Talk to me of dry eye!

Parent Cafe
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<p>I never had a dry eye diagnosis, but my eyes have been extremely irritable for years. I get a bit blood shot on the inner eye and if I can’t soothe it away, the entire eye becomes teary, bloodshot and possibly infected. I am not sure if it was infected or not, but periodically suffering through that, i would see a GP doc and get the antibiotic eyedrop.</p>

<p>It began to happen when I was in the desert and I saw an optometrist who suggested Systane to alleviate the irritation. I never thought of my eyes as dry since they were irritable and watery and never felt dry to me, but the Systane is very nice. I keep a bottle in my nightstand, car, purse, office desk, etc. I try to use the gel drops at night and if all is well I just use it at bedtime and first thing in the morning. If my eye is getting irritated, I use it every time I think of it, all day long.</p>

<p>They have really helped my eyes feel better.</p>

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<p>@kelsmom, what medication does she take? I also have SS but just manage the symptoms.</p>

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<p>VeryHappy, I have SS and take Evoxac. It helps quite a bit. I was on Restasis for over 2 years, and it did not help at all. I am fortunately enough to live only 15 minutes from Dr. Latkany’s office, so I see him now every few months. He’s great. </p>

<p>I usually need to use eyedrops now only once a day or so, unless I’m wearing contacts. I wore gas-permeable contacts all the time for many years with no problems until I started to get corneal abrasions, infections - the first signs of SS. Now I use glasses most of the time and daily soft lenses when I wear contacts. I noticed that the solution the contacts are in seems to irritate my eyes. Dr. Latkany suggested rinsing with Refresh eyedrops, because they are compatible with contacts. When I am wearing contacts, I need to use the Refresh eyedrops several times a day.</p>

<p>The eyedrops I like best are Systane. I use only the preservative-free vials. The best price by far is on Amazon subscribe and save. I use the preservative-free vials of Refresh, too. They can be reclosed and used several times (but I wouldn’t save them for more than a day).</p>

<p>I remove eye makeup with Ocusoft Lid Scrub Wipes. Tried the baby version once - stung like hell!</p>

<p>The best thing I’ve found is Ocusoft Eye Shower. I bought a kit with the eyecup and 6 vials - large vials of nothing but saline, but it’s wonderful. You wash your eyes with it, put the eyecup over them and roll them around. After buying the kit once, I bought a huge box of about 30 vials from Amazon - much less expensive. </p>

<p>I also take fish oil, and I’m going to try the Barleans capsules now that I saw the recommendation on this thread.</p>

<p>A strange thing that makes a difference: Teavana Wild Orange Blossom herbal tea. When I drink it regularly, my SS symptoms almost disappear.</p>

<p>One thing I need to try, but haven’t been able to manage, is a gluten-free diet. Dr. Latkany thought it was worth trying, because gluten is inflammatory. My rheumatologist also thinks it would be a good idea because, although there’s no evidence that it helps, a number of her patients have found it helpful in reducing symptoms.</p>

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<p>missypie, Dr. Latkany says that only a fraction (40%?) of people with dry eye are helped by Restasis. I had it pushed on me, too, by an optometrist and an opthalmologist. I absolutely hated the latter, he ran a sort of cataract surgery factory, very patronizing. I am fortunate enough that this was covered by insurance, but I know that it’s horrendously expensive. I used each vial twice (so used only half of what was prescribed, the optometrist told me it was OK to reclose the vial and use within the day). Why should the insurance company be paying a fortune for this stuff?</p>

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<p>I have Sjogrens too. My rheumatologist doesn’t have me on any drugs for it presently. I just use the special dry-mouth toothpaste, preservative-free eye drops, and that Refresh ointment at night before bed.</p>

<p>Looks to me like Exovac is more for dry mouth?</p>

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<p>Another one with Sjogren’s who uses Exovac. I fought it for years but then had to start using it. Works beautifully.</p>

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<p>Has anyone (post-menopausal) found that HRT helps their dry eyes?</p>

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<p>@VeryHappy‌
Muro 128 oint is a great oint to use at night. Sometimes dry eye and underlying basement membrane disease symptoms (what Muro 128 treats) are similar and muro128 can be used instead of refresh PM pretty much always.</p>

<p>@gouf is correct. Most brands of artificial tears have different ingredients. Trying many different brands of tears help.</p>

<p>As for restasis, I believe that it works only for inflammatory causes of dry eye such as sjogrens, etc. I rarely prescribe it because I tell the pharm reps that it has to work for me first before I go crazy prescribing it (and it didn’t work for me).</p>

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<p>@missypie,
Hormone replacement therapy has worked on some of my patients. Also my mom in law (78 yr old) started taking evening primrose, an OTC HRT, based on the Recs by her ophthalmologist and it worked great for her.</p>

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<p>@YoHoYoHo: Thanks for that OK, to use the Muro 128 at night. My ophthal was very opposed, but when I went back to Refresh PM, the difference was amazing.</p>

<p>I too take Evoxac for oral symptoms of dryness.</p>

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<p>@veryhappy,
Is your ophthalmologist very old? Cornea specialists used Muro 128 oint all the time. Also younger doctors (like me) who have much more thorough training than some of the old timers, use it frequently. I’m Oculoplastics, not cornea, but have to deal with dry eye pts all the time. </p>

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<p>Yes, he is. He’s an acquaintance (we have some friends in common), so I know how old he is. At least 65; probably older.</p>

<p>I just looked him up; he’s 63.</p>

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<p>In addition to the great ideas already listed - I use a microwavable eye compress every evening and every morning before inserting contacts - and that helps. It delivers warm moisture and is very soothing.</p>

<p>It’s also important to know whether your issue is lack of tear production or Meibomitis - which is a lack of the oil layer which is supposed to coat your eyes and keep the tears from evaporating. I have Meibomitis and a job that requires constant computer use - so my dry eyes are a constant struggle.</p>

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<p>I have been suffering with dry eye for a few years. One eye tears a lot, both eyes get red and irritated. What works for me is hot compresses in the morning. </p>

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<p>Another Sjs person here. I take plaquenil for the Sjs, but do not know if it helps the dry eyes, as I have taken it for 10+ years.</p>

<p>Punctal plugs, upper and lower, expelled themselves after hurting like crazy.
Restasis burned and did not help with moisture. The thicker bedtime ointment was uncomfortable and not helpful.
After these experiences, I was referred to a rheumatologist and diagnosed with Sjogren’s.</p>

<p>I find that a gluten free, limited dairy diet helps enormously with dry eyes. Also hormone replacement seems to help.</p>

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<p>Occasionally dry eye is from Sjogrens syndrome, an auto-immune disorder. Has your Dr. done the Shirmer test (uses a little strip of paper to measure amount of tears made) ? If that is abnormal usually blood work to test for Sjogrens is considered. It also causes dry mouth.</p>

<p>Punctal plugs are great, after Lasix my eyes got too dry and they really helped. I’m not a faithful drop user so the little silicone plugs are the best. </p>

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<p>Restasis worked wonders for me. It took 3 months to really kick in but then it totally resolved my dry eye problem. I had tried single usage Refresh before that but it didn’t help. I keep the Restasis in the refrigerator and am able to get about 3 days worth of usage out of one vile so with insurance the cost has nor been excessive.</p>

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<p>I forgot to mention that for very dry eyes, moisture chamber goggles (such as tranquileyes) while sleeping is good. Another option is a humidifier in the room. Another option is wearing sleep masks that have some “weight” or padding so that it keeps your eyelids fully shut at night is another option for people who wake up with dry eyes.</p>

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<p>Regarding the sleep mask, my husband uses one because we have a ceiling fan, which is very drying even when your eyes are closed. He was “banned” from using the ceiling fan by his doctor, so the compromise was the sleep mask.</p>

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<p>BTW, the thing that worked best for my dry eye was lasik. This is not uncommon. Do not know why.</p>