Getting used to eyelid debridement and other dry eye treatements

Miscellaneous and Personal Stuff I Must Share
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Hi Everyone! Stepping out of lurk mode for a minute… let’s talk about our eyelids!
The tl;dr: does using a debridement tool like the NuLids system get easier?

I’ve been dealing with dry eyes for a while - since I’m a programmer and stare at a computer screen all day, it’s actually impacted my ability to work a little bit. Happily I have enough breaks because of meetings, and the whole work-from-home world gives me flexibility on when I need to step away from the computer. Anyway, after many months of first line therapies, I finally saw a specialist for some fun testing. More on that later, since it’s not quite the point of this thread.

Happily, we now have a treatment plan Part of it is eyelid debridement. The doctor recommended a device from NuLids, which I’ve now used twice. It’s like an electric tooth brush, with a different brush head. They gave me some training, and I’ve watched some videos, but it’s still somewhat awkward. Of course, I found contact lenses pretty awkward when I started wearing them, and I got used to that.

Anyone have any experience adjusting to this? Other than “give it a few weeks?”

Another part of the treatment plan is Intense Pulsed Light. I’m not concerned about that, since it’s fairly passive from my side, but if anyone has experience, I’d love to hear it.

The less interesting treatment involves a gel lubricant for my eyes at night (think in terms if a thick eye drop) and some Omega-3 supplements, which might be good for my regardless.

For the eye curious - the debridement is to help clear the path for my tears to better disperse across my eyes, and to clear the openings for my Meibomian glands. Most of my glands are in decent shape, but a few have atrophied, and a few are starting to curl away from the opening. You have something like 30 per eye, so this isn’t quite as bad as it could be. My tears are apparently poor quality. A normal person’s tears evaporate after 15-40ish seconds. Mine evaporate after 5-8 seconds. And a side effect of all of this is that my tears tend to glob up a little bit instead of providing coverage across the eyeball. It was really cool seeing pictures of my tears rolling across the surface of my eyes before they evaporated. Oh, and I have some occular rosacea. The doctor pointed at a bunch of tiny red veins on my lower eye lid, and said something like “those aren’t supposed to be there.”

2

If this thread is open to other eyelid conditions, i had a chalazion removed from my eyelid a couple years ago. A chalazion appears like a lump under the eyelid, and consists of a cyst due to a blocked meibomian gland. My ophthalmologist put some numby juice in my eye, turned my eyelid inside out, and scraped out the contents of the cyst. Uncomfortable, but not not intolerable, and it was over in a very few minutes. It hasn’t come back, but i can feel a residual bump under the eyelid when i rub it with my finger.

3

Yes please. I’ve been suffering from eczema around my eyes for a couple of years (and excessive lines as a result), and have spent a fortune on useless creams which seem to make it worse. Would be keen to hear from anyone with similar experience.

4

My eyes burn and itch. A mild form of dry eye. My ophthalmologist told me to use Refresh Plus Lubricant Eye Drops. I use them twice a day.

They help. The best treatment is getting away from digital screens. Go outside for a walk and let my eyes rest.

5

My eyes aren’t dry. Quite the contrary, they are tearing all the time. My optometrist (just try to get an appointment with an ophthalmologist) says it is the eye trying to compensate for blocked meibonian glands. I use compresses twice a day and an ointment (systane) in both eyes every night. I guess it helps. He never mentioned debridement or any other treatment.

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Interesting. I have a mild case of what you’re describing, or something similar. I have “sleep sand” all day, not just when I wake up. My eye doctor told me to wash my eyelids with baby shampoo, and put a warm, wet compress on my eyes in the evening.

I never had problems with dry eyes, and I stare at a computer all day. But when I tried wearing contacts it was near impossible. My eyes were so dry all the time, my contacts would pop out. I gave it about a year and got rid of them. I do have problems with the eye goop itself impeding my vision, as it gets stuck in my eyelashes.

When I started using a CPAP machine to correct my sleep apnea, my eye goop problem got WAY better. Like, before it was negatively affecting my life and now it’s just like “check your eyes for goop before you leave the house.” I don’t know how they are related but really, it helped.

That machine seems kinda scary! I hope using it brings you a lot of relief, though. Sounds like you have a good doctor, too, who is very thorough.

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I think I have one of these. I’ve been meaning to get myself to an opthalmologist for a general check (I’ve seen an optometrist for new glasses), but the entire COVID situation has delayed some things. I was wondering if that would be a question to a GP or an eye doctor, so that answers that.

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I have dry eyes, too. My doc prescribed Xiidra a couple of years ago, which makes your eyes produce more tears. It worked well: about thirty minutes after using it, my eyes would be running with tears. But United Healthcare decided to stop covering it, and it costs $750 a month (!). So it’s back to plain old Systane or Refresh eye wetting drops.

Oh, and I use gel drops at night, which is a more syrupy version of the daytime eye wetting drops. The syrupy stuff lasts longer, which is why you use it at night.

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Sounds like blepharitis. I have problems with that.

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Medicines like Xiidra are indicated for a specific cause of dry eyes - there’s an inflammation factor of some sort they test for. I was “very weakly” positive for that, but my doctor thinks it’s not related to the problems I’m having, given the other findings. I was a little disappointed, because the treatment seems much more straight forward :smiley:

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I’ve had several years experience with dry eye. For me, I did not notice the fish oil helping. Xiidra worked well, but was off the wall expensive. I hope the cost has come down. Every time I’d finish a work contract, I’d have to switch to a cheap health-care plan that didn’t have Xiidra on it’s list so in the long run, it didn’t work for me. However, I do know that part of my problem is allergies so I switched to OTC allergy drops twice a day and use Systane eye drops in between. I use eye pads/wipes recommended by my eye doc for removing granules.

12

Chemo had given me nasty dry eye, so I used the really thick gloop and these goggles for the overnight, and I used a set of my more goggle like prescription safety glasses that sort of cup the eye socket to keep moisture in my eyes and use a neutral saline drop.

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The doctor actually suggested goggles like that as an alternative to the lubricating gel. I have enough trouble sleeping as it is, and was concerned that the goggles would make that worse. For now, it’s a card we are leaving on the table in case other things don’t help enough.

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They are about the firmness of a two layer velvet sleep mask - really, soft and squishy. I sleep on my side and 3/4 face, and they just squidge down flat. And the ones I bought are clear, so I don’t have to take them off to go to the john, but they are really like looking though murk rather than clear.

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I had dry eye a few years back and was prescribed Restasis (and other eye drops that I used).

Even had MRIs/C Scans of my brain and orbital sockets.

Was so bad that I was getting double vision at times.

Eye drops helped, but I was still getting the double vision.

Then two years later I had a minor stroke.

It cured my double vision.

Then a year after that, I had a dark spot in my vision–occular stroke. So now I’m half blind in one eye.

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Do you use the distilled water with it, to humidify the air intake?

I’ve heard a lot of people saying that getting a humidifier helps with all sorts of issues with dryness. I’ve been meaning to get one, but I need to decide the best kind to get.

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I have two: one for daytime near my desk, one in my bedroom for nights. They really, really help and they are nothing fancy. They use tap water and instructions are to clean them weekly. I don’t see the styles on the market any more, but even boiling water on the range can help (but don’t boil the pot dry).

18

Well, I’m about two weeks into using the NuLids machine. It is getting easier, although it’s still not as natural as brushing my teeth. I’m basically rubbing a rotating plastic nub against the margin of the eye lid, at the base of the eye lashes. You know…those things that make you blink when something gets close to your eye. :joy:

I’m not experiencing any real symptomatic relief yet. But we know I have multiple things wrong, and blockage of the Meibomian glands is just part of the issue. And it’s only been two weeks.

I have my first Intense pulsed light session scheduled for Friday. In theory, that will help with both the flow and quality of my tears.

19

My experience with recurrent corneal erosion …

My eyes have not been particularly dry, but one morning in very low humidity I woke with what I thought was an eyelash in my eye. It couldnt be washed out and we couldnt see any obvious foreign body.
The irritation was causing my eye to water, and after driving home - a four hour trip from the country - it progressively got worse, so I drove straight to the eye hospital. At the eye hospital they discovered it was a corneal tear, which was treated by debriding the cornea. This is fucked up and very painful - it means scraping off the outer layer of the cornea with alcohol and a cotton bud. This thin layer was torn due to my dry eyes. The local anaesthic eye drops were a wonderful relief … for 1 hour. Fortunately the outer layer heals within a couple of days sitting in bed with an eye patch.

The dry eyelid sheared off the outer layer (corneal epithelium) when opening my eye on waking.

Problem was this kept happening. I would wake with an incredible pain. Trip to eye hospital…local…debridement…pain… repeat. The outer layer was weakened after the first trauma and kept peeling off. It wouldnt stick to the cornea.

Fortunately I found an excellent ophalmologist who treated my dodgy eye with laser eye surgury (PTK) - the same as used for modifying optical properties of cornea to treat focus, but just a flat polish. This gives the thin outer layer a good surface to adhere to. And for extra grip he pricked the cornea. This procedure was very well managed, not painful (compared to eyeball peel) and successful.

Now my other eye is dry in the morning with erosions, which heal quickly, but very irritating. Carmellose solution eye drops at night with ointment are great. Ointment is important to provide a persistant lubrication of the right viscosity,

Planning on having the other eye zapped soon.

Eyes are only dry at night. Apparently a genetic thin

20

I’m so glad I only have to do the debridment for the margins of my eyelids :open_mouth: Ouch.