I saw your post and thought I had better register and respond as I have been and still am going through something that sounds very similar to yourself, that being dry eyes post accutane due to oil glands on the lids of my eyes.
Please post back with more detail and we can talk more on the matter (I may be able to help somewhat as I have had a small amount of improvement over time).
Last edited by moderator2; 04-06-2012 at 04:13 AM.
How long were you on accutane and off? Have you seen some eye specialists? I saw a few eye docs and they were useless and said i had blepharitis. Seems like these eye docs lack knowledge in specialist areas.
Last edited by shellsbells1; 04-16-2012 at 06:27 AM.
Sorry for the late reply have had a busy Easter weekend :-D.
I was on a generic form of accutane with my dosage ranging from 40mg up to 60mg a day at the time I stopped taking it.
I had all the usual symptoms such as dry lips, flaking skin and an initial breakout but my dry eyes did not start until a good month or so into taking the drug.
At first my eyes were incredibly watery which then progressed to me having pretty much zero moisture on my eyeballs (I could see them misting over if I kept still and focused on something). I couldn't leave my house for weeks, the slightest breeze or temperature change would result in pain and me having to squint to the point my eyes were almost shut.
After scouting the net I discovered some people had been doing warm compresses and had seen results, so I tried this one night and it did work for a short time but as the drug continued to work on my body I believe my glands shrunk further still to the point they weren't clogged but just not secreting oil.
I saw several doctors and ophthalmologists, non of whom had known accutane to cause permanent dry eyes.
The ophthalmologists were pretty useless in my opinion, telling me the same as you (bleph), I have no signs of irritation on the eyelids, the glands are also secreting oil and my tear film is reported to be very stable. I think possibly the accutane has increased the sensitivity of my eyes?.
One thing to note is that a couple of weeks after stopping accutane I had a clogged gland in my left eye as the oils began to "return", my right eye however is far worse than my left and is so to this very day.
The few floaters that I had in my right eye increased quite significantly in the past month or so (could or could not be accutane related), my eyes have been slightly improving though over the past year, I will detail all that I can to possibly help you (although I fear you may have tried all of these before..)
To begin with my hot compresses were done with the use of boiling water and a face cloth. This was very messy and the towel cooled rapidly, so I bought a wheat filled sack that you heat in the microwave (primary use for muscle pain). They hot for several minutes at a time and have a slight weight to them which helps express the oils.
Before I used the microwavable bag I thought my glands may have been atrophied completely. However after using it just once I could tell a large amount of oil had been secreted onto my eyes, as everything was heavily blurred until my eyes watered and I blank several times to clear it.
I would mould the bag into the sockets of my eyes (if you can understand that) and would gently apply pressure, being able to feel the heat directly on my eyelashes. I would also fold a towel and place it on top of the bag so as to retain as much heat as possible.
OMG it just wiped a whole post I was uploading :-(.
I had success with the use of a heated bean bag that people place in the microwave then use to ease muscle pain. I would heat it up until really hot, then fold and mould the bag onto the front of my face, applying gentle pressure and massaging the bag across my eyes.
I could tell this was working as after each session my eyesight would be very blurry, as the secreted oil lay on my eyeballs. A few blinks and tears would clear my sight, this showed me that the glands were not truly atrophied and were at least producing some oil.
I have also been taking flaxseed oil in liquid form with cold water, again I can not say if this is actually responsible for what little progress I have seen but scientific evidence suggests that it very well may be.
Sorry for the scattered nature of my posts, I am simply typing what comes to my head first from my experience.
The improvement has been verrrry gradual, I have now been off the drug for just over a year, it did clear the majority of my cystic acne (especially on my back).
My eyes are still not 100% but miles better than they were say the first 7 months after I had stopped taking the drug.
One thing that I do strongly believe is that the oils secreted from the glands on my eyelid margins has increased in thickness significantly and is gradually thinning out again as time passes on.
At one point my vision was impaired by how thick the oil was, the fact it has simply increased in thickness and not ceased to be produced at all would also account for the doctors and my optician not seeing anything "wrong" with my eyes.
My optician whom I have complete trust in (he saw me the past 2 times completely free, no charge what so ever). He performed the slit lamp examination, my tear break up time and photographed the backs of my eyes. Not only this but they saw me the same day as I rung up, and if he says that he cannot see anything seriously wrong with my eyes then I have to believe him.
Firstly thank you for your detailed reply, it helps a lot and thank you to this forum also for allowing such posts. I have been worried since i took accutane for 8 months at 40 for most of the months and my eye problems started a few months into taking the drug and after stopping got worse. The symptoms were red veins in the whites of the eyes, eyelid inflamation and at night when the eyes are closed theyd be sore in the mornings.
Things have improved slowly so far, but i still need to use lubricating drops in the eyes such as carmellose and also on odd occasssions drops for infection lke chloramphenicol. I have tried the warm compress and use it on the odd occassion, but I keep my eyes clean using a wet flannel.
My derm says things should improve with bleph. I am in the UK i have taken some tablets to help.
I am glad to hear that your tear film has stabilised, has that improved your eye symptoms.
I will be trying the flax oil and i take fish oil capsules, do you think i should take the fish oil without vit a in instead?
Last edited by shellsbells1; 04-16-2012 at 06:30 AM.
I too am in the UK so can understand what you have gone through with the NHS's eye care.
It sounds like you took the drug for a longer time than me and so going by how long it has taken me to improve it would take you longer still. I too have been told that the bleph is a life long condition (chronic) but am just as confused as you about what I actually have, as like I said my optician/ophthalmologist said that they see no signs of blocked glands or infection on my eyelids.
At one point my eyes were incredibly red , and I would get a feeling of my right upper eye lid not opening up properly. I still have some discomfort when walking about in the open air and when I shut my eyes at the end of the day my right eye will sting as though I have something in it.
I don't think you could class me as having Occular Rosacea, I do believe my eyes have increased in sensitivity though and just the slightest change in climate can send them off on one so to speak, so the improvement I am experiencing now may well be lost once the very cold weather sets back in again.
I tried a number of drops, non of which really seemed to do much for me for too long. Lacrilube was one I used for a short time that was great at first but then gave my eyes such incredible pain and discomfort (think I overused it).
Occasionally I will get a very sharp pain say when I blink my eyes, and if its cold I will notice like a milky veil peel back fractions of a second after I blink (I am positive this is a thickened oily layer that pulls back with the eyelids upon blinking).
And the Vit A is no longer an issue seen as you are now off the accutane. I get my flaxseed oil from Holland and Barrets in liquid form as its meant to be much more potent that way (and cheaper). Keep it in the fridge as light degrades it, have it with cold ta water (you can barely taste it honestly).
I take half a mouthful of cool water and then drop a tablesoon of the oil in and swallow.
Have you tried some of the eyewear available for protecting your eyes and some have moisture features to help the eyes for day and night wear? And have you been tested for any autoimmune conditions, get your gp to check and do tests just in case.
What generic brand were you on?
Last edited by shellsbells1; 04-10-2012 at 12:38 PM.
I don't have an auto immune issue nor is it bad enough to need eyewear (possibly at its worst it was).
I was very stupid and bought my accutane over the internet so it was a different brand each time, I had very bad cystic acne and the waiting list for a dermatologist was 6 months so I got fed up and bought the drugs myself (pretty silly in retrospective but it did work in ridding me of cystic acne)
My main areas of concern are upon waking I have sore eyes, but it doesn't last throughout the day like it use to, still not "normal" though and have a feeling it will either be a long time till I am or I never will be :-/.
The heated rice bag is by far the best option and I highly recommend that you try it out if clogged glands are your issue. I will try and find a link where they are buyable (I got mine from tk max).
Last edited by moderator2; 04-10-2012 at 02:13 PM.