Help, Dr. Hive: I have the worst "dry eye" that it's painful.

[Alicia64]

Hi Everyone,

I would LOVE any ideas to deal w/ dry eye. I life in Atlanta and my skin is dry too, but I don't care as long as I'm not in pain. Dry eyes are painful. I stopped putting on make up. I don't rub them b/c that never ends well.

Here's what I've done:

• I've taken two capsules of fish oil for years.
• I've tried both the cold compress to ease the puffy/pain.
• I've also tried the little baggy thing that you microwave -- the theory is that the heat opens the ducts so your dry eyes stop. Got this from a doctor and it helped last year.
• I've bought expensive drops that are called: ROHTO with a purple top. The label also says dry aid. This helped hugely last year. This year? Barely.
• Doctors say that I don't have allergies.
• Taking two Ibuprofin has helped the most actually.

I'll take any advice. Any.

Thank you so much -- you guys are really the best.

Alley

[Pawz4me]

I have the best results with Refresh Mega 3. If you're using drops more than three or four times a day you definitely want single use vials. They're preservative free. The bottles of drops all have preservatives, and those can cause their own problems if you use them more than a few times a day. Although the vials are labeled as single use, my optometrist says it's fine to keep a vial for 24 hours or so. I keep mine in the fridge. Cold drops are more soothing.

You might try washing your lids with baby shampoo or a product made for lid washing (there are a few to choose from) if blepharitis is a contributing factor.

If you have reason to suspect that you have anything auto-immune going on I'd consider getting checked for that. I have Hashi's and RA and both can cause dry eye. When either is flaring my eyes get particularly bad. My optometrist says that even when AI illnesses are well controlled studies say those people still tend to have dryer eyes than someone without an AI illness. Sjogren's syndrome is another AI issue that can cause severe dryness (eyes, mouth and other places).

[prairiewindmomma]

Go see an opthamologist. There are better Rx meds and procedures—like punctual plugs—that can address this.

[Alicia64]

54 minutes ago, Pawz4me said:

I have the best results with Refresh Mega 3. If you're using drops more than three or four times a day you definitely want single use vials. They're preservative free. The bottles of drops all have preservatives, and those can cause their own problems if you use them more than a few times a day. Although the vials are labeled as single use, my optometrist says it's fine to keep a vial for 24 hours or so. I keep mine in the fridge. Cold drops are more soothing.r.

If you have reason to suspect that you have anything auto-immune going on I'd consider getting checked for that. I have Hashi's and RA and both can cause dry eye. When either is flaring my eyes get particularly bad. My optometrist says that even when AI illnesses are well controlled studies say those people still tend to have dryer eyes than someone without an AI illness. Sjogren's syndrome is another AI issue that can cause severe dryness (eyes, mouth and other places).

Dh is picking up the Refresh -- thank you. I did use those at one point and forgot about them.

Re: autoimmune. I have a super mild version of a disease called Ataxia. I don't think I have the genetic ataxia, but it's possible that I have the autoimmune version. I'm not sure how knowing that helps. Am I being stupid?

Thank you again so much.

Alley

[Alicia64]

5 minutes ago, prairiewindmomma said:

Go see an opthamologist. There are better Rx meds and procedures—like punctual plugs—that can address this.

Last year I went to an ophthalmologist who specializes in dry eye -- and he recommended fish oil and the heated baggie that helps to open up tear ducts.

But you're right: now that I think about it, I think he gave me an ointment to put in my eyes before bed. It made my eyes really blurry, but it also really helped.

Thank you!

Alley

[prairiewindmomma]

Alicia—those are kind of first line measures. There are WAY more options beyond that, so feel free to go back and ask for more help if what you are doing now isn’t working.

Dry eye isn’t just uncomfortable, it puts you at higher risk for corneal abrasions. Corneal abrasions generally heal without much complication but they are dang uncomfortable and they mess with your eye sight in the moment.

[prairiewindmomma]

Also, on the ataxia front, consider more seriously doing the PT/OT if you haven’t yet. My dd’s brain tumor affected her cerebellum and we saw a ton of life improvement after PT/OT even as she declined overall. Be sure they include a vision therapy exam as part of your intake. 🙂 

[Murphy101]

2 hours ago, Alicia64 said:

Hi Everyone,

I would LOVE any ideas to deal w/ dry eye. I life in Atlanta and my skin is dry too, but I don't care as long as I'm not in pain. Dry eyes are painful. I stopped putting on make up. I don't rub them b/c that never ends well.

Here's what I've done:

• I've taken two capsules of fish oil for years.
• I've tried both the cold compress to ease the puffy/pain.
• I've also tried the little baggy thing that you microwave -- the theory is that the heat opens the ducts so your dry eyes stop. Got this from a doctor and it helped last year.
• I've bought expensive drops that are called: ROHTO with a purple top. The label also says dry aid. This helped hugely last year. This year? Barely.
• Doctors say that I don't have allergies.
• Taking two Ibuprofin has helped the most actually.

I'll take any advice. Any.

Thank you so much -- you guys are really the best.

Alley

I had to use prescription eye drops. I’m allergic to a couple ingredients in the others and it actually made my dry eye way worse to use them. 

And it was a symptom of low thyroid for me. Going on thyroid and getting that balanced has come very close to completely resolving my severe dry eye.

And it was painful for me too. I could actually hear myself blinking and it was hard to open my eyes on the am.  

[Alicia64]

34 minutes ago, Seasider too said:

 

FWIW, my experience with years of painfully dry eyes was cleared up when my eye doctor said the cause might be due to an autoimmune disorder. That sent me to a functional med team and an investigation of food intolerances. I know people roll eyes these days at the suggestion to go gluten free without a definite celiac diagnosis, but a trial run couldn’t hurt. There was a time my eyes were so bad, I seriously considered learning Braille. They rarely get intolerably dry these days, and I rarely use drops. 

I've already started to be gluten-free. I started in late July so I'm just plant-based now.

My dry eyes just seem to show up in the winter. It's not all year, just a month every winter.

Alley

[Alicia64]

14 minutes ago, Seasider too said:

 

Oh! Do you have a humidifier? One by your bedside at night could help. 

I was thinking of this very thing. Dh's is going to freak because "mold!" but I need to at least try. I think he sees how miserable I am.

Thank you!

Alley

[Pawz4me]

Definitely run a humidifier.

Around here you wouldn't get anywhere trying to get an appointment with an ophthalmologist for dry eye unless you had a referral from an optometrist. I know what optometrists are allowed to do varies from state to state--here you see an optometrist first for just about everything eye/vision related.

[Alicia64]

8 minutes ago, Pawz4me said:

Definitely run a humidifier.

Around here you wouldn't get anywhere trying to get an appointment with an ophthalmologist for dry eye unless you had a referral from an optometrist. I know what optometrists are allowed to do varies from state to state--here you see an optometrist first for just about everything eye/vision related.

Yes my optometrist as sent me to the ophthalmologist before. In fact she just asked me, "How's your dry eyes." Well the problem hadn't started so I just said, "fine."

Your dog is so, so cute! And I love her cute little haircut. What a doll.

Alley

[Suzanne in ABQ]

My mom had an extreme case of dry eye that was only brought under control under the care of an ophthalmologist who specializes in cornea problems.  She also has an auto-immune disorder called Sjorgren's Syndrome, which affects all glandular functions in the body (tears, saliva, skin). You might want to look it up to see if your other symptoms fit the profile.

Some things that helped my mom.

First line of offense were two steroids to help heal her damaged corneas (cells were flaking off the surface of her eye, causing vision problems and intense pain and redness). One steroid was oral, which she took for a short time to help heal the acute problem, another was an eyedrops (Lotemax) that was used longer (several months).  I got the impression that the steroids are only used for extreme acute dystrophy of the cornea. Once her eyes had healed, these were stopped.  She used Muro eyedrops during this time as well, which help soothe eyes with corneal edema.

He placed tiny plugs in her tear ducts, to prevent her tears from draining, allowing them to sit on the eye longer. This was very helpful, but the plugs kept falling out, so he finally cauterized all four ducts shut. This was not painful at all, and proved to be very helpful. 

The following are to be used daily, for maintenance: 

He prescribed daily practice of scrubbing the eyelashes with a washcloth (with or without baby shampoo -- he said that the scrubbing action was most important).

A warm compress placed on the eyes for five minutes per day (she uses a small rice bag, heated in the microwave).

She uses special OTC ointment (Systane Nighttime Lubricant Ointment) in her eyes at night. She puts it inside her lower lids just before going to bed. Her vision is blurred for about 20 minutes after placing the ointment, so going to bed is the best thing to do. 

She uses special OTC drops several times during the day, 4X/day or as needed, either Retaine, Soothe XP, Systane Complete, Refresh Ultra, Mura, there are many.

[Tap]

I have punctal plugs and they are a God send to me!!!! My eyes were so dry before, that I had vertical scratches from my eyelids.  I still get a flare here and there, but nothing like what I used to suffer with. I use the Systane Balance Restorative eye drops during flares.  They help with the lipid layer in your tears.  I use hot wash cloths on my eyes in the shower to release any clogged oil glands.  When I hurt mid-day, I use a single use (preservative free) lubricant eye drop.  

[prairiewindmomma]

2 hours ago, Tap said:

 I use the Systane Balance Restorative eye drops during flares.  They help with the lipid layer in your tears.  I use hot wash cloths on my eyes in the shower to release any clogged oil glands.  When I hurt mid-day, I use a single use (preservative free) lubricant eye drop.  

This is my maintenance routine. 

[Pippen]

I like Refresh Advanced Optive drops.  My eye dr had me use them 4 times a day. 

My dry eyes were a result of a thyroid condition.

[Lady Florida.]

16 hours ago, prairiewindmomma said:

Go see an opthamologist. There are better Rx meds and procedures—like punctual plugs—that can address this.

 

16 hours ago, Alicia64 said:

Last year I went to an ophthalmologist who specializes in dry eye -- and he recommended fish oil and the heated baggie that helps to open up tear ducts.

But you're right: now that I think about it, I think he gave me an ointment to put in my eyes before bed. It made my eyes really blurry, but it also really helped.

Thank you!

Alley

I was going to recommend an optometrist or opthalmologist, depending on who can do what in your state. I have plugs but I also use prescription eye drops (Restatis). All of the things you're doing or have done are usually tried first. If they haven't worked it's probably time for plugs and/or prescription drops.

Also, I don't know how much time you spend on a computer, phone, etc, but screen time can aggravate dry eye. I notice mine is worse when I've spent too much time with my screen devices. 

[Carol in Cal.]

I get this, and it's bad.  I have ocular rosacea which aggravates it.

What I do is every day during my bath I soak a wash rag in hot water and lay it on my closed eyes and lay back like that for about 8=10 minutes, refreshing the heat a few times during that period.  I find that the moisture helps soften the overnight gunk in my eyes so I can wipe it right off, and the long soak/warmth helps the tear ducts to clear as well.  My optomistrist told me that that's how long it takes and that most people don't do it long enough, and once I started this I could immediately see that it made a big difference all day.  He also suggested Systane drops but I have not needed them since I started this routine.