It's been 2+ years since LASIK. What a journey. It's been hell. It's been heartbreaking. It's been amazing to get the outreach of support and to make the connections through a simple blog. I'm grateful for everyone that reads and sends notes.
Watch this video to get an update on my progress and to hear about my current dry eye regimen. Stay hopeful, stay persistent... don't give up. I hope you can hear something to help you with your treatment. Cheers, Matthew
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Image Source: www.allaboutvision.com
Over the last several months, it's been very encouraging to get emails and posts from you about my LASIK dry eye blog. Initially, it's purpose was to vent my frustration and help someone else that might be traveling the same road (that seems endless without end at times). I had no idea if anyone would read it. Imagine my surprise when people started writing and asking if there would be another blog when there weren't any posts for a month. Thank you for writing... all of you. There isn't always time for me to respond to everyone, but I'll write when time allows.
Today, I'd like to share an email a reader sent me about suffering with MGD or
Meibomian Gland Dysfunction. He's asked some very good questions and it seems that everyone would benefit from reading my answers. I've removed his name and other identifying information.
His Letter (some sections removed to conserve space):
The reason why I am contacting you is because you're the only person that really 'gets me'. A month ago I was diagnosed with 'mild mgd', however, it certainly doesn't feel mild. The pain, the daily struggles is honestly debilitating and only you would know that, but then .. 'it's only a bit of dry eye, you'll get over it'. That's all I used to get told.
4 months ago the pain was unbearable to the point where I would go home from work, after weeks of waiting I finally got told I had MGD. Of course, due to me being obsessive on the web, I knew it wasn't good.
Sometimes I'm okay, but the majority of the time my eye's aren't 'dry', however, have ever so slight pain in the side of my eye that doesn't disappear. Whilst my eye's are open, this slight pain remains. Do you get this? Even whilst using eye drops, it's still there. Like right now, whilst typing this after being on the computer at work for 5 hours, my eye's don't feel DRY, they feel tired and fatigued. Do you get this? Oh by the way, if it makes you feel better, I have this and I'm 22.
I sometimes this is my anxiety/depression (if I have any? - I don't know! I just think about it all the time and go on the DryEyezone.com). makes it worse. I was looking through pictures the other day from 5 months back, I was so happy, getting on with life. It makes me think if I had MGD then aswell, but I just didn't know about it. Knowing I have it has definitely made it worse, before I was diagnosed, I would be in slight pain at work (some days) and then go home and I was fine. Now it's everywhere.
1. How long should I give drops a chance? I have only used three drops, do you recommend I keep trying more to see what suits? Do I use them for a day, a week, a month to trial? If I had a drop that genuinely provided relief and abolished all symptoms for a while, I could live with this.
First off. It sounds like your doctor may not be diagnosing/treating you improperly. This is very common. My LASIK doctor never diagnosed my MGD; he kept blaming it on medications I was taking. Imagine my frustration when it was diagnosed over a year later by another doctor. Your glands are dying. This is the symptom of MGD. The glands secrete oil into your tears to keep them from evaporating. Please get help immediately. Once your glands atrophy, that's it... they are gone. I only have four on each eye lid that express oil.
There is no drop that cures this. I've found preservative free Systane drops and Serum drops (made with my blood serum) most effective. You can also try organic Castor Oil. Unfortunately, you will likely be using drops for the rest of your life. There are only two prescriptions in the market for dry eye and they don't treat MGD (Xiidra and Restasis). I did not find either helpful.
If you aren't satisfied with your doctor look again. I tried 7 doctors until I found the right one.
2. Moisture chambers, do they really work? It's on my list to try in the years to come if everything else fails. Sounds sad, but I don't want to try absolutely everything in 1 month and then be screwed, I like to have some hope and keep things for the future.
YES. Annoying to wear, but I use them. Especially important to wear them at night. See my earlier post on EyeSeals 4.0.
3. I have only seen 1 ophthalmologist. She basically said I have to get used to it as it's a chronic thing, but I can try plugs if I like. I hear MGD gets worse with plugs - I hear it helps - I hear that they're great and that people with MGD have seen great improvements.
Plugs can help. I have them. I don't know if it makes MGD worse. I've never heard that. It helps with tear evaporation. You should be doing hot compresses daily to get the oil to express through your glands. See my earlier blog on this. ...Followed by eyelid massage. Since your in the UK, the EyePeace Eye lid massage tool can help with this as well (I have done posts on hot compresses, eye lid massage, and the Eye Peace).
4. Should I be taking drops more often? On a bad day, every hour, today at work I have only taken 2 drops and it's 2:30pm. My eye's are fatigued! I don't know if they're 'dry'. Should I still use?
Take lots of breaks when you are staring at a computer. Watch my video on blink exercises. One of the causes of MGD is not blinking enough or partial blinking. Keep your eyes lubricated as much as you can. When the cornea gets dry it can cause damage. Always use preservative free drops. Hyco San has a nice product that is in Europe that lasts 6 months per bottle. I did a video on these too. I buy them on ebay.
5. I've gone all in and booked myself into the Dry Eye Center in London, they do an examination, all that stuff up to expression and IPL.
Great! IPL and Lipiflow are the two best options to treat MGD. They are not permanent however. My doctor said I will need Lipiflow every 6 months. I've not tried IPL yet. Apparently, it helps remove rosacea around the eyes and heats the glands so they express more oil.
6. You did lipiflow and you said that you experienced relief for months - what was this relief? Symptoms abolished? Felt normal? Or to the point where you could deal with it and you felt comfortable.
Lipiflow is the best treatment for MGD that I tried. It doesn't cure it, but it makes life more manageable. There are some days where I can go for hours without drops. It just depends on what kind of day I'm having and the weather conditions. Getting a full night of sleep really impacts this as well. Wetter climates and wetter times of the year help. Winter time and dry climates are the worse for my eyes.
I so hope to hear back from you dude,
You did! Stay strong dude. I hope this helps. Matthew
Disclaimer: I am not a medical professional. I take no responsibility or accept any liability for the advice or opinions expressed in this blog (this is a fancy way of saying you can sue me if my advice doesn't work for you). Always check with your doctor before trying anything recommended on this site. Everyone's journey is different and what might work for me, may not work for you.
Did you know that the most important time to protect your eyes from dryness is when you sleep? It's very common for our eyes to open slightly when we are asleep. This is very tricky for dry eye sufferers. The drying effect can last for days. The battle against dry eye is fought when you are sleeping!
Watch this video to learn about protective eye masks for your dry eye. I review some of the various models out there and a new exciting product from EyeCo.
Get EyeSeals4.0 HERE
Have you tried using Castor Oil to treat your dry eyes? It's really helped as a compliment to my preservative free drops, reducing the amount I need per day and helping on really bad dry eye days.
I use it up to three days per day, one drop in each eye. Make sure it's organic. Watch this video to learn more.
I had my second Lipiflow last month. I was absolutely thrilled with the results of the first one, but the dryness came back after about 4-5 months. Upon visiting my new doc at Eyeclectic, Dr, Knouff said that my Meibomian glands were completely blocked.
If you are not familiar, one cause of eye dryness is MGD or Meibomian Gland Disorder. The glands get blocked and they don't secrete badly needed oil into your tears (this prevents them from evaporating). I never had any problems with dryness prior to LASIK, but have had ongoing problems since. My tear production is fairly low and I have major MGD since having the surgery.
What causes this?
They don't always know, but it can be from infection in your eyelids, mites (demodex) and/or an overproduction of oils. One option we have discussed is going on Doxycycline regimen and getting IPL done. Dr. Knouff also has me use Cliradex tea tree oil eye lid scrubs (to treat for potential Demodex).
I was surprised to learn the price for Lipiflow went down to $995 (at least at her office). I'm not sure if this came from the manufacturer (Tear Science). But ask your doc if you are going to have it done.
How am I feeling now?
AWESOME. Of course. It did take about 3 weeks to feel the effect, because Dr. Knouff full expressed my glands after surgery. I'm using eye drops very little. I'm hopeful that this will last at least 6 months or longer. I see her soon. I will report back.
Here is a new harmonica video I made (no dry eye stuff, just blues).
Hi there! Apologies for the hiatus, but when I tend to get some eye relief I'm not interested in being behind a computer! I'm sure you understand. Spring is in the air (it's dating season....looking for someone nice). Unfortunately, so is the pollen. My car looks like it was spray painted yellow. Georgia has a astronomical pollen count in the spring, but the lush forest and greenery make it worth most of the time. Make sure you use your allergy drops folks. Pataday twice a day for me.
I digress... I'd you to watch a new video I've made to review an excellent product for eyelid massage. It's called Eyepeace. I've been using it for a couple of weeks and I really like it. It's not sold in the US, but you can find it on ebay and here is there website. I'm not affiliated with this product or receive any compensation for my endorsement. I just think it's a great invention! Talk soon.
Eyepeace Eye Lid Massager
On my quest for relief from LASIK induced dry eye I've tried about everything! Well there is more to try apparently...an amniotic membrane.
I'm currently in the middle of this treatment (Prokera). I'll update this post as I progress through the treatment.
Bluesifyin' LASIK Dry Eye sufferer. Read my blog to get tips, struggles, blues, reviews, whatever on this journey through hell.