Hi everyone! I've been reading this board for months now, and I figured it was time to introduce myself since I feel like I know some of you by now. This is my whole story, and it's pretty long because I need to talk about it somewhere, and no one seems to understand.

In January I tried to wear contacts for the first time in years. I had a feeling then that my eyes got red sometimes, but I made the mistake of not mentioning it at the appointment. I got fitted for contacts and everythign was fine for a couple weeks. Then my left eye got really red and I had a burning/stinking feeling in both eyes. I went to an optometrist who diagnosed with me with conjunctivitis in my left eye and gave me Tobradex. I went back a week later when it had done nothing for me and all he said to do was add artificial tears. If it wasn't better in a week I should see an opthamologist. He insisted my right eye was fine.

Well, the next day I called one and was fit in that day. He said that he agreed and had me on Tobradex, Ocuflox, and Pred Forte all at the same time, but that I also had developed a corneal ulcer in my right eye...all of a sudden. For two months I continued to see them being bounced between the opthamologist and the optometrist there who kept declaring everything looked like it had cleared up, despite the fact that I still knew my eye was pretty red at times and burned. The last time there they said that and I just said okay and left it alone.

The next day I was on the phone trying to find someone who could see me that day, because it was just unbearable that day. They were great and, I think, finally helped me and gave me a correct diagnosis of blepharitis after several visits. They spend 2 1/2 hours with my at my first appointment to get my whole history and examine my eyes. For the past three weeks I've been doing the warm compresses and lid scrubs, and artificial tears for much longer. There's been improvement, but it's not yet to my satisfaction. I also have a touch of GPC they said, but they didn't think it was enough to cause these problems.

Despite how much better I felt with them, I think I need to see an opthamologist for treatment. I liked them, but I'm going to take Elyse's advice and see a corneal specialist on Monday. I doubt there's much more they can do for me, but you never know. Besides, the other place didn't take my insurance...I was just desperate so I saw them anyway.

Okay, so I ended up telling the whole story...but I need to. Everyone tells me they don't notice any redness (it's not a bright red usually...just a pinkish overall color). While it's better than it was since I've done the warm compresses and everything, I understand most of what everyone has said in other posts here. I've had the doctors that said everything was fine when it clearly wasn't. I have the family and friends that tell me maybe it's all in my head. Not to mention that I work full-time currently and for about three months I was barely able to do my job since I work on a computer all day.

So I have blepharitis apparently. My left eye always has some redness ranging from very slight to completely red, particularly in the morning. They burn when I look at the computer and sting when I'm walking down a hallway. Clearly they're dry, because I do have some glands clogged I was told. At this point though, the burning is totally manageable...for now. It's more the redness that still bothers me.

This whole thing is starting to get to me more and more and put me under a lot of stress. I'm only 21! I'd never want any of this, but if I had to, I wish it'd happen a lot later in life. Elyse..you have it much worse than I do, and we're about the same age. How do you manage?

Anyway, sorry for making that so long, but I had to vent since my frustration has been building day after day. I'll be participating here more in the future, because I need some sort of contact with people who understand.

Thanks for reading!

Chris

Hi Chris!

Boy, can I relate! Your story sounds similar to mine. I'm not sure if you've read my whines :) but they all have "blepharitis" in the title. I know exactly how you feel. I'm glad you've at least got the burning under control. I haven't been able to do that and it's so distressing to live every day in agony. And people (except for us here) just don't understand. I've been told everything from "Just don't think about it!" to "Trust your body to heal itself." Uh, yeah, thanks for the advice.

Has anyone mentioned the oral antibiotic doxycycline to you? I can't take it because I'm allergic (figures) but it's the one antibiotic that actually works on the malfunctioning oil glands. You might also want to see a specialist... that would be someone who is an external disease specialist in ophthalmology. I saw one a couple of weeks ago who was unable to help me, so I'm seeing a different one next week. Don't give up! I think a lot of doctors don't listen and are willing to dismiss you very easily, so it is important to find just the right one.

My eye problems started when I was taking Zithromax antibiotic for acne. Every doctor has dismissed any connection, but I swear my eyelids hurt whenever I took a dose. I was talking to a friend yesterday and I had completely forgotten her husband is a pharmaceutical representative for Zithromax. She is going to ask him if he has any info supporting a connection between the antibiotic and eye problems. My friend is a cytopathologist, and she feels certain that such a thing could indeed happen, since Zithromax is a tissue-based drug and is designed to be stored in one's tissues. I'm kind of excited and hopeful that there is some concrete data I could show the specialist at my next appointment. If it is true, I just hope I didn't do any permanent damage by using Tobradex ointment for five weeks at my doctor's insistence. Tobradex contains tobramycin, which is the same family as Zithromax. I wish now that I had insisted on something else, but I figured, well, he's the one who went to med school....

Anyway, my point in bringing that up is to see if you had any possible triggering factor that you can think of too.

Other than that, know that I completely understand. I know you're only 21, but believe me, it's no better to have this at 42 :) But, you're right, 21 should be a carefree age! At times I don't deal with this very well, and this board has been a tremendous help. I can't whine to my family and friends 24/7. They don't really understand anyway. Hopefully, coming here will make you feel better too.

Try not to give up hope,
Donna

This board has already helped me tremendously just by reading everyone's posts over the past couple months. I have read all of your posts, and I'm sorry about what you've been going through. I know you haven't had the best of times with this. It's nice to be able to read about other people who actually understand and won't say "did you ever think they just hurt because you think about it all the time?" I'll admit that I have become pretty obsessed with it, but that's not why they hurt or are red.

I have heard of doxycycline. In fact, I was on it a couple years ago for acne. I stopped taking it because it didn't do much of anything for me. I have been on minocycline again though since January, which I've read can have the same effect as doxycycline. I had been taking it for about two weeks before these eye problems got out of hand. So it doesn't seem to be doing much good for my eye problems.

The only real trigger I can think of is that perhaps I've had this awhile and I just didn't notice. When I got contacts in January, it aggravated the condition and made it what it is now. And to think just prior to this I was contemplating LASIK. That wouldn't have been good.

The burning my eyes feel have been a little worse again today, but still manageable at least. But the opthalmologist I see on Monday is a corneal specialst, but the biography I read about him at their web site also said he specialized in dry eye and ocular immunology and inflammation. I hope he can help. I'm tired of trying a different doctor every month.

That specialist sounds good. I hope he can help you too. I intend to go to a million specialists until I get a straight answer. I hate this "you have blepharitis, no you don't" nonsense. But I know what you mean. I'm tired of it too. I'm tired of repeating my story. I'm tired of going in full of hope and coming out no better off. I'm tired of living with a mystery ailment day in and day out. I'm tired of seeing a new person every few weeks. BUT I'm not giving up so easily, since I'm in pain. Pain isn't normal. *Something* is causing it, and I know someone can give me an answer.

Hmmmm.... How do I manage it?

Somehow it has just become part of my life. That is definitely not a good thing, but I think that I am able to manage it so well because I am no longer surprised by it. I don't like it one bit, but rather than trying to live my life around the discomfort in my eyes (which is pretty much 24/7 lately) I just carry dozens of vials of tear drops with me (I bought a special make-up case just for eyedrops!), I make sure I have enough of my prescription drops, and I rest when I need to. I have made it a habit to use a cold compress at least once a day (that helps immensely!). I try not to let it stop me from doing what I want to do. I mean, there are just some things that I cannot do, like being outside on a windy day, or being around cigarette smoke, etc... And there are some days when my eyes are so bad that I just have to stop what I am doing and come home (can't tell you how many classes I've missed this semester because of that!) I just try to roll with the punches. Like I said, nothing surprises me anymore. I was totally SHOCKED when I had the corneal ulcer and it took almost 2 months of treatment to go away! But that was over a year ago and I have learned so much about this condition since then. If only I had known about healthboards while I was going through that!

Healthboards and all of the wonderful people here has really been my life support. It's great to have a place to come and share stories, get advice, and just complain without anyone saying "oh come on, it can't be that bad"

I think the most important thing is to have the support of your friends and family members, as well as the support of a good doctor. My parents have always been there with me, driving me to manhattan and brooklyn for doctors appointments....even going so far as to stay overnight with me in Maryland to see Dr. O'Brien at the Wilmer Eye Institute. But it took my other family and friends a while to come around. My best friend still really pisses me off sometimes. But ever since she started getting the occasional eye allergy, she has stopped saying "oh, come on, it's only your eyes."

Even the children in the elementary school that I work at have been extremely supportive. I hear from adults all the time "oh, your eyes look fine, so how can they feel so bad. It can't be true" But the kids are great. "Ms. B, you need a hug." "Ms. B, howcome you need eyedrops?" "Do they hurt?" "I hope you feel better soon." Today, my fifth graders saw me putting in my drops and they got really curious, so I explained a little bit about this to them. I explained how sometimes my eyes get very dry and I don't have any tears. They said "does that mean you can't cry?" We had a nice conversation and I explained to them that when they see me putting in eyedrops, they don't have to be worried because it's normal for me... it's just something that I need to do.

That's what I've come to believe. All this using eyedrops and running to the doctor, it's just something I need to do. It's part of my daily routine now. Get up, put tear drops in (before I get out of bed), brush my teeth, get dressed, use Restasis, have breakfast, use tear drops, go to school, use tear drops, go home, go to the eye dr, etc.... It's all very common for me now. But that is rather sad, that I've had to get used to all of this. The one thing I can't get used to is how other adults look at me funny and tell me there's nothing wrong. How would they like to walk a day in my shoes? I absolutely cannot stand it when people tell me "my eyes were so itchy yesterday... for 15 minutes they wouldn't stop itching." OK, take that and multiply it by 100%, have it 24/7, and then you've got about half of what I (or all of us on this board) have. When your eyes have been giving you problems 24/7 for a few weeks, then come talk to me. If not, get away from me because I'm jealous! I don't mean to sound nasty, but that's just how I've come to feel. Or at least, if someone is going to tell me their eyes are bothering them, then they should try to go to the dr and find out what is wrong, and then follow his directions and do something about it instead of just sitting there and complaining. I take a very pro-active approach with my health. I don't expect anybody else to understand my condition or do anything for me if I am not willing to try to help myself. My dad gets the occasional eye allergy. My entire family has started going to my eye dr. So, my dad makes an appointment with him every time his eyes itch. He gives him an allergy drop and tells him to use it for the entire hayfever season. My dad uses it for a few days and then stops. Then 2 weeks or a month later when his eyes are itchy again, he wonders what is wrong and goes back to the eye dr!

I have to say that basically the entire reason that I have been able to get through this and stay as sane as I am is because I have a fabulous doctor. He has really become my friend. He has never once said to me "YOU are going through a lot." It's always "I can't believe what WE'VE gone through together." or "Don't worry, WE'LL get through this." He is genuinely upset when I come to him and I don't feel well. More than once he has told me "you know, last week when you came in with that problem I was really scared, but I wouldn't tell you then." If it wasn't for him, I never would have survived that terrible ulcer. He took such good care of me. I have quite a unique relationship with him. I feel like he is holding my hand every step of the way.

That's why when people tell me how much of a hard time they are having getting their eye drs to treat them right, I can definitely understand it because I have had other kinds of doctors over the years who have treated me like I am crazy. But I am so grateful for my eye dr. There is truly nothing he would not do for a patient. For example, I have his cell phone number, email address and pager number, and I have been told to use them as much as I want. And believe me, I have done just that! I would never take advantage, but there was a time when there was no other way for me to get in touch with him but on his cell phone. I'm not sure if any other patients have been given that privelege, but I am sure if they needed him he would be there.

Now getting back to friends and family.

The way I see it is this: WHO CARES what your friends and family think... if you know that you are sick and you are suffering, that's all that matters. And if there ever is a time when I want to complain to my best friend (who at times can be very selfish) I basically tell her "look, for months you have been telling me about your problems and I have listened. Now YOU are going to listen to ME and I am going to talk for as long as I want to, and if you are my friend, you'll just listen and offer me a shoulder to cry on."

This may sound strange, but in a way I am glad that there are all of these other people out there with the same problems as me. I would never WANT anyone to have these problems, but I am glad to have people to commiserate with. Chris, it's especially nice that we are both young. I thought I was the only young person in the world with this. Have you ever been tested for Sjogren's syndrome? I used to feel sorry for myself, being so young and so miserable. But now I think this is just part of my life, and if I'm going to feel sorry for myself I'm never going to get anything done.

We all just have to keep going and try to stay happy.

That's not to say that I'm not absolutely terrified that this is never going to get better. I just don't let that consume me. Instead, that fear is what drives me to help myself.

I hope my little sermon here has helped in some way! LOL! :)

If you need to talk I am always here,

Elyse

Just one more thing....

Chris, I see that you had a corneal ulcer (oh, how I feel for you!) And you are just NOW going to see a corneal specialist? Obviously you didn't know that you should have been seeing one, but immediately upon discovering your ulcer, both your ophthalmologist and your optometrist should have referred you to a corneal specialist. IMMEDIATELY! It really surprises me that they didn't. But I am glad that the outcome was good and you were able to recover. I did not need to be referred to a corneal specialist because my dr is one, and he's the one I've been seeing since the beginning.

Also, NEVER do LASIK if you have dry eyes! It is really a good thing that you didn't do it!

:)

I never would have known about seeing a corneal specialist if I hadn't read you telling others the same thing several times. I'm not sure what the opthamologist that discovered the corneal ulcer specialized in, but I do know he was the LASIK surgeon. They knew I wanted to do it, so I can't help but wonder if that's why twice they insisted everything looked normal when I knew better. I don't want to believe that though. This opthamologist I'm seeing on Monday seems to have good credentials, so I can only hope that he wants to help me rather than rushing me out of there, as some doctors seem to do.

When I think back to the first two doctors I saw, I only get upset. If this had been treated appropriately from the beginning, perhaps it would've been under control much quicker. Instead, it was allowed to get worse for three months. And I've done enough reading to know that the longer you have these problems, the longer it takes to get under control.

I think I'll feel better if/when I can get this under control and just do the lid scrubs and warm compresses once a day. Unfortunately, my left eye has taken a turn for the worse today so it doesn't seem like that's going to happen anytime real soon. Doing them 3-4 times a day takes up so much time and isn't convenient at all.

I have been tested for Sjogren's. The results were negative. Then again, I don't have a regular PCP and the one I saw didn't seem all that great. I rarely went to see doctors until January. Now it's almost a weekly thing. I'm still concerned though that something could be wrong because from everything I've read, this is much more common in people that are middle-aged. Why am I having these problems being only 21?

This whole thing is still relatively new to me still since it's only been since January. I haven't gotten to the point where I'm ready to accept any lifestyle changes just yet, though it's becoming apparent that I may have to. One of them would clearly be my job since it's always much worse after working on the computer all day. But I am already scared to death that this won't ever go away and I'll have red eyes that burn and sting for the rest of my life. I'm still in the feeling sorry for myself stage, but at the same time, I am determined to get this under control. Particularly the redness right now.

The ulcer was awful. It was very small and apparently it was caught right away, but it was still very painful. What I've been feeling since then, as bad as it sometimes is, is nothing compared to how the ulcer felt.

And as for unsupportive people, my family I think came around more the last time I was over there. It was so bad that I kept my eyes closed most of the time I was there and was in a really bad mood, so I think they got the idea that this really bothers me. The worst one is my roommate, who also happens to be my ex-girlfriend (that's a long story in itself). I just got into an argument with her earlier this week because my sinuses were acting up on Monday and Tuesday, and I refused to take any antihistamines since a side effect is possibly dry eyes. I wasn't willing to take that chance but she wouldn't let it go and kept telling me one won't kill me. I'm not going to take the chance of making my eyes any worse than they already are. Like anyone else, all I want is a little understanding from people around me and not to be argued with for not wanting to take a chance on making them worse. Maybe I was overreacting and should've taken something, but I don't know.

I know that my eyes are dry. I don't know whether dry eyes caused the blepharitis, or if blepharitis caused the dry eyes (which is my guess since I have some clogged glands), but does anyone know if Restasis could help with dry eye symptoms associated with blepharitis? What about punctal plugs? I haven't been able to find much information about if either do any good when blepharitis is involved.

And Elyse, I know what you mean by being glad that there are others with these problems. I wouldn't wish these problems on anyone, but it's nice to have others out there. Particularly someone around my age like yourself. I hope your eyes improve soon! I know your latest issue with optic neuritis is the last thing you needed.

Chris

[This message has been edited by iChrisi (edited 05-03-2003).]

Originally posted by iChrisi:
And Elyse, I know what you mean by being glad that there are others with these problems. I wouldn't wish these problems on anyone, but it's nice to have others out there. Particularly someone around my age like yourself. I hope your eyes improve soon! I know your latest issue with optic neuritis is the last thing you needed.

Chris



I couldn't have said it better myself Chris! When my dr told me that I have Optic Neuritis, my first reaction was "what the heck is that"? My second reaction was "YOU HAVE GOT TO BE KIDDING ME!" I need this like I need a hole in my head!

If the ophthalmologist who diagnosed the corneal ulcer was a LASIK surgeon, then he may very well have been a corneal specialist. LASIK surgery involves making a flap in the cornea, so I would think (I hope!) that most doctors who do it are corneal specialists. My doctor is a corneal specialist and a surgeon.

Now as for the anti-histamine thing, you are so right not to take one. Your ex sounds like my best friend... she doesn't know a darn thing about this, but thinks she knows everything. Before I had my tear ducts cauterized, I found that taking an anti-histamine was so bad for my eyes. It dried them out terribly. Now that doesn't happen so much anymore because anti-histamines affect the overall production of tears. My problem is no longer that I don't have enough tears, I just don't have good quality tears. And anti-histamines don't really affect the quality of the tears. I too have terrible sinus problems and right now I am taking an anti-histamine (Clarinex). When I couldn't take anything else, I found that taking a 4mg Chlor-trimeton (0ver the counter) did not really affect my eyes and it helped my sinuses.

The reason I am so concerned about my eyes being dry is that the drier they are, the greater the chance of getting a corneal ulcer or abbrasion. Do you know exactly how you got yours? My dr says that at the time, I had not a single tear in my eyes and I must have just gently blinked or rubbed my eye, and I rubbed an ulcer into my cornea. People with the normal amount of tears would not have that problem. I don't recall the exact moment when it happened, but I remember that I was at my friend's mom's house for christmas eve of 2001 and all of a sudden I started feeling like there was something sharp and painful sticking me in my eye. I attributed it to the fact that she has a cat and I am allergic to them. I used plenty of tear drops and washed my eyes out with water. Nothing helped. Seeing how much discomfort I was in, my friend told me it was OK to go home if I wanted to. (I'm Jewish, so Christmas eve is not my holiday anyway!) I slept with a cold compress that night, still not having a clue that anything was wrong. I thought maybe I had gotten an eyelash in there and it had irritated me. By the next day it was still really bad. I called my drs office and the answering service told me they wouldn't be in until december 27th. Why? Is the day after christmas a holiday too? So I called on the 26th expecting to leave a message for my dr to call me, and instead of the answering service, guess who answered the phone? The receptionist! The office was in and my dr was there seeing patients. They got me an emergency appointment and took very very good care of me. I remember it like it was yesterday.... At the time they had a technician working with them who would see the patients before the dr did, and do a vision test, etc... I knew him very well by this point! He came out and sat with me in the waiting room. I told him "I think this is more than just an allergy and dry eyes going on!" He said "Elyse, this is serious. But Dr. M will know what to do." I had to wait a pretty long time for my dr to come out of the exam room, but as soon as he took one look at me I was the next patient to be taken in. There were several people ahead of me, but he basically didn't care. My eye was swollen shut with green stuff coming out of it. I was an emergency! They had to send a messenger out to the lab to get a kit to culture my eye with. Apparently my ulcer was huge. My dr said it was the worst one he had ever seen. Gee, thanks. It took almost 2 months of round the clock treatment with fortified anti-biotics to get it to heal. (I literally had to wake myself up every 2 hours during the night. During the day I used them every half an hour.) My dr said that if he wasn't positive that I was using my drops like I was supposed to, he would have put me in the hospital. But I proved to him that I was using them..... I kept a book of every single drop that I put into my eye and brought it with me to each appointment! He read it for himself!

You know, you said that your ulcer was small. Mine was quite large but I bet we had the same amount of pain. According to my dr, when it comes to eyeball pain, you can have the teeniest little ulcer, or you can have one that covers the entire eyeball... the pain is going to be the same. A larger one just takes longer to heal. And since size doesn't matter, the pain doesn't even begin to subside until it is completely healed. When my ulcer was about 90% healed, I had to wear a bandage contact lens in that eye for about 2 weeks. That really helped with the pain. I couldn't use it before then because I had to get the drops in there and the contact lens would stop them from being absorbed.

You ask "why am I having these problems being only 21?" I ask myself the same thing every day. I have a whole host of other health problems, and I ask myself "why me? why at this age? nobody else my age has these problems?" That's why I'm insisting on blood tests when I see my rheumatologist in a few weeks. No other healthy 22 (or 21) year old has these problems. So obviously there is some sort of underlying problem that is causing it.

I think that Restasis might help you because it helps to restore natural tear production. But the bad news is that it takes at least 2-3 months to start working. You also may want to start taking Flaxseed oil, which is known to promote the production of natural tears by adding to the oily layer. There is a great nutritional supplement called Thera Tears Nutrition that is just for people with dry eyes.

Now about the punctal plugs. If you really want some good information about them as well as any other eye problem, go to http://www.oculartimes.com and click on "dry eyes". There's also stuff there about corneal ulcers, blepharitis, and everything else you can possibly imagine. It's all in very easy to understand terms. This was one of the first websites that I found when I started researching this online.

I think you will be just fine. It takes a lot of getting used to, but you will be able to make the necessary adjustments. Your family and friends will also start to come around. They need time to absorb all of this too.

And we are all here to help as well. It's nice that there are other people out there who have this. It's nice to have someone to talk to. :)

Elyse

[This message has been edited by purple2067 (edited 05-03-2003).]

One more thing..... you are so right Chris... all the eye discomfort in the world cannot compare to the pain of a corneal ulcer!! Once I got through that I thought to myself "hey, if I can get over this, I can deal with ANYTHING!"

I'm not sure how I got my corneal ulcer. All I know is that when seeing my first optometrist I went back after one week since the Tobradex wasn't helping. He said he saw nothing in the right eye, except an eye lash touching the cornea. But according him there was no ulcer at that time. He said if the Tobradex didn't help within another week he'd refer me to an opthamologist, because then he didn't know what to do. Since I don't like the idea of them saying "take this and lets hope it works because I haven't got a clue what else to do," I called that opthamolgist that diagnosed the corneal ulcer in my right eye the next day. I'm guessing that I got it while I was sleeping. I told him the optometrist said nothing was there the day before, even though it was bothering me, and he said it looked like it had developed in the past 12 hours. How they can tell when it developed, I have no idea.

Now that you mention it, you're right, he must have been a corneal specialist if he's a LASIK surgeon. At least I hope so. Even if my eyes were healthy, I'm so glad I didn't have him perform LASIK for me. No doctor should keep prescribing antibiotic eye drops for two months when the condition isn't improving. I'd still like to know what they saw when they said my eyes looked "white and quiet" because I could tell there were problems just when looking in the mirror. My eyes never look white! I don't remember what healthy eyes look or feel like actually.

About the quantity of tears...I have some questions about that. My last optometrist was the first one to do the schirmer test. Well, from everything I've read it's supposed to be done for about 60 seconds and a reading of 15-20 is normal. They only put the strips in my eye for about 10 seconds. The first visit, which was the day I called them because it was much worse than usual, the reading was 10 in my right eye and 8 in my left eye. They did it again the last time I went and they had been improving over the last few visits, but I had a 22 in my right eye and 15 in my left eye. But they had said 20 was normal and 15 was still low, so I'm confused. Maybe there's something I'm missing, but I can't find anything that makes me think they did it long enough. Anyway, from my reading, it seems that, like you, I have enough tears. They just aren't of decent quality. I'm going to have to ask to doctor on Monday what my tear breakup time is. I'm interesting in learning what my reading on that one is.

I'm just a little down today. I thought things were getting better earlier this week, and then over the last two days my eyes have regressed right back to where they were. It hasn't been a great day for my eyes.

Tomorrow my goal is not to feel so sorry for myself and hold out some hope that the doctor on Monday will help me.

Awwww, don't be down. Try to smile. :) It's so hard when you don't feel well, but you'll feel better if you try to think positively. I'm not one to talk though. Today my eyes are the worst that they have been in a long time and I am feeling very sorry for myself. I emailed my dr about possibly using an allergy drop (God knows I've got enough of them to choose from in the house!) but he hasn't gotten back to me yet. I'm just in a lot of discomfort. :(


As far as the tear break-up time is concerned, you are right, that is what they really need to look at in order to decide if you have dry eyes. They won't really be able to tell you exactly what your tear break-up time is since there is no way to time it exactly.... the way to measure it is to put the fluorescein (that orange dye) in your eyes and then look at the eye under the blue light... this makes the dye show up as a greenish color on the dry spots and it illuminates the tears enough so that the dr can see if they are staying on your eyeball when you blink or if they are just rolling right off. Mine just roll right off. That's why my dr doesn't bother with the Schirmer test. Obviously I have more than enough tears. They are just not the right quality. I only had it done two times (never with my own dr). These were the times when I went for second opinions. My dr was at his wit's end with me and sent me to one of his colleagues here in Staten Island, and then I went to the Wilmer Eye Institute in Maryland to see a world renowned corneal specialist. Those were the only 2 times I had the schirmer test done. When I was in Maryland it was not done by the dr, but by one of his residents. Of course, it showed that the quantity of my tears was completely normal. So the resident just basically said "well, your eyes really aren't dry." Excuse me? I am not here to see you. Thank you very much.

Really, the only reason I can see for doing the schirmer test is to have something definite to write down in your chart. They all want some data to record. Yes, it does a good job of measuring the quantity of your tears, but what good is that when the problem is quality??? I don't like it one bit. I had a terrible experience with the schirmer test the first time I had it done.

Normally when my dr wants to see if my eyes are dry, he just looks in them with the dye. This colleague that he sent me to wanted to do a complete work-up, so he insisted on doing the schirmer test. I said "Ok, whatever. Just do it and get it over with." Well, first the strips would not stay in my eyes. Then when he finally got them in, they burned like crazy and made my eyes beet red. A normal reaction, according to the dr. My tears were more than sufficient, and according to the test strips I didn't have dry eyes. I don't know exactly how long he left them in there for, but considering the amount of discomfort I was in, any amount of time was too long. Well anyway, after he took them out he examined my eyes with the dye under the microscope for about 5-10 minutes. Then he dilated them and sent me back out to the waiting room while he went to examine another patient. After about 5 minutes of being in the waiting room, I began to feel like I had something in my right eye. (the one that I previously had the ulcer in) So I took out my mirror but my vision was blurry from the dilation and I couldn't see anything. I went up to the receptionist and said "I feel like there is something in my eye. Do you see anything." Right away she saw something. She made me come in the bathroom to show me in the big mirror. I could see something but I couldn't quite make out what it was. She immediately put me in a chair right outside of the room that the dr was in and went and buzzed him. I heard the phone ring inside of the room, heard him talking, and then heard some rumbling going on in the room. Apparently he was looking for a q-tip, because about 10 seconds later he came out with one in his hand, told me to look up, and proceeded to remove a piece of the schirmer test strip from my eye. Nice, huh? He sent me back to the waiting room, where I flushed my own eye with tear drops (he didn't bother to do that). When I was called back in for him to finish the exam I said "how did that happen?" He said that occasionally a piece of the strip can come off in the eye. Fine. But,.... My question is this: After he removed the strips from my eyes, he examined my eyes under the microscope, lifted up my eyelids, etc... During this entire examination, he never noticed a huge piece of paper in my eye??? How HECK did he miss it???????? HOW???? So I left the office thankful that I was not injured by it. I got home and RAN to the phone to call my own ophthalmologist on his cell phone. He had apparently just gotten off of the phone with the other dr who called to give him a report on my visit. I said "oh, so did he tell you that he got a piece of the schirmer test strip stuck in my eye?" Silence on the other end of the phone. "He did WHAT?" "He left a piece of the test strip in my eye." "OK, I'll be in the office at 9am tomorrow morning. I'll see you then." "But I don't have an appointment." "You do now! I want to make sure he didn't do any damage to your eye! I'll never refer anybody to him again!!" Thankfully my eye was fine and he didn't do any damage. The only other time I had the schirmer test done was when I was in Maryland, and you can bet that they didn't get it stuck in my eye!

My doctor doesn't believe in doing the schirmer test because he says that he is able to just look in someone's eyes and tell how dry they are. Plus, the schirmer test only measures the QUANTITY of tears, not the QUALITY. You can have a perfect score on the schirmer test and still have extremely dry eyes. Like me.

I'd be very interested to know what the quality of your tears looks like. I bet you are missing the oily layer. If you close one of your eyelids, do you notice any tiny white bumps at the base of your eyelashes? Those would be clogged meibomian glands, which lead to dryness because they are the oil glands. If they're clogged then there is not going to be enough oil in your tears. I've got several of them. The way to get rid of them is by using a warm compress. But it is so uncomfortable for me to use a warmm compress that my dr just said to forget about it for the time being. I prefer to use COLD compresses. They feel SOOOOO good!

I think I need to go use one right now. (it's how I fall asleep at night when my eyes are as bad as they are today.) I'm sorry to hear that you are having such a bad day with your eyes. I am feeling like crap too. I hope the new dr has some answers for you. Please let me know what happens,

Elyse
http://www.healthboards.com/ubb/heart.gif

[This message has been edited by purple2067 (edited 05-04-2003).]

Also......

What kind of artificial tear drops do you use? Do you use any kind of artificial tears ointments at night? When you go to the new dr you may want to ask him about a new drop called Restasis. It's not a tear drop. It's a form of Cyclosporine that is supposed to reduce the inflammation in the tear glands and allow you to produce more of the right kind of your own tears. It's only available by prescription, but it's supposed to be the next big thing in dry eye treatment.

I can't believe he didn't notice the piece of the test strip in your eye after examining you for as long as he did! It makes you wonder how closely he was really paying attention when examining you.

I haven't found the warm compresses all that comfortable either. My eyes look much worse after the warm compress. I love the cold compresses too, but I already spend so much time with compresses every day. Maybe I'll try falling asleep that way.

I do have tiny white bumbs at the base of my eyelashes...quite a few actually, and it's mostly my left eye, which is the one that bothers me most usually. I haven't seen any improvement in them over the past few weeks as I've been doing the warm compresses. The only improvement I've noticed is that I don't lose as many eyelashes every day.

I've been using TheraTears lately, and prior to that I was using only Refresh Plus. Actually, I still am using Refresh Plus because I still have plenty left in a box I keep at work. These are all the preservative-free types of course. I also tried Refresh Endura a couple times, but it seemed to make things worse. I don't always use an ointment at night, but I have the last few nights. I've been using Refresh PM.

Today's another bad day unfortunately. Actually, the redness is slightly better. Unfortunately, the stinging is much worse today.

Tomorrow I'm going to ask the doctor about Restasis. I'm also going to bring up the minocycline I'm on. I'm on 100mg 2x a day right now for other reason, but my understanding is that it also helps with the eyelids. However, the recommended dosage (from what I've read) for that is 250mg 4x per day. So perhaps that should be increased.

Chris

Yeah, I really did wonder what he was looking at when he examined me! Was he even looking in my eyes? I can tell you that the reason I didn't FEEL it in my eye sooner than that is because he had numbed my eyes in order to check my pressure. But thank God I eventually felt it, because if not I could have very easily left there with a piece of paper in my eye! Then I would have gotten another ulcer! :mad: :mad: :mad:

I just spent an hour laying with a cold compress... the problem with that is that my eyes feel great while I am using it but 5 minutes after I take it off they are back to feeling like crap again. :( And today I have got to read William Shakespeare's "The Tempest" for one of my classes. The print in the book is so tiny that even when my eyes are good I can hardly see it! So I have taken to reading with a magnifying glass, and I downloaded the Cliff Notes online! (shhhhh.... don't tell anyone!) :)

I have also used Thera Tears but found that I like Bion Tears better. They are more soothing for me. But everybody is different. Thera tears and Bion tears are the two leading brands for people with severe dry eyes.... I just happen to like Bion Tears better. I also used to use the Refresh Endura, but I found that it didn't help me. I like something called "Tears Again Gel Drops". They are thicker than a regular tear drop but not as thick as an ointment, so they don't blur your vision. When I am having a particularly bad day and I can't use ointment because I am driving, I like to use those. They have a disappearing preservative and they don't irritate me.

I hope your new doctor can give you some answers. I will be seeing mine again on wednesday. I don't know anything about Minocycline, but I do know that Doxycycline is proven to help clear up clogged Meibomian glands. The usual dosage of that is at least 100mg twice a day. I took it for a while but I had to start out on a lower dose because I have a sensitivity to anti-biotics. It caused me more problems than anything else (not with my eyes... it gave me stomach problems) and my dr and I agreed that it was not worth it at the time for me to be on it. Once my stomach problems subside we may try it again.

Well, I'm going to go attempt to read The Tempest now. :( UGH!!!

Elyse

ichrisi,

You should talk to your doctor about switching to doxycyline. I have been on minomycin and doxy and the doxy wins hands down with unblocking the oil glands.

I have been on doxy since feb 2003 and went back to my eye doctor on 15th April and he said "your tear film looks significantly healtier than it did in Feb" and that is saying something as I have previously been told I have dry spots on my eyes and my schirmer tests revealed ZERO tears. I do not have to use my eye gels and ointments to the same extent that I was using them before, so it is worth trying.
Good Luck
Christine

Originally posted by ronaldo1:
You should talk to your doctor about switching to doxycyline. I have been on minomycin and doxy and the doxy wins hands down with unblocking the oil glands.


I'll have to consider switching. The problem is that I take minocycline for acne, which it's working great for. I've taken doxycycline, and that has done nothing for me.

I'll have to see what the doctor says when I go in a few hours. If I have to switch for awhile, I will.

Elyse, I may give Bion Tears a try sometime. The TheraTears really only do anything for me if I follow their "saturation dosage" recommendation. I've also used the newer TheraTears gel drops, which seemed okay. If it's a bad day, they don't seem to help for all that long...though they do work better that just regular artifical tears.

Today my eyes seem to be just a little better. That's different...normally the weekends are better and work days are worse, since I have to stare at a computer for 8 - 10 hours every day. Speaking of which, I should probably go do some work before my doctor appointment.

Anyway, I hope everyone's having a better day today. From all the posts I've read, it seems that almost everyone here has been having a difficult time lately.

Chris

Originally posted by iChrisi:
I'll have to consider switching. The problem is that I take minocycline for acne, which it's working great for. I've taken doxycycline, and that has done nothing for me.



The few weeks that I took doxycycline for acne (before I developed a chest rash and had to stop) my skin was fantastic! Not only didn't I break out, but the texture changed too. My pores completely disappeared and I developed skin like a baby's. I really thought it was a miracle! I was crushed when I had to discontinue it. My dermatologist said I was the first person she ever saw who was allergic. La la la, story of my life.

Alright, so I had my latest doctor appointment. I explained the whole history to him and he didn't tell me anything I didn't already know. Well he did say something that contradicts everything I've ever read, but more on that in a minute.

So I got there and the one guy that took me back and took my whole history down didn't impress me. It was going fine until he mentioned that "if you can't wear contacts, have you ever considered LASIK?" Well yes, of course...but I'm not going to do LASIK with this condition. But the fact that he mentioned that just annoyed me. Anyway, I wasn't there to see him, so I finally got to see the doctor.

The doctor just didn't come across as friendly to me. Not for any particular reason...I just didn't get that vibe.

He told me that I'd have this for the rest of my life, which I already knew. He said to keep up with the lid scrubs and warm compresses, and to try adding massaging the eyelids afterwards. He said punctal plugs may help, but there's no guarantee. He also mentioned that it tends to flare up and then I might go a few years without it, only to have it flare up again. I knew all of that already, so I didn't gain much from this visit.

The one thing he said that surprised me (and I'd be interested in hearing some reactons about this one) was if I ever considered using any vasoconstricters such as Naphcon A or Visine to get rid of the redness I told him I had wanted to, but I haven't used them because my understanding is that over time they can make dry eye problems worse. He said they're fine to use periodically, or even daily if I don't mind using them once or twice every day. I'm thinking that might help with the redness, but won't that make the dryess worse over time? That statement completely shocked me. Is he right and I've just misunderstood everything I've read?

Anyway, surprising I'm actually going back on May 19 for the punctal plugs since this place at least accepts my insurance. I'll see how that works out, but I don't know if I'll keep going to this place afterwards. The last optometrist I saw was at least very friendly and very willing to help me and spend all the time with me I needed.

He also said to keep on the minocycline. I forgot to ask about Restasis, because I was still just put off that I didn't feel he was very friently and in shock about telling me it'd be fine to use Visine every day.

I was hoping for better!

Chris

They mentioned LASIK to you since "you couldn't wear contacts"?? Gee, if your eyes are too dry for contacts, I wouldn't think you're a candidate for LASIK. That's like saying, "Could you please guarantee I'll have dry eye problems for the rest of my life? I'll even pay you for it."

As for the lid massage, I was always told that was an important component of keeping the blepharitis under control. After your warm water compresses, press really hard along the base of your lashes. The idea is to squeeze out any thickened oils clogging the glands. When I do it, I can see little dots of oil on the inner lids.

I don't know if the Visine is a good idea or not. Hopefully someone will have an opinion on that.

Sorry your appointment didn't go better. I have one tomorrow, and I'm sure it will be a waste of time.

Oh, just out of curiosity, when did you first start taking the antibiotic for acne and when did your eye problems start?

I'm going to try massaging the eyelids. That hasn't been mentioned to me before by any of my previous eye doctors. I did know about it though...just never tried it.

Some things I forgot to mention about my appointment. He put in some drops and then said "these will help reverse the dilation." Following that, he said "huh..he dind't dilate your eyes much." In actuality, they didn't dilate my eyes at all. Why's he putting in drops that I don't need?

When I left, my eyes were completely red for several hours. It was much worse than I've seen them before. Anyway, earlier I said that my eyes were doing pretty well today. Going to this doctor ruined all of that...ever since then my eyes have felt awful. I can't walk down this hallway at work without having to close my eyes...it stings too much.

I don't even know if I'm going to keep the appointment for the punctal plugs. I can't find much information on it, but from what I can find, it doesn't sound as if the punctal plugs are going to help much in this scenerio, if at all. I guess it couldn't hurt though.

I'm very discouraged with doctors right now. I'm probably going to end up going back to the optometrist I was last seeing, at least for a little while, just because I was most comfortable there. I didn't expect any new information or miracle cures...I'm well aware that it doesn't exist. If I keep up with trying new doctors at this pace, by this time next year I'm going to have to move just to gain a new selection.

Is your appointment with a new doctor or one you've already seen? Good luck with it. But I can see why you're sure it'll be a waste of time...it seems most are.

I started the minocycline in mid-January. I developed these eye problems in mid-January as well.

Originally posted by iChrisi:

I started the minocycline in mid-January. I developed these eye problems in mid-January as well.


Eeek! And you don't think there is a connection? I started taking antibiotics for acne in mid-February and my eye problems started mid-February. Coincidence in both our caes?? Hmmmmm.

The specialist I'm seeing tomorrow is the same guy I saw three weeks ago who couldn't find anything wrong with my eyes. He's a SPECIALIST for Pete's sake. I'm in agony right now (after having two good days), but, of course, NOTHING IS WRONG. I'm not even sure why I'm going back. On Thursday I'm seeing a "top gun" at U of M. I pray she can tell me something.

I'm pretty disgusted, as I'm sure you are.

:(

[This message has been edited by qwerty75 (edited 05-05-2003).]

Originally posted by iChrisi:
I'm going to try massaging the eyelids. That hasn't been mentioned to me before by any of my previous eye doctors. I did know about it though...just never tried it.

Some things I forgot to mention about my appointment. He put in some drops and then said "these will help reverse the dilation." Following that, he said "huh..he dind't dilate your eyes much." In actuality, they didn't dilate my eyes at all. Why's he putting in drops that I don't need?

When I left, my eyes were completely red for several hours. It was much worse than I've seen them before. Anyway, earlier I said that my eyes were doing pretty well today. Going to this doctor ruined all of that...ever since then my eyes have felt awful. I can't walk down this hallway at work without having to close my eyes...it stings too much.



Concerning the use of Visine, or another vasoconstrictor to decrease the redness in your eyes, it usually is ok to use them once a day, maybe twice a day. The constricting medication in Visine doesn't cause dryness in the eyes, but the preservatives will. Especially if the drops are used quite frequently.

So, the doctor put dilation reversal drops in your eyes and you weren't even dilated??? What a moron. Judging by your complaints and symptoms afterwards, it sounds like he used Rev-Eyes (dapiprazole). This drug WILL DEFINATELY cause redness, dryness, and irritation for almost an hour after it is instilled. Did he at least put an artificial tear in your eyes BEFORE using the Rev-Eyes??? That should be done for patient comfort.

I think you should go back to your original doctor since you felt comfortable with him and he was willing to spend some time with you. I don't think the punctal plugs are going to help much in your case.

Sounds like you and Donna both had an adverse reaction to the antibiotics you were taking. :(

Chris and Donna,

I think there's an obvious connection here: The use of the antibiotics.

Tetracylines work by inhibiting bacterial protein synthesis. As a side effect, tetracyclines decrease the fatty acid content of sebum. Sebum is secreted by your meibomian glands on/in you eyelids. If the fatty acid content of the sebum is decreased, it will negatively effect the QUALITY of the lipid tear layer of the eyes and eyelid margin....resulting in irritation, dryness, stinging, etc...

I think this is possibly a cause for the irritation, burning sensation of the eyelids you're both experiencing. There may also be a possible mild allergic reaction playing a role in this too.

I've contemplated the thought of it being a reaction to the antibiotics before. I did try to stop taking it for several weeks in fact. That didn't help.

I started taking it again, but perhaps I should go back off of it. I know, the timing would point to the antibiotics. I guess I assumed it wasn't the cause since there wasn't improvement when I went off of it for a few weeks and that it's used to help with clogged oil glands (plus maybe a little bit of denial since it's working for what I take it for). But your explanation makes sense, and maybe there is even an allergic reaction to it.

Donna...you're off of your antibiotic now, right? How long has it been and how long did you take it for?

Chris

I forgot to answer one question. I do believe he used artificial tears before using the Rev-Eyes. I'm not really sure, but he did use some drop prior to it. I didn't ask what it was either.

What I'm wondering now is that if both Donna's and my eye problems are a result of an adverse reaction to the antibiotics, which seem to be reasonable assumptions, will it ever get better?

In any case, I'm likely going to cancel the May 19 appointment for punctal plugs. I don't see the point in having those inserted. I guess I'll try stopping the minocycline as well.

Anyone know if any topical acne medications, such as Retin-A Micro (which I'm also on) can have any adverse effect on the eyes? I wouldn't think so, but I don't know much about that.

Boy Chris, your doctor really does sound like an idiot! He put reversing drops in your eyes and they weren't even dilated? HELLOOOO??? How difficult is it to remember whether or not you dilated the patients eyes? All he had to do was LOOK at your pupils before putting in the reversing drops! And somebody in the office actually mentioned LASIK to you? Did that person know that you were there for a dry eye problem? Before I knew what I know now, I had asked my dr about doing LASIK on me since I couldn't wear contacts. He pretty much said the same thing that Donna did... "do you want a guarantee that you will have dry eyes for the rest of your life?". He said that even if my dry eyes were to miraculously get better, he would never even consider doing LASIK on me.

I am sorry to hear that you didn't get everything that you needed out of your appointment. Hearing everyone's stories about bad doctors really makes me realize just how UNIQUE my ophthalmologist really is. I mean, I have always known that he is unique because he goes way above and beyond for his patients. He'll do just about anything to make a diagnosis and give a patient the correct treatment. But now I realize that the number one reason that he is unique is because he's COMPETENT!! Why is it that competency has become such a unique attribute in the medical profession?

Now about the Punctal Plugs. I think that they can't hurt. Why not try them? If you don't like them, they are extremely simple to remove. Even if they don't help tremendously, if they help preserve just the tiniest bit of your own tears, it is worth it. I'll try to find you some information on them, maybe with pictures. :) I am surprised that the oculartimes website is not back up and running yet. I have got tons of ophthalmology websites bookmarked. I'll see what I can find. And if this dr thinks that the plugs will help you, WHY ON EARTH is he making you wait until May 19th? If he had the right size plugs in the office and you decided to have it done, he could have done it right there on the spot. It takes no more than 30 seconds per eye. Numb the eye with drops, pop the plugs in, look to make sure they are in properly, and be on your way. This dr sounds very strange to me. If you didn't get a good vibe from him then definitely don't go back. I usually recommend going to an ophthalmologist for problems like yours, but if you are comfortable with your optometrist and feel that you are getting better care there than anywhere else, then by all means, go back to the optometrist. Can the optometrist refer you to a good ophthalmologist? (if that is what you want.) Also, if you decide you want the plugs, can the optometrist do it?



[This message has been edited by purple2067 (edited 05-05-2003).]

http://www.avclinic.com/Dry_eye.html http://www.dryeyepain.com/StandardTreatments.htm#punctal-occlusion

Here are some websites with descriptions of punctal plugs. Hopefully they won't get removed before you see them. :)

Originally posted by iChrisi:

What I'm wondering now is that if both Donna's and my eye problems are a result of an adverse reaction to the antibiotics, which seem to be reasonable assumptions, will it ever get better?




That's what I'd like to know. I can't find anything in the literature to support a connection between the two (although, granted, I'm limited to what can be found online) and every doctor I've been to has dismissed a connection. Wouldn't even consider the possibility, I should say. I started taking Zithromax in February. Prior to this my eyes were fine and I was happily wearing my contacts as I had for the past 28 years. I took the initial 5 day dose, then I took one dose every three days. Zithromax is tissue-based, so you don't need to take it every day. The first 5 days I was fine, but every three days my eyelids hurt a little. It would go away, so I shrugged it off, but after the third time it didn't go away and my face started burning too. Doesn't this sound like an allergic reaction? I stopped the Zithromax, but the burning didn't go away. After a week I saw an ophthalmologist who barely looked at me and said I had blepharitis. And then he prescribed Tobradex, which is half antibiotic, in the same family as Zithromax. And he insisted I keep using it, even though I told him it wasn't working. Arghhh. Sooooo if I started off with an allergic reaction, I just perpetuated it for weeks. And my sore lids and clogged glands didn't start until after I was on the Tobradex for a few weeks.

Anyway, I've been off everything (except lid scrubs and warm compresses) for three weeks now in my right eye. I was using Pred Forte in my left eye, but it didn't help. I was so psyched because I had terrific days on the weekend, and thought I was getting better. And then yesterday was a horrific day. I couldn't even sleep last night because my lids hurt so much.

So what's the answer? I can't get an eye doctor to consider the antibiotic connection, so I don't have an informed opinion as to whether or not this will go away. I'll bring it up with the specialist again today. He's the one who said I don't even have blepharitis, or anything else for that matter... so then why is my theory so far-fetched? It's better than anything he came up with (which is a big fat nothing).

Elyse, I wish I still lived on SI... I would definitely see your guy. Does he ever do email consultations (for a fee)? I'm guessing not, but I'm getting desperate here! I wish someone whould just listen to me, or care enough to try to solve the problem.

Originally posted by purple2067:
And somebody in the office actually mentioned LASIK to you? Did that person know that you were there for a dry eye problem?

That person did know I was there for blepharitis and dry eye symptoms. That place does LASIK, so perhaps he was trying to "sell" it to me, since I can't wear contacts anytime soon, if ever. But yeah, when he mentioned that I was completely surprised. He had to ask me twice actually because the first time I didn't even respond...I didn't know what to say to that!

You know, all these doctors have these web sites that make them sound like the greatest doctors in the world. But yet it's so hard to find one that really takes the time to help and go through all possibilities and try different treatments. And then they do stupid things like using reverse dilation drops when they didn't even dilate the eyes. Couldn't he have at least warned me that my eyes would be very red and burn constantly afterwards for awhile? My eyes don't recover from that very quickly! I wasn't feeling "normal" (for me) until just before I went to sleep last night.

And if this dr thinks that the plugs will help you, WHY ON EARTH is he making you wait until May 19th?

That's a good question, and one I was wondering myself. Why couldn't he do it right there? I don't know...he didn't impress me, nor did he seem very understanding. He did give me some line about how he has skin like mine and has to do lid scrubs as well, but that doesn't mean that he has the burning and red eyes, or even that he was being truthful. The first thing he said to me after examining me was also "you need to understand you'll have this for the rest of your life." I already knew that's very possible, if not very likely, but it didn't need to be the first thing said in that manner.

I always get the feeling from these opthalmologists that they have more important issues to deal with...like their LASIK patients.

My preference would be to find a great opthalmologist who is as understanding and willing to help as my optometrist. I'll be going back to the optometrist though because them actually being able to listen is the most important thing I think. I'll have to call the optometrist sometime soon and see what she say sabout punctal plugs and if I can be refered to someone else who can do them. I'd love for the optometrist to do it, but they don't accept my insurance. I have no problem paying for office visits for a doctor I actually like, but the punctal plugs are a little too much to pay up front.

If I was referred to an opthalmologist elsewhere, I wouldn't be surprised if it was to the guy I just saw. After looking at the web site for the office my optometrist works out of, the doctor I saw yesterday is listed as one (of many) co-managing physicians.

As for the possible connection between the antibiotics and these eye problems, when I went off of it for a few weeks it was actually due to the recommendation of my eye doctor. Both opthalmologist's I've seen have said "great, you're already on a tetracycline...that helps with the eyes." The optometrist did actually bring up that acne medications can have that effect on some people. My understanding however is that it takes about 5 days for minocycline to clear out of your system, so it was expected to have improved over the few weeks I was off of it. But maybe, if it changes something in the eyelids, it's not so quick to disappear. But like you I'm limited to what's online, and I can't find anything about any possible connections between any antibiotics and eyelid problems. I don't expect to find any real answers to our questions about if this will ever go away or not if caused by antibiotics.

Donna, I don't understand how one doctor can see blepharitis and the next see nothing wrong. I hope the doctor at U of M will help more, or at least confirm a diagnosis of blepharitis or something. At least then you'd know what's wrong, instead of being left to wonder who to believe.

Originally posted by iChrisi:
Donna, I don't understand how one doctor can see blepharitis and the next see nothing wrong. I hope the doctor at U of M will help more, or at least confirm a diagnosis of blepharitis or something. At least then you'd know what's wrong, instead of being left to wonder who to believe.



Well, I just got back from my appt., and it was as disappointing as I thought it would be. The specialist again couldn't find anything wrong. I asked, "Do I have blepharitis?" and I got a resounding NO. I told him the first ophthalmologist insisted that was my problem, and he said, "Well he's wrong." So who do you believe?

I brought up my antibiotic theory and he said he didn't want to say it's impossible, but he has never heard of anything like that happening.

I also mentioned that my eyelashes are still falling out at the rate of 5-10/day, and he said, "Oh, you have plenty of eyelashes!" and that I probably always lost that many. Oh c'mon now. I think I would know if every day for my whole life 10 eyelashes fell out. And this guy won an award last year for "Specialist of the Year"!

Hopefully I'll have better luck at U of M on Thursday.

Sorry to hear it was disappointing...not surprised though of course. I still don't get it.

When a doctor can't physically find anything wrong, my understanding has been that most diagnoses are made from symptoms. Sometimes that's all doctors have to go on. I can't go back and read all of your prior posts right now, but if I remember correctly, you have the symptoms that point to blepharitis.

I don't know how a doctor can win "specialist of the year" when he can only tell he can't find anything wrong.

About the eyelashes, I would think you'd know if you were losing that many every day for your whole life. I was losing between 5-10 as well, except that's one thing that has improved significantly since I've done the warm compresses.

Maybe you'll have more luck on Thursday. You need to at least be diagnosed with something so you can find the right treatment. But I still say the diagnoses of blepharitis has to mean something, I would think.

Originally posted by iChrisi:

When a doctor can't physically find anything wrong, my understanding has been that most diagnoses are made from symptoms. Sometimes that's all doctors have to go on. I can't go back and read all of your prior posts right now, but if I remember correctly, you have the symptoms that point to blepharitis.

Maybe you'll have more luck on Thursday. You need to at least be diagnosed with something so you can find the right treatment. But I still say the diagnoses of blepharitis has to mean something, I would think.


I'm going to repost what I posted before:

Tetracylines work by inhibiting bacterial protein synthesis. As a side effect, tetracyclines decrease the fatty acid content of sebum. Sebum is secreted by your meibomian glands on/in you eyelids. If the fatty acid content of the sebum is decreased, it will negatively effect the QUALITY of the lipid tear layer of the eyes and eyelid margin....resulting in irritation, dryness, stinging, etc...

I think this is possibly a cause for the irritation, burning sensation of the eyelids you're both experiencing. There may also be a possible mild allergic reaction playing a role in this too.


I'm starting to firmly believe that the use of the antibiotics is the source of the lid discomfort/irritation you're both experiencing. It is a result of the decreased fatty acid content of the sebum, AND/OR an adverse, mild allergic reaction to the antibiotic.

The absence of any signs of blepharitis by the 'specialist' leads me to believe that Donna DOES NOT have blepharitis. I think the first specialist she saw used this diagnosis for lack of a better or more definative diagnosis.

The definition of blepharitis is a simple and straight foward one: inflammation of the eyelid(s). Blepharitis is quite difficult to diagnose soley on symptomotology. There usually has to be much redness, pain, flaking, etc of the eyelids to confirm the diagnosis along with a thorough history.

This is what I would do for treatment:
1. Cool or warm compresses as needed, whichever yields the most relief.
2. Unpreserved artificial tears...Thera Tears recommended.
3. Unpreserved bland ophthalmic ointment at night or even during the day if cosmesis isn't a concern.
4. Dietary supplementation with flaxseed oil (again, Thera Tears Nutrition recommended).
5. Plenty of distilled drinking water during the day.
6.)I would also discontinue any lid scrubs, medicated ointment, or medicated drops. The scrubs may be too abrasive/traumatic to the delicate eye lids and making things more irritated. The medications may be too irritating as well...preservatives and all.
7.)Wait. If there was an adverse rxn to the antibiotics, time will help get things back to normal.

HTH

Qwerty, you seem to be very knowledgeable about all of this. I'm sure you've mentioned this in some post awhile back, but what's your background that makes you so familiar with this?

Maybe you can give me a guess as to the answer to a question I've been wondering. I wasn't diagnosed with blepharitis until my third eye doctor. I had two visits to my first doctor, probably about 10 to my second, and then was finally diagnosed with blepharitis on the 4th visit to the third doctor. Like you said, signs of blepharitis are visible. I had the flaking eyelashes, loss of eyelashes, red eyelids, and clogged meibomian glands. The only thing is my eyelids don't burn...just my eyes. Any guesses as to why it would take so long for doctors to come up with this diagnosis?

Originally posted by iChrisi:

I wasn't diagnosed with blepharitis until my third eye doctor. I had two visits to my first doctor, probably about 10 to my second, and then was finally diagnosed with blepharitis on the 4th visit to the third doctor. Like you said, signs of blepharitis are visible. I had the flaking eyelashes, loss of eyelashes, red eyelids, and clogged meibomian glands. The only thing is my eyelids don't burn...just my eyes. Any guesses as to why it would take so long for doctors to come up with this diagnosis?

It shouldn't have taken that many doctor's visits to come up with the diagnosis. Especially if you said you DO have the signs of blepharitis...flaking, redness, clogged glands. I guess I don't really have an explanation as to why it took so long to come up with that diagnosis.

I read that the first doctor prescribed Tobradex for one of your eyes...? Right? Then another prescribed Tobradex, Ocuflox, and Pred Forte...? Right? None of those medications are commonly used as a 'front line' for the treatment of blepharitis.

I may be getting you and Donna confused (some of these posts are so long, I go cross eyed and get dizzy spells trying to read them :) )but one of you, or both of you, started experiencing discomfort upon using a tetracycline derivative...right? So there has to be some sort of connection there. I'm sticking with the fatty acid/sebum 'hypothesis'.

Qwerty, thanks for your post :-)

I took doxycycline for a few weeks in Dec-January, but my problem started when I was on an erythromycin. Can I assume it does the same thing as a tetracycline, since it was prescribed for acne?

I haven't used anything (at least in my right eye) for three weeks. I actually had some improvement over the weekend, but yesterday and today were horrible. Why? I mean, if the theory that this is related to antibiotics is correct, wouldn't it be expected to slowly get better as the antibiotic left my tissues (or whatever was going on)?

Also, why could the specialist not have seen anything? My husband commented that my eyelids look "bruised" although the doctor said there was no redness, swelling, flaking, or debris. He did admit a couple of my glands were clogged, but he said there was no way to get rid of them unless I rubbed them off with a Q-tip (?) What? I was sitting in his chair in a significant amount of pain while he told me "everything looked good." Ugh!

I just want a diagnosis of "something"!

Originally posted by qwerty75:
It shouldn't have taken that many doctor's visits to come up with the diagnosis. Especially if you said you DO have the signs of blepharitis...flaking, redness, clogged glands. I guess I don't really have an explanation as to why it took so long to come up with that diagnosis.

Then I'll go with my theory that they were just incompetent. I forgot to add that my eyelids do itch, and it's worse in the corners. The type of blepharitis I have is actually angular blepharitis. Can't find too much on that specifically though, except that it affects the corners of the eyelids, which is where the inflammation is at it's worse according to my doctor.

I read that the first doctor prescribed Tobradex for one of your eyes...? Right? Then another prescribed Tobradex, Ocuflox, and Pred Forte...? Right? None of those medications are commonly used as a 'front line' for the treatment of blepharitis.


Right. First it was Tobradex in my left eye only, because he insisted my right eye was fine twice despite being terribly uncomfortable. I was told it was conjunctivitis in my left eye. Then the second one agreed with the conjunctivitis diagnosis and prescribed all three of those drops for both eyes, because the ulcer had developed apparently out of nowhere.

I'm the one that went on the tetracycline derivative as well.

I'm liking the antibiotic theory. I hate this guessing though. I wish I hadn't started wearing contacts in early January, even though I only wore them for two weeks until these problems started. That would at least take one possible cause away. But I haven't read anything about contact lens use causing blepharitis, so I'm not sure if there's any possible link there.

Originally posted by DonnaDe:
He did admit a couple of my glands were clogged, but he said there was no way to get rid of them unless I rubbed them off with a Q-tip (?)


So am I to understand that it is possible to rub the clogged glands off with a q-tip? That makes absolutely no sense to me!

Even if he meant that you should use a q-tip to massage your oil glands, that would still be odd. I try to avoid poking myself in the eyes with q-tips! :)

I think that your theory about the anti-biotics is correct. I just wish somebody would give you a diagnosis! Donna, I am sorry to hear that your appointment with the so-called "specialist" did not go so well. Hopefully your appointment at U of M will go much better and your new dr will have some answers for you. Incidentally, I was doing some research online and came across a website for the Kellogg Eye Center at the University of Michigan. Is that where you will be going?

Originally posted by DonnaDe:


Elyse, I wish I still lived on SI... I would definitely see your guy. Does he ever do email consultations (for a fee)? I'm guessing not, but I'm getting desperate here! I wish someone whould just listen to me, or care enough to try to solve the problem.


I can barely even get him to respond to MY emails! I don't think he has the time to do email consultations. He hardly even has the time to read mine and get back to me. :( I used to be able to get in touch with him at the drop of a hat, but his practice has picked up a lot since moving to the new office, so even though he is always around, it is much more difficult to get in touch with him. I sent him an email last week about my eyes, asking him about using an allergy drop. But I am not sure if he even got it, because he never wrote back. If I wasn't going to be seeing him tomorrow I would write him again or I would call him. I loved it when I could get in touch with him 24/7 by his cell phone (I can still get him in an absolute emergency) but now it has become harder. But at the same time I'm very glad for him that his practice has picked up. It means he'll be around for a while! I partially have myself to blame for his being so busy though... if I'd just keep my mouth shut and not tell anybody about him he would have time to return my emails! :) But I want him to have a thriving practice.

I will mention the email consultation thing to him tomorrow and see what he says. I really doubt it though.

You know, there is another way to get the opinions of some really good ophthalmologists.... you have to pay for it though. I'm not going to post the actual web address on here because it will get removed, but I'll tell you to go to yahoo and do a search for AskPhysicians. (or just add a dotcom after the name!)
I found this website and I posted my questions there and they are the ones who mentioned Dr. Terry O'Brien in Maryland. Once I brought up his name to my dr, he totally agreed. My dr also said that he knows some of the drs who post on the site. (one of them was his senior resident!)

So maybe that will help you. Ask them for a referral to a really good dr in your area.

I hope this doesn't get removed before you see it.

Good luck with your appointment at U of M.

Elyse

[This message has been edited by purple2067 (edited 05-07-2003).]

Well I was going to try to not post here while at work today, but I can't concentrate on my work right now, so I thought I would. It seems my problems from last night have carried over to this morning. My eyes feel awful right now. It's just a constant stinging. And the artificial tears aren't helping at all right now either...not one bit. Unfortunately, when it starts out bad on any given day, it doesn't ever seem to get better...so I think this is going to be a bad day for me.

Elyse, Donna...how are you both doing today?

[This message has been edited by iChrisi (edited 05-07-2003).]

Yes, that's where I'm going tomorrow... the Kellog Eye Center at U of M. I'm going to be really depressed if they have nothing to offer me.

I've had the AskPhysicians site bookmarked for quite some time now. Unfortunately, I have been unable to register. I never get the necessary comfirmatory email. I've even written the webmaster with no response :-( I saw how helpful they were to you, though, especially with supplying names!

Chrisi, sorry your day is not going well. I know what you mean.. if it starts out bad eyewise, it's not going to get better! I spent the morning out in the freezing rain at a petting farm with my preschooler. Oh the joys of class trips ;) My lids hurt, but what else is new?

Suprisingly my eyes do feel a little better tonight (though still much too awful to consider anywhere near acceptable). Or maybe I just got use to it so it doesn't feel quite as bad by now.

This morning and early afternoon, I think I was in the most discomfort I've been in since these problems (outside of the ulcer) started. Thank goodness I have some periods where my eyes feel at least decent, or at least not as bad as this morning. If they were that bad all day every day, I don't think I'd be able to function.



[This message has been edited by iChrisi (edited 05-07-2003).]

Chris and Donna, I am sorry to hear that you are both still feeling crappy. As you know, I am feeling really bad too. I just don't seem to be having too many good days right now.

I occasionally wake up feeling "decent" in the morning, but that doesn't mean it is going to be a good day. Or if I wake up feeling bad that doesn't mean it will be a bad day. My eyes are very unpredictable, as we all know!! It also depends a lot on the weather (rain, pollen, etc...)

Chris, have you given any more thought to getting punctal plugs eventually?

Donna, I can't believe the trouble you are having registering for askphysicians! Did you ever get a response from the webmaster? You must have read my extremely long post on the website. Do you think I gave them enough details? :) I wish I could go on there and ask your question for you, but you have to pay! :(

Good luck with that and please keep me updated on how you are both doing.

Elyse
http://www.healthboards.com/ubb/heart.gif

Well the burning isn't nearly as intense today, though it's still there. I can at least get something accomplished today as long as it doesn't get any worse.

Anyway, I have thought about the punctal plugs, and I think I would really like to try them. They can always be removed afterall. It just doesn't sound like they're going to help much based on my reading, but it's worth a shot. Afterall there's plenty of people that have these problems due to a lack of oil in the tears, like me, who have their tear ducts plugged.

I've stopped all the acne meds I was on, plus I have a two week vacation coming up soon, during which I'll be going to California and Las Vegas. I'm hoping that stopping the meds (which are hopefully the cause of this), plus a change in environment and getting away from the computer and work for two weeks will help a lot as well. I won't count on it though, because I don't want to be disappointed.

Elyse, you have to pay at AskPhysicians? It doesn´t seem so from the site. Not that it matters, because I can´t even get a response from the Webmaster.

Christi, I was thinking about you last night. You know, you may have blepharitis, which you´ve gotten under control, but your topical acne medicines could be causing the eye irritations and burning. Getting off everything and going on vacation sounds like a great idea. Wouldn´t it be wonderful if everything cleared up?? If it did, you could reintroduce your acne meds one at a time, and see if you have an eye flare up.

I've thought about that recently actually. Maybe I've had blepharitis, but the acne meds irritated it and made it much worse.

If it were the contacts that irritated the eye, I'd think that I wouldn't have been able to wear them for two weeks without the sudden redness and burning I now have.

It would be wonderful if it all went away after stopping the acne meds and taking a vacation. It'd also be nice if I could KNOW it was the acne meds that started this mess. We'll see what happens.

I've thought about that recently actually. Maybe I've had blepharitis, but the acne meds irritated it and made it much worse.

If it were the contacts that irritated the eye, I'd think that I wouldn't have been able to wear them for two weeks without the sudden redness and burning I now have.

It would be wonderful if it all went away after stopping the acne meds and taking a vacation. It'd also be nice if I could KNOW it was the acne meds that started this mess (and I'm sure you feel the same way about your own eye troubles). We'll see what happens.

Okay, I've done some research on the timing of all of my problems. Perhaps someone with some knowledge of how medications work can tell me if they still think this could be a reaction to the acne meds.

On January 9th, I had my dermatologist appointment and was given minocycline and Duac Gel. My eyes were fine at this time.

On January 11th I had my visit to an optometrist and was fitted for contact lenses. They were Acuvue 2 lenses.

Saturday, January 25th I went back so she could see how the trial lenses were working out. They were fine, except that they were not comfortable in my right eye (the eye giving me the least of the problems between the two, but later developed an ulcer). It felt dry all the time. I was also getting starburts in the dark, but not very bad. She changed the power on them, and I'm not sure if anything else was changed.

That following week, maybe just a couple days later, was the beginning of my current problems. I stopped wearing the contacts immediately.

So actually, the timing would indicate the second set of contacts. But it's soon enough to also be the meds I guess.

Anyway, due to the timing, it makes me a little less hopeful that the acne meds are the cause of my problems.

No, it could still be a reaction.

When I took doxycycline in Dec-January, I took it happily for a few weeks, then >boom< I got a big rash all over my chest and neck. It was definitely from the antibiotics, no doubt about it. As soon as I stopped taking them, the rash began to go away.

The side effects don't have to be immediate for there to be a link.

Originally posted by DonnaDe:
Elyse, you have to pay at AskPhysicians? It doesn´t seem so from the site. Not that it matters, because I can´t even get a response from the Webmaster.



Yes, it is a pay site. It is either $10 or $15 per question. I forget which. You have to register and then when you go to post your question you also enter your payment method. After you pay you are allowed to continue to talk to the doctors as long as you do it under the same topic. In other words, you pay once and then when they post a reply, if you want to talk to them about it you don't have to pay. They usually tell you to feel free to ask follow-up questions. I did, and they were answered.

There used to be a site that was run by the Henry Ford Healthcare system. It was a forum just like this one, only doctors were the ones who answered your questions. It was completely free. Only, I found it too late for it to be of any use to me. It's not running anymore. I found the archives. :(

Chris, it is so nice that you are going on vacation. But a word of advice... Las Vegas is a dry climate. Bring PLENTY of tear drops with you!!! My parents want to move to Vegas eventually and they keep mentioning that they want me to come with them. My eyes are dry enough, thank you very much! I will stay right where I am!

When are you leaving for your vacation?

You know, I am a little concerned about the vacation. Not only is Las Vegas a dry climate, but wasn't California just named the smoggiest state or something? That probably isn't helpful either. And I thought I've also read that flying is bad for dry eyes, but I could be wrong(I've never been on a place before, so I wouldn't know).

Really, this could just end up being two weeks of torture. But I'm hoping that my mind will be on other things enough to not think about my eyes. Or hopefully the time away will just help. We'll see.

I leave on May 25th and return on June 8th. I don't know what I'm going to do without being able to come here every day! Actually, I think I'll be able to sneak on every now and then since we're staying at my grandparents, who live out there.

Either way, I'll have plenty of tear drops with me.

Moving to Las Vegas would be a lot of work for you...you'd have to kidnap your eye doctor and everything. It's much easier to stay where you are.

[This message has been edited by iChrisi (edited 05-09-2003).]

Originally posted by purple2067:

Yes, it is a pay site. It is either $10 or $15 per question. I forget which. You have to register and then when you go to post your question you also enter your payment method. After you pay you are allowed to continue to talk to the doctors as long as you do it under the same topic. In other words, you pay once and then when they post a reply, if you want to talk to them about it you don't have to pay. They usually tell you to feel free to ask follow-up questions. I did, and they were answered.

There used to be a site that was run by the Henry Ford Healthcare system. It was a forum just like this one, only doctors were the ones who answered your questions. It was completely free. Only, I found it too late for it to be of any use to me. It's not running anymore. I found the archives. :(



Thanks for the info! I've found a number of free medical boards, but on two where doctors actually answer, I've gotten ridiculous responses. (Remember the one that said there must be something going on in my life that I don't want to look at? LOL)

I actually just told me story to AskPhysicians. It was only $10, so what did I have to lose? I don't really expect much, but maybe they can refer me to a better doctor or something. They'll probably tell me to give it more time or something.

I didn't leave out anything at all I think. It was quite long, but I think I actually got all of the details in for once. Hmm...maybe I'll just print that out if I end up seeing any new doctors instead of explaining it again.

Donna, have you only given them one e-mail address? You might want to try giving them another one. I don't see why it'd possibly be a problem with that, but perhaps that has something to do with it since you're not getting the confirmation of any response from the webmaster.

I'll try that, thanks!

Chris, I am looking forward to reading your post on AskPhysicians. They are pretty good. In fact, like I said before, my dr told me that one of the guys that responds on that board was his senior resident at Massachussetts Eye & Ear Infirmary. I hope they have some answers for you.

You know Chris, you are just too funny. You really had me cracking up with this one....

This is so true....
Originally posted by iChrisi:
Moving to Las Vegas would be a lot of work for you...you'd have to kidnap your eye doctor and everything. It's much easier to stay where you are.


LOL LOL LOL! Yes, I would have to find out his address, break into his house in the middle of the night and kidnap him and lock him in a trunk with air holes! LOL! :) Really, when I even go away somewhere for a weekend, I panic. What if I have an eye emergency and I am not home? You know, this is going to sound ridiculous. I even have to laugh at myself for this one! In January when I was leaving for Maryland to see Dr. O'Brien, I actually thought to myself "OH MY GOD! What if I am in Maryland and I have an eye emergency? I won't be able to see my dr! What if I have an emergency? What if I get something in my eye? Where will I go? Who will take care of me?" A million scenarios ran through my head. I was afraid I would not get good care if I had an emergency. DUH!!!!!!! HELLO????? EARTH TO ELYSE!!! I was going to Maryland for the sole purpose of going to see Dr. O'Brien at the Wilmer Eye Institute (which, I might add, has a 24 hour eye emergency room and trauma center.) I trust my dr so much and I have gotten so used to him being the only one to examine my eyes that I actually got worried (only for a second) that if I had an eye emergency in Maryland I would not be able to get good care because he wouldn't be there! But, the fact that Wilmer has an eye emergency room staffed by ophthalmologists gave me some comfort. (my reasoning was "OK, if I wake up in the middle of the night with blinding eye pain, I have someplace to go for help! But they just better call Dr. O'Brien and make him come down there to see me!)

I have to say, it is quite strange for me to have somebody other than my dr examine my eyes. I have gotten so used to him that it is just plain weird for me when there is somebody else on the other end of the ophthalmoscope! And I have had too many bad experiences with other doctors. (getting the schirmer test strip stuck in my eye, etc...) In fact, my dr told me that he is looking into hiring a technician to bring patients into the room and check their pressure before he comes in there. I said "excuse me? You know I don't trust anybody with my eyes. Nobody but YOU is going to come near my eyes (with the possible exception of Dr. O'Brien)! And considering the terrible time I have had with my eyes, you are lucky that I even allow YOU to get near them!" He laughed and promised me that if he ever does hire anybody, he will tell them that I am off limits! I swear, I will sit there with my eyes closed if any technician ever tries to come near them! My eyes are for his hands, and his hands only! This is what the conversation between me and the technician would be like:

Technician: "OK Elyse, I'm going to check your eye pressure now".
Me: "No offense to you, but nobody but Dr. M goes near my eyes. So get that idea out of your head and get your grubby little hands away from my eyes!"

Ok, maybe I wouldn't be quite that rude. :)
But I hardly trust anybody to go near my eyes.
So therefore, I can never move from Staten Island.(unless I move to Maryland and take up residence near John's Hopkins and Dr. O'Brien!) I told my dr that he is never allowed to leave either. :) (hence, the idea of keeping him as a pet.) Like I said before... Other people have cats and dogs. I want an eye dr.

[This message has been edited by purple2067 (edited 05-09-2003).]

Originally posted by purple2067:
(getting the schirmer test strip stuck in my eye, etc...)

I had this done yesterday, and was wondering how it could have been forgotten. The doctor only put the end of the strip in my eye, under the lower lid. Most of it was hanging out, and flapping most annoyingly when I blinked. He then removed the entire strip. How else would you read it? The tears move down the strip, and it turns blue where they wet it. Did your doctor tear off part of it? It doesn't make sense, as you have to see the whole thing to read the numbers.

I wish I knew what it was like to be so use to one eye doctor! But yeah, if I had the relationship with any doctor that you have with your eye doctor, I'd panic when going away too. So yes, you'd have to kidnap him if you moved, because it's not easy to find a doctor like that...i don't see any other way around it. I wish I lived in NY so I could see him!

My story at AskPhysicians is excessively long, like most things I write. I found yours actually, and mine looks even longer, but it's probably really about the same...and I haven't even been through nearly as much as you! It'd be shorter if my first two doctors knew what they were doing. But if they're going to charge $10 just for asking some questions, I'm getting my money's worth out of it. No way am I spending $10 for those short questions that are a couple sentences long. And at least, for once, a doctor won't get to rush me through my story.

And now for the technician thing, I'd say don't get me started on that, but since you have, here's my rant about that...

I hate when doctors have technicians take the pressure and the patient's history. But it's so hard to find a place where they don't do that around here. In fact, I haven't found one. I want to talk to the doctor, not the technician.

You know, when I went to the doctor on Monday, the technician is the one that checked my pressure, he's the one that flipped my eyelids, he's the one that took down my whole history and asked me questions. The doctor came in, asked a couple questions, looked at my eyes for about 20 seconds, agreed with the optometrist that I have blepharitis and clogged glands, explained I'll have this forever and there's isn't really much else they can do, and left. The technician did more! Anyway, that really bothers me. I'm there to see the doctor and have him examine me, not some technician. For example, the technician flipped my eyelids and saw the GPC I had, and agreed with my optometrist that it's not enough to cause these problems. What does he know? I want to hear the doctors opinion, not his! He's also the one that brought up LASIK.

Okay, my rant is done. Am I the only one annoyed by this?

Anyway, I hope to get a response from AskPhysician's soon. Maybe they can at least tell me the name of a good doctor in the area, and any other thoughts would be nice.

One of the doctors from there is in Santa Monica, CA. I'll be in Hollywood for a couple days, which is about 25 minutes from there...I'm tempted to make an appointment, but I figure what's the point if I can't ever see him again.

Chris

Originally posted by iChrisi:

Anyway, I hope to get a response from AskPhysician's soon.



You might want to ask your question at WebMD too. It's free, and an ophthalmologist will answer your question. I wasn't thrilled with the response I got, but it never hurts to ask!

Originally posted by iChrisi:
You know, when I went to the doctor on Monday, the technician is the one that checked my pressure, he's the one that flipped my eyelids, he's the one that took down my whole history and asked me questions.
Chris

Oh, no no no no no. :nono: The technician should not be flipping your eyelids! No no no. That's not the technician's job. In my doctor's old office (when he was part of a different group) they had a technician there. He was very good. I liked him a lot. He was the one who gave me the vision test, and I think he may even have checked my pressure once or twice. But this was way before I started with all of these problems. When I got the eye ulcer, all the technician did was bring me into the room, ask me how I was feeling and tell me that the dr would be with me shortly!!

Once I had to go into brooklyn to see my doctor at a different office. They had technicians there too. This woman decided that it was her place to look at the spot on my cornea where the ulcer had previously been and examine it more closely. She checked my pressure (against my better judgement) and then declared that she didn't even see a spot where the ulcer was. WHO THE HECK ASKED YOU???? Then after she finished checking my pressure she wanted me to put some tear drops in my eyes. She handed me GenTeal tears. Those are very good, but not for me. I said "I can't use these. I'm allergic to the preservative in them." She didn't have anything else so I had to get my own out of my purse. But being that we were in an ophthalmology office, I find it hard to believe that she didn't have anything else. Just didn't want to go get me some.

The reason that my dr said he may want to hire a technician is so that he can spend more time examining his patients and less time taking a history, etc... He said he'd rather spend an hour examining the patient and discussing treatment options than taking a history and doing things that he could have a technician do. He feels that he could better serve his patients this way. He also said that he may hire a scribe to write down notes in the charts so that he doesn't have to do it, he can spend even more time talking with the patients. I truly believe that he wants to do this for the benefit of the patients, not just to make things easier for himself. But I told him there is no way that any technician is ever going to come near me again (I am sure there are some wonderful technicians out there and I don't mean to insult anybody!). And he said that there is no way that he would allow it. :)

Chris, I totally agree with you that it is worthless to have a technician if the doctor is going to use that person to cut down on the amount of time that he spends with his patients. But I can tell you that my dr would probably use it the other way around... so that he can spend more time doing a meaningful exam and less time checking pressures, etc... It must be extremely annoying when you go to see the dr and the technician is the one who you wind up talking to. My dr always spends at least 10 minutes examining my eyes, and another 10 or 15 minutes talking to me. My average appointment with him is 20-30 minutes, just him and me in the exam room with him examining me and us talking. I really love the way that he runs his practice. The receptionists are wonderful. They think they're my second mothers. They will always get a patient an appointment for an emergency. You may have to wait 2 hours in the waiting room (which is another reason for having a technician, so the patients get taken sooner) but you'll always have a meaningful visit with him. Technicians are good if they just do their jobs... i.e. take the pressure, get a history, check your glasses and get out. But even after the tech takes your pressure, if it is high the dr should still check it himself. And the dr should ALWAYS go over your medical history with you.

I think that the technician was overstepping his bounds when he flipped your eyelids. I don't even like it when my dr does that, because it is so uncomfortable! But if the technician is not the one prescribing the medicine, why on earth is he the one flipping your eyelids? That is the doctor's job!!!! This just really makes me mad. I wish you could get better care. You know, I saw on askphysicians that there is a dr there in Illinois. Are you anywhere near him? (I don't even know what he specializes in.)

Okay, technician's can be useful. I've just had bad experiences with them because I always get the feeling they're there not so the doctor can spend more time with me, but see more patients.

None of this actually applies to my last optometrist. That place was wonderful and went over my medical history that I gave them. The technician took notes, but the optometrist went over the whole thing with me and asked me tons of questions.

Any other place I've been, I feel rushed through the story, they don't really ask any questions, and I seem to remember once actually being cut off in the middle of the story so they could check my pressure. I know my story is long, and keeps growing as I find more doctors I don't feel comfortable with, but I'm a paying customer...they need to know the whole story!

Seriously...can a doctor really diagnose anything after looking at my eye for 20 seconds? Maybe I exaggerated a little, but I'd say he spent 45 seconds max looking at my eyes. I get more angry just thinking about it. To compare, my optometrist usually does spend a good 15 minutes just examining my eyes.

Do you think it was a good idea to tell the doctor I saw on Monday that the optometrist I had seen diagnosed blepharitis and mentioned some glands were clogged? I feel like I should say everything I know, but at the same time, with how little I trust these doctors right now, I'd be interested in hearing what he would have come up with on his own if I didn't mention it.

I did find something though that gives me a little hope though thanks to Donna's suggestion to check out WebMD. Which brings up one other thing I've had on my mind.

The optometrist said I have angular blepharitis. I didn't think to mention the angular part of it on Monday's doctor appointment, but he just said blepharitis. He didn't mention angular blepharitis. I just don't understand the angular part of it, because all of my eyes are inflamed when I look at them. But maybe she can see more that I can't...my optometrist did say it's worse in the corners.

Anyway, my point is that I remember reading on some web page a list of treatments for all types of blepharitis. They all mentioned the warm compresses and lid scrubs, except for one: angular blepharitis. It only mentioned the use of an antibiotic ointment.

I found this on WebMD:
"It?s not normal for the outer corner of the eye to be uncomfortable. The first impression I have is a condition called ANGULAR BLEPHARITIS. The angle refers to the outer corner of the eye, the lateral canthus. Blepharitis is inflammation of the eyelid tissues. It can generate exsquisite pain and irritation. Unfortunately, it usually leaves the affected skin raw and weepy. Persistent moisture only makes matters worse."

"A very inexpensive topical antibiotic ointment usually cures angular blepharitis. See an ophthalmologist soon for a definitive diagnosis and for prompt relief."

Maybe my treatment is wrong. If moisture makes it worse, then I would think it is. Anyway, if it is angular blepharitis, the word "cures" caught my attention. On Monday I'm going to call the optometrist and bring this up. I want to try an ointment either way.

The only thing is that the itching is worst on the inside corner of my eye, though it can sometimes be intense at the outer corner too. I also sometimes having itching along the lashes, but it's not bad at all. And the opthalmogist didn't mention it. Then again, he spent less than a minute looking at my eyes, so what does he know?

The AskPhysicians doctor in IL isn't anywhere near me unfortunately. He's closer to St. Louis, which is right by the IL/MO border. I work in the north Suburbs of Chicago and live in
southern WI(until August when I can go back home to IL!)...so I'm nowhere near him. Otherwise, I would have been on that phone calling him this afternoon!

Actually, I'm thinking I might make an appointment at Northwestern University's opthalmology department. Since I'm having a hard time with doctors, maybe I can at least find a majority opinion of what's wrong with me. It's a long drive at an hour and a half, but worth it for some answers I don't have doubts about.


Chris

Well I got an answer at AskPhysicians. While I didn't learn anythign I didn't already know, I at least got their thoughts on a couple of my questions.

They doubt that the medications or the contacts caused this, but the contacts could have made the dry eye symptoms worse. They also said that punctal plugs can't hurt, but I want the removable (can't they all be removed?) kind in case they work "too well." I don't think there's any such thing as working "too well" right now though.

It can take months to get this under control. And it's nice to actually get some type of response to that by a doctor, as every time I ask a doctor I don't get a straight answer. On the Internet I can find anything from a few days to two to eight weeks.

The first two paragraphs of their answer to me though are scripted...I've read that same response several times in their archives.

Anyway, I feel like it basically came down to them telling me I need to give it more time. They're right...it's just not so easy to be patient when you're in discomfort and reading items that say symptoms should improve rapidly...and then they don't.

On a brighter note, I had another pretty decent day today. It got bad in the evening, but I made it through most of the day without being in too much pain. Unfortunately there's still no improvement in how my eyes look.

The $10 was worth it, because I really just wanted to get their opinion on the possible reactions to medications and the punctal plugs, and I got that.

I hope everyone else was feeling okay today!

Chris

Glad you got an answer! I haven't used them yet because I'm not up to typing up my whole history. And probably in the back of my mind I figure they won't tell me anything new anyway.

So Chrisi, did they say your problem is getting the blepharitis under control? I did a lot of research on it when I thought I had it, and I think the key is doing those warm compresses 3x a day until you get it under control. I mean really do them, not one minute of a warm wash cloth once a day. I´d heat up two at a time in the microwave, and apply one at a time until both had cooled. Then repeat three or four times. Is it a pain? Sure is. But I think it really helps liquify those oil glands.

Microwaving two washclothes at the same time actually sounds like a good idea...why didn't I think of that? The most annoying thing about the warm compresses is how quickly they cool...even when microwaved.

I've been continuously doing the warm compresses between 2 - 4 times per day, for about 10 to 15 minutes. But that ten or fifteen minutes isn't actually all used for the warm compress because at least a few minutes of it is me reheating the washcloth.

I could also go buy one of those reusable gel packs that can be used for cold or warm compresses. But I wonder if the moisture from the washcloth also helps the eyes, which I'd lose with one of those gel packs. I might have to look into that, because that would be a whole lot easier.

Basically, according to them, it does seem that the problem is getting it under control. In moderate to severe cases, it can take months.

I'll try your idea of heating up two washcloths at once. I'm just so tired of the warm compresses and taking 20 or so minutes out of my life a few times everyday.

Chris

I tried using a heating pad for a while, but like you wondered if it was moist heat that was most beneficial. I even bought a heating pad that had moist heat, but it barely got hot enough, so I went back to the washcloths.

Yeah, too bad they don't stay warm! It would be great to just heat up a washcloth and lay down for 5-10 minutes. I make mine burning hot, but once it is cool enough to apply, the heat disappates really quickly.

I was out this morning and having a pretty good day lid-wise, until I got home and looked in the mirror. My top lid near the inner corner is all swollen! What the hey? I give up! I'm defeated! Yes, my eyes have defeated me and I surrender..... (Of course, since there is NOTHING WRONG WITH MY EYES, I must be imagining it...)

Hey, I just thought of something. You could put a wet, warm washcloth over your lids, then put the heated gel pack on top. Maybe that would work.

[This message has been edited by DonnaDe (edited 05-13-2003).]

Originally posted by DonnaDe:
Hey, I just thought of something. You could put a wet, warm washcloth over your lids, then put the heated gel pack on top. Maybe that would work.

Donna, you're a genius. I don't see why that wouldn't work. I'm going to have to try that tonight. Like you I prefer it to stay really hot(but not too hot), but I've noticed when it cools off enough to apply, it cools off too much shortly after.

Sorry to hear about your eyelids today. Do you think that maybe, since the swollen lids are evidence that SOMETHING is wrong, it might be worthwhile to see another opthalmologist if it continues? They couldn't say "I don't see anything wrong" at least.

I feel like giving up sometimes too. There's not much motivation when, after over a month of treatment and four different doctors, there's little or nothing to show for it. And there's even less I'm sure when doctors can't find anything wrong at all, like in your case.

Chris

Hey, sorry to keep calling you Chrisi! I just realized I was doing that. Now I´m wondering.. are you male or female? Not that it matters, of course!

The swelling has mostly gone down, so I guess it was just öne of those things.¨ Ugh, and now my keyboard has somehow changed over to Spanish ÑÑññññ¨^*?))=,.-_:
Everyone is out to get me! LOL

Now I´m wondering, ok, if this isn´t an eye thing per se, is it a skin thing? Like contact dermatitis? Maybe it would be worth it to see my dermatologist? There is nothing different about my lids that I can see, though, so I don´t know. Hmm, did I post that already? I swear I´m losing my mind! LOL

Anyway, don´t give up! At least you have a diagnosis of something. I´ve read moderate cases of blepharitis can take up to 8 weeks to get under control. Be diligent with those warm compresses, lid scrubs, and massage.

Oh, and I saw your post on AskPhysicians. With such great scores on your Schirmer test (22 and 15), why do you think plugs would help you? You seem to have enough tears... it´s probably the quality that is lacking due to the blepharitis. What do you think? My scores were 5 and 8 at U of M! Two days earlier at the regular specialist, I was told my eyes were not dry at all. Grrrrrrr.

In case you´re interested, there is a sourcebook on blepharitis. You can get it online at Amazon or Barnes and Noble.

¨A comprehensive manual for anyone interested in self-directed research on blepharitis. Fully referenced with ample Internet listings and glossary.¨

This book has been created for patients who have decided to make education and research an integral part of the treatment process. Although it also gives information useful to doctors, caregivers and other health professionals, it tells patients where and how to look for information covering virtually all topics related to blepharitis (also eyelid inflammation), from the essentials to the most advanced areas of research. The title of this book includes the word official. This reflects the fact that the sourcebook draws from public, academic, government, and peer-reviewed research. Selected readings from various agencies are reproduced to give you some of the latest official information available to date on blepharitis. Given patients' increasing sophistication in using the Internet, abundant references to reliable Internet-based resources are provided throughout this sourcebook. Where possible, guidance is provided on how to obtain free-of-charge, primary research results as well as more detailed information via the Internet. E-book and electronic versions of this sourcebook are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). Hard-copy users of this sourcebook can type cited Web addresses directly into their browsers to obtain access to the corresponding sites. In addition to extensive references accessible via the Internet, chapters include glossaries of technical or uncommon terms.¨
¨

The title is..

The Official Patient's Sourcebook on Blepharitis
by Icon Health Publications, James N. Parker (Editor), Philip M. Parker (Editor)

It's okay about the name thing...I didn't really notice anyway. But I'm male.

As for the plugs, I'm not sure they'll do anything for me. But the opthalmologist I saw last Monday said they might, and the one on AskPhysicians said it might be a good idea, so...it really can't hurt I guess. The other thing I'm wondering is that my first scores were a 10 and 8, which are low(at least the 8 is). I think I remember reading somewhere that tear production can vary throughout the day as well, so perhaps at some points during the day it's decreasing? I don't know...it can't hurt though(unless there's an infection or something, which would be the last thing I need), and my insurance covers it. But you're right...I'm not getting my hopes up that the plugs will do anything. But I'm being told that they may help, so why not give it a try.

I have seen that Blepharitis sourcebook. The ad for it comes up on every search I do. I've been close to ordering it several times, and I probably will in the near future. Thanks for the info though!

Now you say that at U of M you had scores of 5 and 8? That's low. Did the specialist mention anything else about that?

Also, I found after doing some research that it wasn't actually the Schirmer test that I had done on me. I'm not sure which one it was, but I think it was called Zone Quick, which is the same idea as the Schirmer test, but it's done in 15 seconds. I'm not sure if the same range of scores is considered normal or not, but they had said 15 was still a little low...20 was normal. So I don't know what to think...I don't know enough about that. For the Schirmer test I've read that 15-20 is normal, but symptoms don't really show until it's less than 10.

Chris

They just told me they like the results to be at least 10 on the Schirmer test. To be honest, I never looked up the normal range. Nothing else was said about it.

My eyes only started to become dry once I was putting all that prescription junk in them. And they're only dry when I wake up in the middle of the night, not during the day. Who knows what that means?

I'm so sick of thinking about my eyes!

I know what you mean by being sick of thinking about your eyes! Unless something important is happening, I think about it every second of every day. I just want to move on with my life, but I don't feel like I can until this is under control. That's all I want!

I can only hope that when I go back to the doctor on Monday for the punctal plugs(if I go...I'm back to being undecided), he'll prescribe an ointment as well. Hopefully that would help speed up the process.

Anyway, a warm compress is calling my name...

Chris

Chris, all punctal plugs are removable. I'm glad you got a response from them. I wish they could have told you more, but at least you actually got to speak with a dr and not a technician. :) I think the technicians should be there to help the dr by bringing the patients into the room, checking the glasses prescription and possibly checking the pressure. They can write down the patient's medicines and symptoms for the dr, but they can't be the ones to do the actual examination. It's not right.


I think that it can't hurt to try the punctal plugs. Like I said, they are all removable. Although excessive tearing can be a pain too. But you are only going to get the lower ducts plugged, not the uppers. So, your tears will still have someplace to go. My problem is not enough tears and also poor quality tears. So the cauterization of all 4 ducts helped with the quantity, but even though I have more than enough, they are still not good quality, '

Donna, I think you should look at it as a blessing in disguise that your eyelid is swollen. Maybe if you go back to an ophthalmologist and he/she sees this, you will finally get a diagnosis.

I'd love to post more, but my eyes are burning too much. I have an appointment with my eye dr on thursday... we'll discuss everything that happened at the rheumatologist (which I posted under the dry eye purple topic) as well as figure out how to get in touch with dr O'Brien, and check my pressure and examine my eyes. I'll keep you all posted.

Elyse

I thought that all punctal plugs are removable. I don't understand why the doctor at AskPhysicians had to point out that's the kind he'd recommend. But you're right...at least I actually got to talk to a doctor that would answer all of my questions, instead of some technician.

It seems like it's a whole lot easier to treat a problem of not enough tears than it is to treat a problem of poor quality tears. I know that's my problem because of this blepharitis and the clogged glands, but you're right...the punctal plugs can't hurt.

I really don't know if tear quantity is a problem for me. I don't think it is, but does anyone have any idea how over two weeks I'd get a 10 and 8 on that test, and two weeks later get a 22 and 15? 22 and 15 sound just fine to me, but the 10 and 8 don't. That's the one thing I don't understand. But again, I don't think that test is always very accurate.

Anyway, I have more to write I think, but I'm very tired tonight, so I think it's time for bed instead.

I hope everyone has a better day tomorrow!

Chris

I remember reading somewhere that there are temporary plugs that dissolve in about a week. Don't recall what they're made out of, though.

Elyse, the swelling was only temporary. Maybe it was an unrelated thing.

The temporary plugs are made of collagen and dissolve in 7-10 days. I guess those are better for people who just want to try them for a few days, and don't want to have to go back to the dr to have them removed. (I personally liked having them removed, because that meant that he had to numb my eyes for a few minutes! ahhhhhhhhh..... relief)

But even the so called "permanent" ones are not really permanent, because they can be removed very very easily, and they can even fall out! They just don't dissolve like the collagen ones. The "permanent" ones are made of silicone.

My eyes are not too bad today. I love my FML. :) I'll be seeing my eye dr tomorrow for a pressure check and to talk about other things.

Tonight, I am off to the GP to discuss gallbladder surgery. My gallbladder has been absolutely horrid for these past few weeks, and I think the time has come for me to have it removed. They do it laproscopically and the recovery time is only about 7-10 days. Incidentally, did anybody see my post about general anesthesia and eye problems? I believe that I read somewhere that it can sometimes cause or worsen dry eyes. I really don't have a choice, but I'd like to be prepared!!!

Elyse, I'm glad to hear that your eyes don't feel too bad today.

I would've been interested in trying the temporary plugs first if he would have done the prcedure the last time I went to the doctor. But since he didn't for some reason, and I have vacation the week following Monday, when I'll get the punctal plugs, I really just want the permanent ones at this point because of my upcoming vacation and because they can always be removed.

I'd also like the permanent ones because when I wore contacts I often felt they got too dry at times, and IF I ever get to wear contacts again(which is very questionable at this point), I think I might benefit from them then at the very least. When I get this whole thing under control, after some more time has passed, I want to give contacts one more try. And I know that doctors normally say(based on what I read online anyway) that most can go on to wear contacts while the condition is under control, so we'll see.

My eyes haven't been all that great today. Not as bad as they get sometimes, but I've definitely had better days. It's more my left eye though.

Elyse, good luck with your GP tonight. I saw your post about general anesthesia and dry eyes, but I haven't got a clue. I tried looking up some information online after you posted it, but I didn't find anything.

Anyway, I'm off to get dinner and then find out who's getting voted off American Idol.

Chris

Elyse, I saw your anesthesia post and did a quick search too. I didn't come up with anything on target though, sorry :( Is it the anesthesia itself that would worsen dry eyes? How? Or is that what you wanted to know? :) My pharmacist friend mentioned a prescription eye ointment the other day that they use on people having general anesthesia. I wonder if you could benefit from that.

Chris, I'll be watching American Idol too :)

Thanks guys... I looked it up too and I couldn't find anything. Donna, that is what I wanted to know... if the medicines that they use for anesthesia can possibly worsen dry eyes. I really thought I had read something about it somewhere, but maybe I am mistaken. My eye dr says everything should be OK and that it really should not have any effect on my eyes whatsoever. He said to just make sure I put some tears ointment in before they put me under, like I do when I am going to bed. But do you think you could try to find out the name of that prescription ointment for me? I'd be very curious to see why they use a prescription eye ointment for patients who are going under anesthesia. What is the purpose of it?


So who do you guys think is going to win American Idol? I can't decide if I want Clay or Ruben to win. I'm completely addicted to that show!!!

[This message has been edited by purple2067 (edited 05-15-2003).]

I will certainly ask my pharmacist friend for you! I have no idea what's in it that would make it a prescription drug.

I don't know who I want to win either! I guess I'd be happy whichever way it goes. I'm addicted too! I rarely watch any TV but that is the one show I never want to miss.

And dang, I know I shouldn't even dream of typing this, but my eyes have been getting gradually better all week. Tonight I put on eye make-up and my contacts and went out and actually forgot about my eyes! KNOCKING WOOD!! THROWING SALT OVER MY SHOULDER! I was talking to my husband's uncle, who is a surgeon, and he said I'd be surprised at how many illness doctors can't diagnose that eventually go away on their own in a few months. He also wondered why no one even suggested that maybe I have some sort of virus. Then he thought he was funny by making up medical names for burning eyelids of unknown origin. I think he decided I had "idiopathic blephadyne" or something LOL

<Tomorrow will probably be a horrible eye day now because I've jinxed myself>

I always make the mistake of mentioning when I'm noticing a pattern of my eyes improving too. For example, yesterday when I woke up, my eyes looked great. This morning my left eye was completely red.. I jinx myself over and over, and yet I keep doing it. Anyway, good luck tomorrow Donna..hopefully it continues to slowly improve like it has and you didn't jinx yourself.

Now as for American Idol...I have no idea who I want to win. I was hoping it would come down to Clay and Ruben, so I'm happy with that. I think Clay actually might pull it off though. They both really deserve to win.

I'm glad American Idol is over next week though so I have my Tuesday and Wednesday nights back. And I can finally have Thursday's back again too with the season ending for Friends(my favorite show, just ahead of American Idol) this week. There's so much free time now!

Chris

Chris, that made me laugh about the free time! What a relief, huh? :) My "must-see" shows are American Idol, The Sopranos, Sex and the City, and that Larry David show.. shoot, what's the name? If I see anything else it's because I pass by the TV when my husband is watching. I got to see a little of Survivor that way. I wouldn't have turned it on on my own.

Wishing you, me, and everyone else an excellent eye day!
Donna

I just started getting into the Sopranos last season. However, my brother's birthday is coming up and he wants one of the seasons on DVD, so I'll probably get him Season 1 and then "borrow" it. Works out nicely for me.

Unfortunately, while they have felt worse, today was pretty bad for my eyes. Most of the day, in addition to the pink look they have, they just look terribly dry. They felt pretty bad all day too.

Also, I've noticed that my the lower lid of my left eye is twitching. I actually noticed this a couple weeks ago, but it's finally annoyed me enough that I'm starting to always be aware of it. I wish it'd stop. I've read that this can be caused by irritation however, so I'm sure it's due to the blepharitis and dry eyes.

At this point, I'm just looking forward to my doctor appointment on Monday, even though it's the one I didn't like. Maybe it'll go better this time. I just can't wait to get the punctal plugs and see if they do anything at all for me(though again, I'm not expecting much), and to ask about the possible use of an antibiotic ointment for the blepharitis to hopefully speed things up a little.

I'm so sick of doctor appointments by now. Coming up after my vacation is the dermatologist and an ENT...and I'm sure another eye doctor appointment will follow.

How has everyone else's weekend been? Hopefully everyone else is having better luck with their eyes right now.

Chris

Well, I had my eye appointment again today.

It went much better than last time I think. The doctor still just doesn't come across as friendly, but at least it went better. The technician did what they were supposed to as well...they just checked my vision and asked how I was doing, and that's all.

Anyway, the doctor said I'm doing a good job of keeping my eyelids clean. There's also still some clogged glands, but it looks a little better.

I asked him if he agreed that I had angular blepharitis, and he said it's all around...so he didn't really agree.

Then he mentioned that I do have a low tear film. He didn't measure it or anything, but he said it looks really low and he thinks it would be a good idea to do the punctal plugs. So apparently I have a low tear film of poor quality. If my tear film is low, then this leads me back to my original question of whether the blepharitis caused dry eyes, or if dry eyes caused the blepharitis.

After he put them in, I did ask him about the antibiotic ointments, and he said it could help and he'd be willing to try it. He gave me a sample, so I didn't have to go get a prescription filled. He told me to use it for up to 10 days.

I also asked about Restasis, but he said maybe in the future, but he wouldn't want to try it now.

Anyway, my eyes don't feel any different or look any different, but he did mention that it may take 1-2 days for them to have the most effect. He wants to see me again in a month. Hopefully between the warm compresses/lid scrubs I'm already doing, the antibiotic ointment, and the plugs, I'll see some improvement soon. I can only hope...I've really had enough of this.

Chris

Chris,

I'm not an eye doctor, but you may want to consider not trying two new things at once. If you have great improvement, you won't know if it's due to the plugs or the antibiotic ointment. Think about giving the plugs a few days to work, then add the antibiotics if there's no improvement.

Remember how I mentioned I was having a good week? Mon-Fri my lids barely bothered me. Friday night they were bad and now (Mon) they are awful. I just can't figure out why. As usual, they appear perfectly normal. I was wondering, since I've exhausted the eye doctor route, if I should consider my problem dermatological. Is it a skin thing? Everything I've read about contact dermatitis, tho, indicates there would be physical changes.. redness, swelling, rash, *something.* Ugh!!

Oh and I still can't register at AskPhysicians! I even gave a different email account.

Anyway, glad to hear your appointment went relatively well!

I've thought about waiting a couple days before trying th eointment, and I don't think I have the self-control to wait. I'm trying to determine right now if i want to use it tonight or not, and I can't make up my mind.

Sorry to hear about your lids bothering you again. Everytime things start to improve, it just reverts back to the way it was...every single time. Maybe tomorrow will be better?

I think it wouldn't hurt to try seeing a dermatologist. I don't know if it would do any good since there's no physical evidence of anything wrong, but you never know. Besides, you've been told that nothing is wrong so many times, what's one more right?

And I don't know why you can't register at AskPhysicians. It doesn't make any sense to me. I'm out of ideas if using an alternate e-mail address didn't work. I guess they don't want your money.

Anyway, I hope everyone has a better day tomorrow!

Chris

Ugh, well, no better today. I can't understand why I'd have 5 good days then it's back to agony again. I don't do anything different on the "good" days.

Yeah, I guess there is no harm in seeing my dermatologist. Why not add another "I don't see anything wrong" to my collection? :) I don't think I can get more depressed than I already am.

And I finally was able to register at AskPhyicians. For some reason I couldn't register with any AOL address, so I tried Yahoo email, and it worked. But STUPID ME registered with a phony last name and address. I don't like to give out that info if it's not necessary. Little did I know they use THAT info when you go to pay by credit card. So I still couldn't post my question!

Let us know how you're doing today. I hope the plugs make a difference! And where is Elyse?

Plugs haven't made much of a difference, if any, so far. I ended up using the ointment last night. We'll see what happens.

Sorry to hear your lids aren't doing any better either. But you're right...what harm can one more "I see nothing wrong" do?

I'll bet that AskPhysicians has AOL blocked or something...I don't know. But at least Yahoo worked, so now you know that if you decided to you could ask a question there.

I was wondering where Elyse is as well. It seems unusual to go several days without hearing from her.

Chris

I posted my question but all the apostrophes got replaced with question marks! WHATever :-) I'm not hopeful they will tell me anything of value.

Sorry your plugs aren't working. Hopefully the antibiotics will clear things up. Did the doctor think there was an infection?

He didn't say whether or not he thought there was an infection. I only asked him about the antibiotic ointment because I read that it can help, and he said he'd be willing to try it and that sometimes it can help.

I saw your question on AskPhysicians. That was odd that it placed all those question marks all over, but at least they'll still be able to understand it.

Was American Idol good tonight? I missed it.

Yes, it was good! I enjoyed it! I'm not even sure who I'm rooting for. Both contestants are great singers, but their styles are so different it is hard to compare them.

How are your eyes feeling today? Mine were bothering me yesterday, but by late afternoon they actually felt fine! I went out from 6-7:45 and barely thought about my lids at all. Today they're not as great but I'm not in agony either. I don't know what to make of this.

First things first...I'm a little disapointed with the results of American Idol. I think Ruben was great and all, but I would have preferrd Clay to have won. Oh well.

I saw the answer to your question at AskPhysicians. Did you find it useful at all? It sounds like they gave you some options to explore though...sounds like a lot more information thatn you got from any of the opthalmologists. What I'd like to know is why don't the opthalmologists you actually see discuss these other possibilities with you? They shoud know the same information...they did go to med school afterall.

As for my eyes, well...I still don't really notice a difference. Maybe every so often they feel a little better, but there's still plenty of times that they don't feel great. Definitely not 100%, and it's still consistently bad enough to the point that I can't forget about it during the day.

The eyes still don't really look any better either. I used some of the Visine LR this morning that I had, and that got rid of the redness...so far it hasn't returned to where it was. My right eye still looks perfect from it, and my left eye looks better than usual, but not perfect. It's only supposed to work 6 hours, and it's been 12, so I'm hoping it stays like this. We'll see what happens.

However, this is only the third day since I got the plugs and the ointment, so I'm still hoping things improve just a little more. I don't know what to try next if they don't.

Chris

I'm not really sure if I found the answer particularly useful. Maybe I should have asked on the dermatology board, because I didn't really get that question answered. I think mostly I got annoyed because here was ANOTHER doctor who thinks I pull out my own eyelashes!! What, they've never heard of eyelashes falling out on their own? I can guarantee 100% without a doubt that I DO NOT pull my eyelashes out. Geez.

What is bothering you most about your eyes? Is it the redness? I think you posted that they're not that noticeably red to others. Mine have gotten the same way lately. No one would say, "What's the matter with your eyes?" but I can see they're a little bloodshot. I've always had the clearest, whitest eyes, so it looks funny to me. I can live with that, tho :-)

I had another good day today as far as my lids go, but my eyes themselves felt irritated. I just trade one problem for another! But since I am at least having some good days, I'm hopeful. Before every day was bad!

It depends on the day whether the redness or the burning bothers me more. If the discomfort is really bad, I really don't care how red they are if it'd go away. It's I'm not in too much discomfort, I'd feel a little better if the redness would go away.

Others don't really notice the redness unless it's particulary bad, but to me, it's very noticeable in my left eye even when I'm not looking closely at my eyes.

The most bothersome thing of all is having to close my eyes when just walking anywhere. The air apparently stings my eyes, and that just doesn't seem to go away, except on particularly "good" days.

Did the person who visited Dr. O'Brien (ichrisi, was it) find his suggestions helpful? I see the Wilmer Institute is one of the best. Also has anyone seen improvement with Restasis? I've been on it along with Doxycycline for 6 weeks with no noticeable improvement. My doctor says it could take 3-6 months so I have to be patient. My sympathy to all fellow sufferers. This has lasted over a year with not much relief. Celluvisc gives the most relief.

It was me that visited Dr. O'Brien. He did have some good suggestions, which you can read about under the dry eye purple topic. But in the long run, nothing has really helped very much.

Dear Chris and Donna De,

I feel exactly the same way about the redness- self conscious and ugly. The left eye is worse and often pink while the right eye looks pretty normal. Like you it varies by day.

This started a year ago, just when I was enjoying retirement (teacher/librarian) fun like golf, art and gardening. These activities have become less fun with burning irritated eyes, but I refuse to give them up.

I was considering going to see Dr. O'Brien but it sounds as if I'm doing everything he recommended to Elyse. Seven weeks ago started Doxycyline and Restasis (shouldn't they have been tried one at time?) but don't see any improvement yet. That's why I wondered if any had been helped yet.

I feel better knowing that people are here for support and send my wishes for improved health for everyone.
Janice