy ointments for overnight use such as Lacrilube or night time gel.
Often there is no cure for dry eye problems and people require regular maintenance of the symptoms with drops, lid hygiene etc.

Some questions I would usually ask are:
when are your symptoms worse? Time of day, certain activities etc
how long have you been aware of the Sx?
Any change in meds recently?
how is your general health?

A visit to your local optometrist may be a good idea unless it was them that referred you to the specialist in the first place but seeking alternative advice may be worthwhile if you are still unhappy.

Hope his helps.

Ps. Thanks sqad
w

[albaqwerty]

I don't have half your problem but you have all of my sympathy.

The rubbing of the corner of the eye in a circular motion towards the nose releases some of my gunk towards the nose side of my eye. A cool damp cloth has also helped (suggested by another AB'er)

[Eve]

Most of the things I was going to ask/suggest I would have thought would have been ruled out if you had seen a specialist eg blocked ducts, sjorens, environmental and similar factors such as contact lens wear, smoking/smoky atmospheres etc...

Are you generally well hydrated? Is it just your eyes or do you get a dry mouth, other places as well?

[Maydup]

Hi York, thanks for your detailed post.

I am in good health, no meds. The situation began last year follwing a head cold which took a while to shift and the watery eyes simply didn't clear up. Pharmacy suggested Optrex, then I went to GP and was prescribed infected eye drops. Next they gave me gel drops, then (a month or two in between each time) I wa sprescribed antibiotic drops.

Eventually I asked to see a specialist and was refered. He diagnosed very mid blepharitis and checked that the tear ducks weren't blocked (which they weren't)

He suggested warm compress, bicarb solution twice a day; steriod drops, optrex infected eye drops three times a day (yet again!)for 2 weeks and liquidfilm artificial tears as and when necessary.

I've done all of that religiously now for 10 days and not a thing has changed to be honest.

Its worse when I'm outdoors but it is intermittant all day long. Especially bad if I do close work or read, or if the room is cool. (I sat in a meeting today with a tissue, mopping my eye discretely but I'm sure people must have thought I was emotional! )

Errr what else should I tell you. Oh yes.. went to an optician and they just did a regular eye test and encouraged me to wait for the hospital appointment.

Also, I have no itching or stickiness of the eyes. Just a little bit of "sleep" in them in the mornings, but nothing unusual.

[Maydup]

PS - No contacts lenses, I just use glasses for reading . Non smoker and very light make up wearer until this last year when its now pointless to try any at all.

I am quite a dry skinned dry lips person. Always have needed lipsalve but not an overly dry mouth really.

[Eve]

Maybe try something for better hydration. My osteopath who does some kind of nutritionalist stuff as well recommended some fish oils for better hydration generally (joints for me with arthritis) and I found they worked well I I felt a lost less dehydrated generally including mouth and eyes though I was a contact lens wearer (on a break), am a dirty smoker and despite downing cordial by the pint glass, drink a lot of coffee.

Might be worth a try though, I felt better for it. I got some from a local health food shop.

I had dry eyes for a while due to blocked ducts and it is annoying, hope you sort it soon! My optician had me washing my eyelids with babyshampoo to unblock them, not something I want to try again! I find drops differ for me too. I used to use the Allergen ones before putting my contacts in which made a big difference in them drying during the day. Not found any others so good.

Have you tried allergy drops which could help if there is any kind of environmental trigger or other allergen causing the problem. They are great when I've used them for the bad reaction I can get to horse hair.

[york310]

IMHO I would recommend the following:-

Lid hygiene two to three times per week and the use of Hycosan plus artificial lubricant 4x daily as routine not just as you feel necessary.
Regular breaks from concentrating work (vdu and reading).
Drinking plenty of water.
The use of vitamin supplements such as omega 3 and vitamin C is an option if your usual diet is not the optimum source of good nutrition.
Cessation of alcohol and caffiene could be a benefit also.

lid hygiene would involve a hand hot warm compress over the eyes for a few minutes, followed by firm massage of the lower and upper lids, the the use of a good cleaning scrub such as I mentioned earlier ( lid care wipes, supranettes, blephasol, blephaclean, etc.).

Hycosan + is a good lubricant in my experience and benefits from being preservative free, easy instillation, and the bottle lasts 3mnths at least.

There is no quick fix for dry eye problems and usually I would only review someone after two to three months of this type of management routine. Keep at it and if the symptoms start to reduce then the lid hygiene can be reduced to weekly.

Hope things start to feel more comfortable soon.

york310

[Maydup]

Thank you York, I will continue just as you describe.

I'm especially pleased with the suggestions for lid care wipes as I find the cooled boiled water and bicarb solution a real chore at midnight. If I do a hot compress and then use wipes I can see myself sticking to it regularly.

Once I have finished the two week course of all these drops (one of which has to remain refridgerated - how impractical is that!) I will continue with the lubricant 4 times a day. I was never really sure when to use that one but your advice is sound. Thank you.

Off to fetch a drink of water now....... :-)

[Maydup]

An update for york310 if you're about.

Back in 2011 I saw a specialist and after a series of drainage tests he diagnosed blocked tear ducts. In 2012 i had stents put in and later removed but over the course of this year one eye still fails to drain and the other drains poorly. Seen the specialist again this morning and he has decided i need bypass surgery on eye and a slight modification on the other while he's there. He says its an overnight stay in hospital and a couple of weeks recuperation.

Do you know how invasive that bypass surgery is? Will i be able to see or have to keep my eyes covered after surgery. Any info and reassurance gratefully received.