Dealing with chronic dry eyes (take 2)

Some people know when they have dry eyes. Their eyes feel…well, dry or maybe gritty, scratchy or irritated. I think my problem is that my eyes are dry, but I’ve become used to that feeling so I never feel my eyes are dry. I don’t know there is a problem until it starts to affect my vision.

I was diagnosed with chronic dry eyes back in 2019. To correct the damage to my dry eyes, I tried amniotic membrane applied to my eye. Amniotic membranes have been used in the healing of burn victims. It promotes wound healing and prevents scar tissue formation. It also helps about 88% of those with chronic dry eyes.

And it did work – for a year until I ran into the same problem with the severe dry eyes and dry patches on my eye. Since it had worked before, I decided to go ahead and try the amniotic membrane again. This time, a different doctor in the office did the procedure. Let’s just say, it didn’t go as smoothly as last time. Instead of only covering my lower part of my eye, this time they put the membrane over my whole eye, which obscured my vision horribly (something that should have gone away but this time didn’t). And then because my eyes were dry, they had trouble removing the membrane a few days later. It was not a good experience, but it did fix my dry eyes.

My insurance didn’t cover either procedure (needed to meet the deductible first). So, in December when I noticed a small change in my eyesight while reading my phone, I wanted to deal with my dry eyes before I get to the stage of dry patches and amniotic membranes. I’d be cool with it if it went the way the first one did though the expense isn’t one that I really want to pay if I don’t have to.

Once again, I researched dry eyes. I began doing some of things I really should have been doing all along. The problem with chronic dry eyes is that there is no cure. You can only treat the symptoms and work to maintain the moisture in your eyes. It is something I should be working on daily. I needed a routine that I would keep up with.

Here are a few of the things I am doing.

Eye Drops – I think this is the first thing that many of us grab when we have dry eyes. I am currently using two different drops with different lubricants. Since I wear contacts, I use Oasis Tears Plus as recommended by my doctor. For first thing in the morning, I have been using Refresh Digital PF and before bed I use GenTeal Lubricant gel. I have heard that you have to find what works for your eyes so experiment with which lubricant works best for you.

Mask – A heated mask can help improve gland function and slow tear evaporation. When I started, I was using a mask that you heated in the microwave, but the heat always didn’t last long enough so last year my brother bought me this electric mask. By adding a little water to the mask, it provides a moist heat which feels good. Afterwards, a gentle massage of the lids is beneficial and take almost no time.

Eyelid Scrub – This can be either a pre-moistened cloth or liquid spray and is used to clean the eyelid of excess oil and debris. This is the one I am least sure of as way to maintain the moisture in my eyes, but I saw several recommendations for it so thought I might give it a try. I am using these pre-moistened cloths that I cut into fourths. I have added this to both my morning and evening routine after the mask.

Supplements – Omega 3 fatty acids can the eye’s oil film, so I have been taking a supplement meant for dry eyes. The negative is it is 4 pills. But I plan to try this one next as it requires only 2 pills per day.

Humidifier – With the heater running in the house, the air in the house is drier so I ordered this humidifier to run in our bedroom during the evening and through the night.

Hydration – And one of the simplest things should be to drink more water but this is still one I struggle with. I am not good a drinking throughout the day but I am working on it.

And of course the other thing to do is blink more. I spend a lot of my day staring at the computer. Looking away from the screen and blinking is something I am trying to getting in the habit of doing.

I’ve been working on this new regime for a few weeks. On a few days, my eyes have been bad enough to affect my eyesight. On others, everything seems fine. Hopefully, I can keep on top of this and not have to see the eye doctor for more advanced treatment.   

Dealing with chronic dry eyes

I’ve been wearing contacts or glasses for over 30 years. At each yearly checkup, there is little change to my prescription. But I am getting older, and last year finally started needing reading glasses in addition to using my contacts to sharpen things in the distance.

When I went to my last eye appointment in October, the doctor suggested trying progressive lenses for my glasses and trying monovision for my contacts so that I would not need the reading glasses. Monovision is where they correct one eye for distance and the other eye for reading. As strange as it sounds, it does work though the viewing of things in a distance is not as perfectly clear as it would be with regular contacts.

I adjusted to the new contacts and glasses, and everything was fine until in late February, I noticed a slight change in my vision. Sometime in the morning or evening, focusing with my contacts seemed harder when looking at the computer screen, but the problem wasn’t there for the rest of the day.

Over the next month, I noticed a slight change in my vision when looking at things in a distance. At first is wrote it off to still not being used to the not-as-crisp vision of monovision. But then I noticed that I had the same problem with my progressive-lensed glasses.

Finally, in April, I decided I needed to go to the eye doctor and talk to them about the change in vision. It seems that as many aging people (I am in my mid-forties), I have developed chronic dry eyes. I had not noticed them feeling dry. They weren’t scratchy or irritated. Sometimes they felt tired but certainly not dry. Now looking back at it that tired feeling may be them being dry.

But this isn’t the case of just having to put drops in my eyes regularly and everything is fine. My dry eyes have created corrosive patches on my cornea. The swelling from this is what had changed my vision and needed to be repaired so as not to get an infection in those open areas. (My vision had decreased so much by the time I went in that I could not see the computer screen with my glasses on. It was blurry but readable with my contacts in. I pretty much rarely wore my glasses in the weeks before my appointment.)

I went home from that appointment with a prescription for some drops that had antibiotics (for any possible infections), steroids (to reduce swelling) and a lubricant (for the dry eyes). I was also to put on a special warm mask to help produce lipids (the oily substance that moistens the eye). It was also suggested for me to not wear my contacts as to not introduce possible bacteria to my eyes.

Within a day or so of treatment, I noticed an improvement in my eyesight. After a week, I went back to the eye doctor having noticed about a 50-60% increase in improvement. Imagine my surprise when the doctor said that he saw no change in my eyes. Yes, my vision had improved but a close look with his instruments still showed swelling and dry patches – including one on my iris.

He discontinued the first set of eye drops and recommended another one to help with the swelling associated with dry eye disease. There are only 2 prescription eye drops for the long term that address my condition. Both are expensive – especially if not covered by insurance. He recommended Xiidra which works faster than Restasis. There is no generic of either medication.

Well, wouldn’t you know it, my health insurance doesn’t cover either one. And he wasn’t kidding when he said they were expensive. At my pharmacy, Xiidra was $609 without insurance. Yikes! And that is for a month’s supply. Dang.

After looking online and downloading several specials and coupons, I went to a different pharmacy where I thought I might be able to get the medication cheaper. Unfortunately, they were not able to combine all my coupons, but I was able to get the medicine for $290. (I figured I didn’t want to mess with my vision and eye health so I couldn’t let cost be a factor here.)

In addition to the new drops, I researched online things I could do to help with the chronic dry eye condition. They mentioned the warm compress/mask which I now try to do twice a day. Another suggestion was to drink more water. Done. And then there was the suggestion to blink more often. As we stare at the computer screen or our phones, we tend to not blink as often. I’ve been working on this too (as I look away from the computer screen and blink several times). And the last suggestion was to increase fatty acid intake, so I pulled out the fish oil capsules I had bought in the past but never faithfully taken and started taking those.

I have been with the regiment for a week and a half. My vision is better, but I won’t know if the dry spots have cleared up/improved until I go to the doctor later this week. I hope so but if not, he has a list of other treatments to try.