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  • Ocusoft lid scrubs

    My ocular problems have really gotten serious this past year. My upper lids are red and irritated with veins.
    I just started Ocosoft lid scrubs 2x a day to improve my lid hygiene as per my eye DR. After 2 weeks ther eis no improvement. I'm sure it takes some time for improvement. Anyone know about how long until there is some noticable improvement in redness and dry eye symptoms..?
    take care,

    John

  • #2
    John,

    Crystal posted this article that I think is great on how to treat blepharitis that I think you may find useful.

    http://www.cme.ufl.edu/selfstudy/ethis/blepharitis.pdf

    Did your doctor diagnose you with blepharitis and if so with anterior or posterior bleph? As you see the treatment varies a bit.

    Depending on what the diagnosis is the treatment may need to be modified to best suit your issues.

    You mention dry eye symptoms. What are they? And what are you doing for them besides lid scrubs?

    Best wishes,
    Melissa

    Comment


    • #3
      Hi again Melissa,

      My main problem is a burning sensation on my upper lids, and occasional redness of the lower lid. My upper lids are also veiny now with some white bumps. I'm guessing from the article it is posterior Bleph although my Eye DR didnt mention that. He only said my glands were blocked which gave me symptoms of dry eye.

      The lid wipes have helped with the gritty sensation and discharged. But my eyes are still VERY sensative and often burning. Again the lids more so than the actual eye. I have tried Restasis but it burns and makes my eyes bloodshot for hours/days. Warm compresses make me flush. Right now, i'm only doing the lid scrubs and cool compresses. I am also on Oracea. After reading the article I think I may need azithromucin topical or orals. Unless, I just need more time for the lid hygiene to take effect?

      As usual thanks for responding and taking the time to help...
      take care,

      John

      Comment


      • #4
        Hi John,

        I think you are on the right track with the lid scrubs and Oracea so maybe give it a few weeks to see if it is helping.
        I also think the topical azithromycin is a good idea as bleph is chronic and it helps penetrate and treat the bacteria for a longer period of contact time. And it is an excellent anti-inflammatory and bacteriostatic drug.


        If you do not see any improvement after a month I would ask your doctor for a steroid eyedrop to help. But adding the azithromycin should help as it is a good anti-inflammatory and may allow you not to have to use a steroid. I definitely like the idea of adding the azithromycin for a month.

        It's too bad you cannot tolerate the warm compresses as that helps "melt the blocked oils and microcirculation to the meibomian glands". I wonder if you are trying too warm a compress and if you tried slightly less warm that may not trigger you.


        Good luck John and I think that this combo might finally give you some relief. FIngers crossed!

        Best wishes,
        Melissa

        Comment


        • #5
          John,

          from what I have found on various web sites, posterior Bleph is the same thing as MGD.

          warm compresses does help me better than the lid scrubbing. And I do warm compresses followed by a lid scrubbing with Q-tip everyday. I found that wash cloth does not do the trick, so I bought rice baggy from dryeyezone and I saw a different result - the white oil secretion on the lid edge can be melted after 10 mins of warm compress with rice baggy and my eyes do not feel irritated afterwards. I have to do it twice everyday and I see it is working now with rice baggy.

          Like Melissa suggested, sometime eye drs prescribed steroid eye drop for a short course so that anti-inflammation eye drop (e.g.AzaSite) can have a jump start to kick in. When you can better control the lid inflammation, you would have better chance to fight MGD. You may discuss with your dr about your options.

          Hope it helps. It takes time for us to understand the theory of dry eye and practice the techniques. Information is power!

          C.

          Comment


          • #6
            C,

            Thanks for the info. The lids scrubs are helping a litle so far. How warm does the bag or compress have to be? I tried it pretty warm and it made my upper cheek under my eyes flush. Is luke warm enough?

            I have an appt in 2 weeks with my eye dr and will ask for steroids to kick it up a notch..

            Your right information is power!
            take care,

            John

            Comment


            • #7
              Dea John,

              You are on the right track since Melissa and others here are wonderful at helping us.

              I also have the blepharitis too. I just dont have the caking or stuff on the lashes but still i have been told i hae blepharitis. at the begining of this which was around march i also had the styes/bumps under the eyelids. but thankfully i have gotten that under control.

              Melissa who is wonderful at helping once told me since i also was having problems with the heat on the eyelid since it just made me so red and more irritated she suggested that afterwards i would use a cool ice gel pak. I will tell my routine:

              in the evening:

              take off my makeup including eye makeup (you are lucky you dont have to wear makeup_
              then i start the warm compresses for 5 minutes i tried the rice compresses but that irritated me more. so i get the cotton squares, fold them half way down, wet them with warm water the warmest i can tolorate and then squeeze the water out so i just have the warm cotton compress, i do this over the bathroom sink, and apply over my eye lids just to cover the top eye lid and lower not to cover the cheek area so i dont flush. i do this for 5 minutes i keep the water running, also in between i apply the compress over to just below the eyebrows i read somewhere taht this is helpful so i do it too.

              once the 5 minutes are up i take sterilid foam, just enough on the palm of my hand take a q-tip and soak the tip not much then i rinse my palm take some saline water the one for contact lenses and put a small amount on the middle of my palm and soak the same q-tip that has the sterilid foam then take that q-tip and scrub gently the top eye lid rim were the lashes begin a bit under also try to massage at the same time over the eyelash on top to massage a bit for the oil glands to melt then i rinse with cool water. repeat the same with another q-tip for the lower lash, then the same for the next eye with a different q-tip total q tips 4 each night.

              once im done rinsing the last eye i then take and apply systane eye drops to both eyes about 2 times each eye.

              then i take the ice pak gel wich i have put aside at the begining of this routine inside a pillow case and apply this cool gel pak to my eyes and this cools the top of my eyes so they are not so red anymore from the warm compresses.

              you are probably irritated also on the top lid when im so irritated and dry i take some over the counter hydrocortisone 1% ointment and carefully apply some to the top lid.

              when you see your eye doctor ask him for an ointment you can apply for emergencies only since applying steroids to the eye lid can be dangerous cuase whatever we apply there can get in to our eyes and cause glaucoma.

              i do the steroid oinment only wehn im really bad for about 2 days and on the others i apply a little of vaseline on the top eye lid to soothe a bit.

              i also am going to ask my eye doctor next week about the azythromicin which thanks to Melissa she put an article up and have him try that on me see if that helps more.

              Im also applying restasis eye drops morning and night. it has helped been on them since february 08 but i still have dry eyes and i have good and bad days but at least im defiently better then when i was 1st diagnosed.

              also b/4 going to sleep i apply night time ointment by genteal inside the eye, this helps me since i have to sleep with a fan directly hitting my face becuase of my stupid rosacea, the heat on my face would not let me sleep.

              In the morning i was my face, then i use the sterilid foam on my closed eyes just let the foam on the closed eyes mostly on the eyelids/lashes sit for about a minute rinse. then i apply sever times the systane eye drops, then i apply the restasis. i then apply the cool ice gel pak to the top of the yes well all over helps me cool my face but help to cool the eyes so the restasis dont burn my eyes.

              the other night i got home late and i just was too tired to do the warm compresses and i was bad yesterday so the warm compresses do help alot also help soothe my dry tired eyes.

              good luck!
              using elidel at night, taking atelenol, had 2 vbeam laser treatments, 46 year old female

              Comment


              • #8
                John,

                This is the link about MGD that I think make sense to me. It is consistent from what my dr said and my self-diagnosis.

                http://www.dryeyezone.com/encyclopedia/mgd.html

                The technique of warm compress I follow,
                http://www.dryeyezone.com/encycloped...ompresses.html

                I looked my eyes in the mirror and saw 3 glands on my right lids are plugged with white lipid secretion, which is a symptom of MGD. I tried warm compress with wash cloth on luke warm water in the past 2 months but found that was not enough for the lipid to get “softened” and keep flowing. In normal people w/o MGD, the lipid secreted by the gland should be melted in body temperature so it keeps flowing on the tear film. But for some reason because of MGD, the lipid got stuck therefore we got “dry eye”.

                So, now that I did not get good result with wash cloth, I started to explore new technique using rice baggy(pls read more on the link to see the reason behind). My goal is to get these lipid secretion melted and get a blurred vision after warm compress which means compress works as it supposed to. I soaked the wash cloth with water and put it in between my eyes and rice baggy to keep the moist as I found dry heat is not tolerable. So far I feel good about this technique and I am willing to share the experience.

                But please no over-heated otherwise the hot temperature would hurt the lid.

                Regarding the steroid eye drop, pls discuss with the eye dr as it is not good for the cornea and dr prescribes it only if he/she thinks the case is severe.

                Fyi – lid scrubbing,
                http://www.dryeyezone.com/encyclopedia/lidscrubs.html

                Hope you feel better soon.

                Crystal

                Comment


                • #9
                  I personally find lid scrubs useless for my ocular rosacea. I don't have any flaking or anything like that though so other people may be different.

                  The best thing for my eyes is omega 3 from flaxseed, but it actually makes my flushing worse so i have to keep it to a bare minimum.

                  Topical Metronidazole twice per day is really helpfull, anti histamines also help my eyes a great deal.

                  Comment


                  • #10
                    hey there-
                    i also have bleph and some days are bad and others are good.. warm compresses were also part of my instructions and i use 2 white paper towels which i find works great. then the lid scrub. one premoistened scrub per eye. which antihistamine do you guys feel works for blepharitis? i always thought that they make the eyes more dry.
                    all the best...........lin.

                    Comment


                    • #11
                      If you have rosacea and eye trouble its ocular rosacea - the terms blepharitis/MGD/ocular rosacea are pretty much interchangeable (although if you want to get technical bleph is all encompasing lid inflammation). I find Ocusoft lid scrubs to be too harsh - Novartis brand "Eye Scrub" works the best - hard to find though - Wallgreens is the only place that still carries it as far as I can tell.

                      Anyways, I noticed that nobody is discussing lid massages - the most important step. Here's what I do and my eyes are doing pretty decent:

                      Upon waking and before bed - do 10-15 minute hot compress using rice baggy heated 1:00-1:15 and wrapped in towel wetted with hot water. Then "lid massages" - use forefinger or middle finger to express the oils from the lids by running finger vertically (up or down depending on the lid) towards the lid margin and then horizontally accross the lid margin. Then lid scrubs using Novartis brand "Eye Scrub". Then restasis (it burns for the first few months but you get used to it). What I have started doing recently that has REALLY helped with dryness is drink 1 gallon of water/day.

                      Hope this helps.
                      Last edited by Brighteyes; 12 November 2008, 08:15 PM.

                      Comment


                      • #12
                        Thank you for mentioning the lid massages. The eye doctor didn't say anything about that and maybe it will be something that will really help. I was just curious as to why you thought Occusoft lid scrubs are too harsh. Did they sting or irritate the skin?

                        Comment


                        • #13
                          When I said Occusoft lid scrubs were too harsh I meant that the material is too rough - leaving my eyelids feeling raw after cleaning them. I prefer the Novartis brand eye scrub because the material is very soft - resulting in a more gentle cleaning.

                          Comment


                          • #14
                            The Ocusoft lid scrubs changed their lid scrub material and I find it to be very soft compared to their previous lid scrub. However, they changed it a while ago so I am not sure if maybe their old one is still on the market and that is the one you had tried brighteyes.

                            Here is some info that may help clear up the difference between the conditions of dry eye, MGD and bleph.

                            http://www.dryeyezone.com/encycloped...esyndrome.html

                            http://www.dryeyezone.com/encyclopedia/mgd.html

                            MGD Meibomian gland dysfunction (MGD)
                            also called...MGD, meibomitis, meibomianitis, lid margin disease
                            WHAT IT IS Your oil glands have gone on strike!
                            The meibomian glands are located in the eyelids. Secretions from these glands comprise the lipid (oily) layer of the tear film which is so crucial in preventing rapid evaporation of the tears. Failure of these glands to produce or secrete oil - due to chronic blockage, thickening of the meibum, etc. will affect the quality and stability of the tear film, which in turn will produce classic dry eye symptoms even in people whose dry eye test results appear normal. A TBUT should show whether the oil layer of the tear film is adequate or not.
                            Meibomian gland dysfunction is quite common and unfortunately it often goes undiagnosed. Even when diagnosed is often not treated or is not treated effectively until it has become chronic or severe.
                            MGD may be inflammatory (often as a result of blepharitis) or atrophic.
                            For more non-technical background to put MGD in context, please read Dry Eye for Dummies.
                            CAREFUL! MAY BE CONFUSED WITH... "Dry eye" (in the aqueous deficiency sense): Many people who have dry eye symptoms are treated as though the cause is aqueous deficiency, e.g. with artificial tear supplementation and punctal plugs, when in fact their primary problem is meibomian gland dysfunction. Some researchers believe that up to 70% of chronic dry eye may actually be MGD, not "classic" dry eye.
                            Blepharitis: Blepharitis is related because chronic blepharitis will cause chronic meibomian gland dysfunction, which in turn will cause dry eye symptoms. But blepharitis should not be confused with meibomian gland dysfunction. Keep in mind that you may clear up the bleph and still have MGD.

                            TREATMENTTypical treatments for MGD may include, depending on specifics of the condition: in simple terms, the tear film is comprised of three layers: 1) a watery layer sandwiched between 2) an oil layer on top, which is produced by the MGs and which keeps the watery part from evaporating too quickly and 3) a mucin layer underneath, which "glues" the watery layer to the surface of the eye.
                            When meibomian glands aren't producing their full quota of oil (due for example to inflammation or atrophy) dry eye symptoms ensue. Promoting good meibomian gland health is often the number one task of the chronic dry eye patient.

                            http://www.dryeyezone.com/encyclopedia/lidtherapy.html
                            These links are very informative and will explain everything you ever wanted to know about dry eyes, blepharitis and MGD.

                            Best wishes,
                            Melissa

                            Comment


                            • #15
                              Hey Melissa, always on top of things =) To be honest, I haven't used Occusoft lid scrubs in probably two years. If they've changed then great because I always found them too harsh!

                              Regarding your post, I think it should be made clear that the term "blepharitis" is a general term describing all kinds of lid inflammation caused by a number of different diseases - not just rosacea. I find it's best to just say that if you have rosacea or seb derm and eye problems you have ocular rosacea. The treatment options are the same.

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