Sounds like a recurring nightmare. I’m thankful to be able to manage my problem as is right now. I didn’t have a problem with dry eye until Lasik surgery. My allergies exacerbate it, and so does dry winter air, but I have learned how to deal with those. I wonder what will happen after my cataract surgery (not yet scheduled because not almost blind yet; I need insurance help with this.)
Possibly on hold. I’ll find out tomorrow morning hopefully. I had a mole of some sort removed from my eyebrow this afternoon. I noticed it about a week ago, and had my regular 6 month dermatology checkup today already scheduled. She didn’t like the way it looked and wanted to biopsy it. Afterwards she said it was noticeably deeper than she expected.
It’s probably nothing, but I effectively have an open wound on my eyebrow right now. The pictures I’ve seen for the IPL suggest it won’t be a problem, but I called the eye doctor’s office for advice. They’re going to call me tomorrow to let me know if I need to delay my appointment.
And just as a follow up, in case anyone is still paying attention 
I did, in fact, have to postpone the IPL session. Twice. The biopsy results came back on Tuesday as basal cell carcinoma, which is one of the “best” cancers to get. I went back today and had the thing properly excised and cauterized. But it means a new two-week window before the eye doctor will treat me.
In the mean time, I’m keeping up with the debridment, which I’m getting reasonably comfortable with. Although the 3/4" gash above the eye brow is going to make it tricky for a few days.
But good news that you don’t have to worry about cancer in that spot for a while now. Glad they caught it.
Yes! I have friends going through much scarier cancers. This one is just a minor annoyance, compared to what they are going through. I thought this particular spot looked enough “different” from the kinds of moles I tend to grow that I was a bit concerned. When I spoke to the doctor today she agreed - when she saw it she suspected the biopsy would come back positive.
I’m on the 3-month checkup plan now, instead of the 6-month plan. I was already considered high risk for skin cancer for a variety of reasons, including being a somewhat outdoorsy guy in South Florida, and having a family history of skin cancer.
I finally was able to do my first IPL session.
They numbed my eyes with some drops, then placed laser-grade protective shields between
my eyes and eyelids. They then put some ultrasound-like gel around my eyes for comfort and
protection.
The IPL treatment itself is very well named. It was a series of very INTENSE, brief PULSEs
of LIGHT. From very close range. There were about 10 across the top of each eye, and maybe 3-4
on the lower part of the eye.
After the procedure, he expressed some oil from my glands and looked at the quality.
He says he sees improved quality compared to my initial visit - that’s almost certainly
from the omega 3 I’m taking. He graded it at grade 2, which is the second best. Grade 3
is the best. The IPL treatment tends to improve by one grade, so we are hopeful that I’ll
be a success story.
Most people show improvement after visit 2 or 3 - it’s a four visit series. He thinks I have
a decent chance of being one of the rarer ones who has improvement after day 1. We’ll
wait and see how that works out.
The follow-up visits are at 2 week intervals.
If you are anything like me, you’ll see those light pulses reappear when you close your eyes to compose yourself for sleep. Drove me buggy for a few weeks.
I had my one month follow-up after my fourth IPL session today.
Overall, it’s been a positive experience. I have many more days without needing any eye drops now, although I still do use them once or twice on some days. Before treatment, I was using drops five or six times a day. That’s a big improvement.
They did a professional cleaning on my eyelids today. Think of a q-tip with a motor, or a dremmel tool with a buffing attachment. Then run it along the upper and lower margins of each eyelid five or six times, with some lotion. Thankfully, this was after they put some numbing drops in. So it was mildly annoying, but very tolerable.
My tears are much better quality now. They last longer, and spread across my eyes better. The pretty little chart they make from the images shows all green, which is good 
The one complicating thing is my bout with COVID about a month ago. The doctor says he can see the inflammation in my eyes, and that I will feel even better when that goes away. I see my GP next week, and the eye doctor says to ask if an oral steroid would be indicated.
I go back in 6 months for a regular checkup.
That’s great to hear. I will look into this.
Glad to hear you got some relief from the procedure.
A week from today I go in to have “punctal plugs” inserted. I suppose it’s the next step for stubborn dry eye if drops aren’t helping. We’ll see if it does anything - I’m not enthusiastic about plugs being stuck in the tear-holes in my eyelids.
There are a bunch of different reasons for dry eyes. We took a series of pictures looking at the structure of my tear glands, and some video looking at how my tears disperse on the eye and how quickly they evaporate. That data drove the treatment plan. Besides the IPL and debridement, I’m using a gel instead of a drop at night, and taking Omega-3 to improve the quality of the tears. We also tested for inflamatory issues, which could indicate a different type of eye drop.
teelabrown, have you had anything like that done, or is your doctor just going through series of treatments? If you aren’t happy about the plugs and they haven’t done other testing to make sure you’re working on the right cause, it might be worth finding a different specialist.
No mention of duct plugs for dry eyes yet? I know someone who has had those for years. Occasionally one goes AWOL and needs to be replaced. They block the drainage ducts for tears allowing more buildup of fluid. Works for mild cases and helps some for more severe ones.
Really simple procedure.
BTW: Be really careful in enunciating “duct plug”.
I do the gel drop at night, and am taking Omega-3 as well. I had been prescribed Xiidra, which causes you to produce more tears, but my insurance just decided not to cover it anymore. And it’s $750 a month! So we’re going the plugs route. I know the plugs are no big deal, it’s just me being squeamish about the idea of sticking foreign bodies in my eyes. I’m told the first ones will be collagen, which will melt away after a couple of months. Then the doc will decide if they were effective and well-tolerated, and if so, insert more permanent surgical plastic ones.
My understanding of Xiidra is that it is good to treat specific types of inflammation in the eyes. If it helped you, it’s a good diagnostic data point. I’d guess that indicates the you just aren’t getting enough tears, and so the ducts make sense to prolong yours.
In my case, my tears were evaporating too quickly - not draining - so we went a different route.
It does sound like you’re going through most of the same stuff I did - hopefully your outcome works out too! I’m very interested to hear what it’s like to have them placed, and if they work for you.
I had the same experience of being prescribed Xiidra and not being able to afford it. But it was prescribed with a full, 3-month sample when it first came out. It works beautifully for me, and Restasis does not. Effing insurance.
Welp, I’m just back from getting plugs stuck in my tear ducts. It was painless, or just about. I did feel a teeny sting in the left eye when he put it in. At the moment, the plugs are uncomfortable. They feel like my lower eyelids are swollen and blinking is a little unpleasant. I should get over that in a day or two.
It might be my imagination, but I think my eyes feel a little wetter already. I’m directed to cut back on the 8X a day wetting drops so that I can tell the difference between eyes wet from my own tears as opposed to wet from the frequent drops.
The doctor was pissed when he found that my insurance stopped covering Xiidra, and also won’t cover Restasis or even generic Restasis. He started saying “Do they know how many people in this country have dry eye . . .?”, then clammed up.
Yep. My doctor was furious. She even wrote a letter to insurance about my need for the product. They still turned it down. Imagine that.
Hopefully they start feeling natural very quickly, and work! I wouldn’t be surprised if they work immediately, since it’s a physical blockage of some of the drains. It’s not like a medication that needs to build up in your system. There’s probably some inflammatory action going on to confuse the situation initially, though. Keep us posted!
Meanwhile…I’m still holding on roughly one set of drops a day. Five weeks after my last treatment, this is a very good thing!
Mine tear up regularly and I think it’s allergies…I’d rub my eyes because they itched so much and then one would flame up like I had pink eye or something. Pataday used to be prescription but now it’s OTC…it helps.
My dry eye manifested the same way. I did some Googling to try to figure out why my left eye was watering and diagnosed myself with a blocked tear duct. I went to the campus health center (I was in law school at the time) and they agreed with my diagnosis but had to refer me to an outside ophthalmologist to treat it. The ophthalmologist told me I was wrong, and that I actually had evaporative dry eye caused by blockages in my oil glands along my eyelids, and my left eye was tearing up to try to compensate. He flushed out my tear duct just to make me happy and prove he was right (he was.) He then showed me some materials about a procedure that might have been the debridement described here, though I sort of remember it as being some kind of suctioning device (but I could be wrong. First time for everything!) But he also said I might not need it just yet. Instead, he gave me a prescription and a coupon for a gel to put in my eyes, and talked to me about preservative-free eyedrops, baby shampoo, and warm compresses.
Even with the coupon, the prescription eye gel was expensive, and I found it difficult to put in. When I graduated and was between insurance plans, I bought some OTC eye gel that seemed to work better, was much easier to put in, and was a lot cheaper. My eye recovered, I never went back to the prescription stuff, and I haven’t seen an ophthalmologist since.
I still get random flare-ups, which I treat at home with a warm compress, eyelid wipes, preservative-free eyedrops, OTC overnight eye gel, and as much time away from screens as I can get. I’m lucky; they always go away within a week or so. I have yet to identify a pattern that might explain what brings them on, though.