Dry Eye / Blepharitis

I am 30 years old and my eyes are so dry and I have crusty like material on my eye lashes. After many, many, many trips to the eye doctor all he says is that my tear lakes are dry and that my eyes are so dry, especially my upper lids that this is causing the irritation/redness and burning.

He has checked my vision and its fine 20/20 and 20/25.

I use restasis (5 months now) and not really a help. I also use Optive. I even tried washing eyes with baby shampoo.   Is there any thing else I can do to help this. I am tired of going to the eye doc. to be told its just my dry eye.

This dryness seemed to have come out of no where.  I was treated for a blood vessel leak behind my macula with a shot of avastin about 7 months ago and my macula is doing fine for now. No swelling or leaking. Of course I have the spot but my vision is stable at 20/25.  Could the dryness be a result of this injection, my left eye is the one where the dryness is worse (same eye as macula problem)

Please help ! I am so tired of this irritation.

[Michael J Kutryb, MD]

Consider a trial of flax seed oil and fish oil supplements.  Thera Tears Nutritional capsules (by mouth) have both ingredients and might help.  Also consider punctum plugs to increase lubrication of eye.  Maybe get a second opinion to see if you also have lid margin disease (blepharitis) which often co-exists with dry eye.  Try to reduce oral medications that might be worsening your dry eyes.  Sometimes a short course of mild steroid drops can help in proper situations.  Unfortunately I cannot solve your problems - but there is hope - you just need the proper treatment regimen and you should find at least some improvement.

Michael Kutryb, MD

[Chasity2000]

My doctor has used mild steroid drops and the do help for the time I get to use them but a couple days after going off them, its back.

These punctum plugs? Are they something the doctor would give me.

How do you test for blepharitis?

Could this have been brought on my my Avastin injection?

[Chasity2000]

Could you respond to my additional questions. Great appreciated.

[Michael J Kutryb, MD]

Avastin totally unrelated.  Blepharits can be seen during your slit lamp eye examination.  Punctum plugs are inserted by doctor - takes a few seconds for each plug - very, very easy - nothing to it.  Perhaps you could try ALREX for a while longer if doctor thinks it is OK - it is a very, very mild steroid drop that could give some relief for a month or so until restasis kicks in a little more.

Michael Kutryb, MD
Edgewater, FL

[Chasity2000]

Thank you.  

My doc. has had me use Vexol. Is this similar to the ALREX you mentioned

[Michael J Kutryb, MD]

Similar, yes, but stronger.  Vexol is a little milky (a suspension)and tends to gunk up the eye a little.  I wonder if it might not be as good a drop for you as Alrex which has some lubricating properties or or even Lotemax - both of which are non-suspensions.  Regardless, these steroids (even the weak ones) have possible side effects and should only be used short term and under direct ophthalmologist supervison.

Michael Kutryb, MD