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If you have or have had this, please share your experience. I have dealt with chronic eye pain for four months now, have this diagnosis and have made little progress. I got more kinds of eye drops than you can imagine. A bandage contact lense has been the only sustained relief but I got a bad edema while wearing one so the docs are very reluctant to put one back on. I also get abrasions and these have been seen when no filaments are present. Pain at times has reached levels the where I had to take strong pain meds, that only my gp would prescribe. Frustrating! If you know about this, talk to me. Thanks.
I have had corneal abrasions, filamentary keratitis, a corneal ulcer, you name it. I feel your pain! Did they tell you *why* you are getting all this?

Basically filamentary keratitis is teeny, microscopic abrasions on your cornea. You could probably find a more technical definition than that, but that's how my doctor explained it to me when I had it. Make sure you use a lot of preservative free artificial tear drops and keep the surface of the eye super lubricated. Tears ointment would be a good idea too. The idea is to keep your eyelids and eyelashes away from your cornea so that they don't rub up against it and irritate it more.
[QUOTE=purple2067]I have had corneal abrasions, filamentary keratitis, a corneal ulcer, you name it. I feel your pain! Did they tell you *why* you are getting all this?

Basically filamentary keratitis is teeny, microscopic abrasions on your cornea. You could probably find a more technical definition than that, but that's how my doctor explained it to me when I had it. Make sure you use a lot of preservative free artificial tear drops and keep the surface of the eye super lubricated. Tears ointment would be a good idea too. The idea is to keep your eyelids and eyelashes away from your cornea so that they don't rub up against it and irritate it more.[/QUOTE]

Thanks. How long did it take you to get over the filamentary keratitus? Did you employ any strategy other than tears? Ever try an bandage lense? That solved it for me but I got an edema from it. Did you ever have to have them remove filaments off your eye? Ever try mucomist? I am really not clear where the abrasions fit in. I mean they find abrasions and no filaments and vica versa. All the docs that I went to talk about dry eye a lot but come up with no clear cause. One said we cannot know the cause in my case but he was sure it was not bacterial, viral, or fungal. Sorry for all the questions but you are the first fellow sufferer I have found! God bless you for answering. It has gotten so pain I have taken narcotic painkillers. I have this contant pain in the corner of my eye closet to the gland all the time. Yea I use tears. Sad, my insurance getting billed into the many thousands to have docs tell me over and over to go buy over the counter lubricating drops!
For me, the dry eye is causing a lot of inflammation. One solution for me was to have all 4 tear ducts cauterized (permamnently closed) so no tears can drain out of my eyes. That has helped. I did not have to use a bandage lens when I had the filamentary keratitis because my doctor gave me enough anti-inflammatory drops that it went away without that. But I did have to use a bandage contact lens when I had a corneal ulcer. It took two months to heal with round the clock anti-biotic treatment. I cried from the pain. The bandage lens really helped a lot with the pain and sped up the healing process quite a bit. My doctor did have to try a few different lenses though before he found the one that worked best for me. The problem was also that my eyes were so dry that the contact lens would not stay in. I had to go back every day for him to put in a new lens. (he wouldn't let me touch it myself.) You might want to try some different lenses.
Oh, in answer to your question, yes I have had to have things removed that ere imbedded in my cornea. Once or twice I had a piece of dirt stuck in there and even some specks of eyelashes.
[QUOTE=purple2067]Oh, in answer to your question, yes I have had to have things removed that ere imbedded in my cornea. Once or twice I had a piece of dirt stuck in there and even some specks of eyelashes.[/QUOTE]

Well the calling card appears to be the removal of mucous filaments, thus the name, "filamentary keratitus." Ever had these? I asked other questions also. Will you answer them? Thanks. :)
I never heard of mucomist. What is that? I have had tiny bits of mucus that got stuck to my cornea that my doctor had to scrape off. (or pull off, or whatever he did.)

I think the only way to prevent this is to just use a lot of very thick tear drops and ointments. When I feel my eyes getting particularly dry I use some gel drops. I also go to the eye doctor every two weeks for an exam because my eyes have become so desensitized (or I've become so used to it!) that sometimes I have a small infection and I don't even know it.

I don't always have filaments. I've been battling my dry eyes since 2001 and I finally seem to have gotten my treatments down to a science. If you have a lot of filaments, your corneas must be very inflamed, right? Has your doctor ever suggested any sort of anti-inflammatory drops? My doctor worries about me getting filaments and specs on my corneas because it can lead to an abrasion. So he jumps on the tiniest little thing. I have A LOT of spots on my corneas from my dryness also.

How many times a day do you use the over the counter preservative free tear drops? Which ones do you use?

You also might need to try a softer contact lens to prevent the edema.

Also, is your ophthalmologist a corneal specialist? That's who you need to be seeing.
Purple my doc is an OD,and he seems to know as much or more than the young corneal specialist I went to. He also spends time and listens. Bottom line, as appears obvious, no one has any real answers... That is except to tell you to buy over the counter tears, and my insurance company has been drained out of 1000s for this advice. Yet another chronic illness with no sure, my second... Dry eye syndrome is behind this I think. One doc pushed restasis but I researched it and only 15% of 1200 patients in the clinical study got relief. And the "side effect" profile is horrible. Side effects may well include withdrawal effect, if you got dependant on it could find yourself worse off if you need to discontinue. Have you tried this drug restasis?? There are some well touted natural remedies on the net for dry eye, Biotears and Theralife Eye. Have you heard anything about these? These docs want your money... Hey, no one has even done a dry eye test on me yet! A ten minute talk and some refresh samples, me back in agony in 3 or 4 days, pretty profitable for them.... They love it when patients like us show up, with such regular income could upgrade from a Lexus to a Benz...
I tried Restasis but I was allergic to it. I am allergic to so many things that I'm afraid to try any of those natural remedies. I have not heard of the ones you mentioned.

I'm sorry you have had such a bad experience with the ophthalmologists you have seen. But the sad fact is that somebody other than a corneal specialist is not going to be qualified enough to really treat you properly. They spend years just studying diseases of the cornea and they see a lot of this stuff. It sometimes takes a while to find a doctor you can really trust and who really cares about you. It's really great that your doctor listens to you and cares, but he doesn't seem to be able to help you. I urge you to find a corneal specialist.

Not all M.D.'s are greedy and in a rush. Some will rush you out the door in 5 minutes, and that is not a doctor who I would ever go back to. It's true that some are money hungry but honestly, I really don't care how much money my insurance company pays out as long as I am getting some sort of help. That's what the insurance company is there for. And I am getting help. My ophthalmologist is wonderful. And he's not money hungry! He doesn't even charge me copayments (I'd be paying him probably about $100 a month in copayments and he said he can't take so much money from me. He said he wants me to spend my money on buying all of the drops that I need. I write him a check and he tears it up and gives it back to me.) I use the artificial tears, and a lot of allergy drops and steroid drops and ointments and gel drops. This seems to help with the overall poor condition of my eyes.

But the thing is, there really is not much out there right now other than artificial tears and thick gel drops to help with Filamentary Keratitis. They just can't prescribe what hasn't been invented yet. I would try to give the bandage contact lens another go if I were you. See if you can get a softer lens. Was your lens specifically made to be a bandage lens, or was it a regular contact lens like acuvue? (without the vision correction, of course.)

For pain, I suggest soaking a washcloth with water and squeezing it out and putting it on a paper plate in the refrigerator until it gets ice cold. Sometimes I even stick it in the freezer for a quick blast. Then stick it right on your eyes and lay with it for hours. I fall asleep. It works very well for itching, burning, pain, etc...

If you need help finding a qualified doctor in your area, you should contact the opthalmology department at your local teaching hospital. Or look up the American Board of Ophthalmology. If you tell me where you live, I could look it up too and help you find an eye hospital. So many major cities have eye institutes/eye hospitals. I bet you have one within a few hours driving distance.
Purple,

I have been to a corneal specialist and he has had nothing more to offer than anyone else... I assume you are seeing one and you haven`t told me anything I have not already heard... "Liquid tears, liquid tears, liquid tears".... What is the point in my insurance paying mega bucks to hear that again and again? And, actually, long term use of liquid tears could be keeping the cycle going. The body naturally develops dependencies to medications and if you keep dumping in artificial tears month after month it seems plenty logical that the eyes would produce less of their own. I only need the doc to monitor for infection and to remove filaments. What needs to be solved is the underlying cause, dry eye. In the restasis study on 15% of the 1200 patients got relief and the side effect profile is horrible. That is the only prescription medicine they have. The better approach seems to be natural, something European docs have long used but it is so to catch on in America. I am going with Theralife Eye, all natural, though Biotears reports good results. Both have many endorsements from opthamologists. There is also an antibiotic, doxycycline, that helps restore the corneal surface. Your cold cloth idea is excellent! I have done something similar but use a thick bounty paper towel. I do not want to use a bandage contact long term on an already comprimised eye. All my docs have cautioned against that and I have had observable swelling (edema) from the use of both a bandage and a normal lense.
Have you had any blood tests for the known causes of dry eye? Sjogren's Syndrome (an auto-immune disorder that they think I have) and Thyroid Disorders are the two that pop to my mind right now.

This Theralife Eye, is it a supplement? What's in it? Most ophthalmologists recommend taking a lot of flaxseed oil and fish oil.

I was on Doxycycline for a long time and it didn't do anything for me. I have a very sensitive stomach and when I developed severe digestive problems with it, my ophthalmologist immediately took me off of it. Besides, I was on it for 6 months and it didn't help. By the way, it does not help restore the corneal surface. It helps unclog clogged Meibomian Glands (which are the glands that produce the oil in your tears) in your eyelids. I guess in the long run, unclogging the Meibomian Glands would help restore some of the corneal surface, but it's not a direct effect of taking the anti-biotic.
[QUOTE=purple2067]Have you had any blood tests for the known causes of dry eye? Sjogren's Syndrome (an auto-immune disorder that they think I have) and Thyroid Disorders are the two that pop to my mind right now.

This Theralife Eye, is it a supplement? What's in it? Most ophthalmologists recommend taking a lot of flaxseed oil and fish oil.

I was on Doxycycline for a long time and it didn't do anything for me. I have a very sensitive stomach and when I developed severe digestive problems with it, my ophthalmologist immediately took me off of it. Besides, I was on it for 6 months and it didn't help. By the way, it does not help restore the corneal surface. It helps unclog clogged Meibomian Glands (which are the glands that produce the oil in your tears) in your eyelids. I guess in the long run, unclogging the Meibomian Glands would help restore some of the corneal surface, but it's not a direct effect of taking the anti-biotic.[/QUOTE]

Have had no tests. I`ll research the antibiotic, I get a different report regarding it`s effects from someone on another thread. My problem is mostly medication related I am nearly sure. Docs say it is clearly not fungal, viral, or bacterial. I am about to complete a detox off Klonopin, dry eye is a very common withdrawal symptom. Unforutnately it can persist many months after discontinuation. Theralife eye, you can look up the ingredients, is on the net. Has a lot of stuff in it. I`m going to try it.
One of the most important things you can do to help dry eyes is to take a lot of flaxseed oil and fish oil. I didn't see that on the ingredient list for the Theralife Eye or the BioTears. I will be in the Vitamin Shoppe tomorrow to get the oils I just mentioned, so I'll see if they have either one and look at it up close instead of just glancing at it on the web. The thing is, I'm on prescription medication and I'm not allowed to mix it with a lot of the herbal supplements, so I need to make sure it is OK for me before I start taking something like that. I'm on Interferon injections for my MS and it has a lot of contraindications. I probably would not take any kind of supplement other than the oils, because as far as I know nothing else has really been proven to work. If there was something really good out there, my doctor would know about it. And I'm allergic to so many things I'd be afraid to try it.
[QUOTE=purple2067]One of the most important things you can do to help dry eyes is to take a lot of flaxseed oil and fish oil. I didn't see that on the ingredient list for the Theralife Eye or the BioTears. I will be in the Vitamin Shoppe tomorrow to get the oils I just mentioned, so I'll see if they have either one and look at it up close instead of just glancing at it on the web. The thing is, I'm on prescription medication and I'm not allowed to mix it with a lot of the herbal supplements, so I need to make sure it is OK for me before I start taking something like that. I'm on Interferon injections for my MS and it has a lot of contraindications. I probably would not take any kind of supplement other than the oils, because as far as I know nothing else has really been proven to work. If there was something really good out there, my doctor would know about it. And I'm allergic to so many things I'd be afraid to try it.[/QUOTE]

Both of those supplements have been proven to work in many patients and all the ingredients are listed on the web at their respective sites. You can also find the back label to Biotears. Theralife did an extensive double blind study. I`d send you links but that is not allowed on this site. I do not think they are sold in stores. I`m getting involved in this as docs have not helped me much and I do not feel any are the final authority or know all there is to know. I am very sorry you have MS. If you are taking any of the benzodiazepine drugs for that, unfortunately, these are notorious for causing severe dry eye in response to tolerance or withdrawal. U.S. docs are generally oblivious to this fact though, Euro docs more knowledgeable...
[QUOTE=Jonny412]. I am very sorry you have MS. If you are taking any of the benzodiazepine drugs for that, unfortunately, these are notorious for causing severe dry eye in response to tolerance or withdrawal. U.S. docs are generally oblivious to this fact though, Euro docs more knowledgeable...[/QUOTE]

Thank you. I am doing pretty well with my MS. But since I am on Interferon injections for the MS, I can't take a lot of the herbal stuff. I also have to be careful which Vitamins I take. I can't even take Echinacea because it sends the immune system into overdrive. So I am steering clear of all the herbal stuff.

I actually am not taking any Benzodiazepine drugs. Never have. I do take Lexapro for my depression, but my dry eyes did not coincide with the starting of anti-depressants. That was one of the first avenues that my eye doc investigated with me. He had me switch from Zoloft to something with less side effects. (well, my Psychiatrist decided what else I could go on.) I was on Celexa for a while, which has less side effects than a lot of the others, and then when Lexapro came out I switched to that because it has less side effects still.

My dry eyes didn't come on until almost three years after starting anti-depressants.

Actually, my ophthalmologist did advise me against any long term use of Benzodiazepines because he knows they can cause dry eyes. Hopefully when your body gets used to not being on them anymore you will not have such bad eye problems. (you did say that you are withdrawing from Klonopin, right?) I know this board is not for talking about Benzos, but I will tell you that after I took IV steroid treatment for my MS I had to be on Klonopin for a few days while I came down from the steroids. I HATED IT! I was so drugged from one pill that I could barely stand up. Then I only took it to get to sleep until the steroid withdrawls went away. If I can help it, I will never take it again.
Thanks for sharing Purple. I hope you found some joy in your day. Here is something interesting....

I had some tests done today and only my right eye is dry. The tear breakup time is too fast, about 5 seconds, while it is normal in my left eye. Insane... Doc said this is very rare and I only have trouble with my right eye. More filaments taken off the eye today and I was in agony last night to the point of having to take a pain pill. I cannot sleep while on these pills though plus they make me nauseated. Pick your poison... What kind of pain do you prefer? Doc does not know for sure what is causing this and he says no one else will either. I am seeing another doc in the a.m. to beg for a bandage contact. The other is out, has them on order. I suspect this is not caused by Klonopin withdrawal for the simple reason that the problem is only in one eye...
The human body does very strange things! It is rather odd that this is only affecting one eye. Is there anything wrong with that eye in particular that would be causing this, like inflamed lacrimal glands? I hope you are able to get a bandage lens that works for you this time.
[QUOTE=purple2067]The human body does very strange things! It is rather odd that this is only affecting one eye. Is there anything wrong with that eye in particular that would be causing this, like inflamed lacrimal glands? I hope you are able to get a bandage lens that works for you this time.[/QUOTE]

I do not know. Can you test for inflamed glands? The doc I saw today gave me the impression that there are inumerable glands related to the eyes...
Honestly I do not think they will give me a bandage lense as I got an edema from a lense, but it was a prescription lense (all the doc had) not a bandage. All was rosey, eye fully stable, with a bandage lense in and taking it out once a week to clean it. But it looked so good that the doc decided to take it out two days and it went straight downhill. I have not been the same since... Any thoughts would be appreciated. I have depression and anxiety, plus Klonopin withdrawal, plus this and am overwhelmed.
You really can't test for inflamed lacrimal glands. An experienced doctor just knows what to look for. Yes, there are many glands in the eye. The ones I am talking about, the lacrimal glands, are the big glands that are next to your nose. They produce the watery layer of your tears. If one is inflamed for any reason, it won't produce tears. Is it possible that you ever had any sort of infection or trauma to that eye that would cause that?


I have depression and anxiety too. But to tell you the truth, a lot of my depression and anxiety came on when I started having these dry eyes. I wasn just so nervous and upset and I didn't understand what was happening to me. Now I've got a pretty clear picture of what is causing my dryness (I've got auto-immune diseases) and I pretty much know how to treat the symptoms. I still get a lot of eye infections though. At least 3 or 4 a year. Not ulcers or anything like that. Just plain old pink eye.

Talk about depression and anxiety, I never told you how my ulcer came about and what I went through with it. I came very close to losing my eye, or at least needing a corneal transplant because it was so infected. It was Christmas Eve 2001 and I had been battling dry eyes for about 4 months. Just by plain luck I found my ophthalmologist in the phone book and went to him for an exam in October of that year because my eyes had been dry for like a month. He told me that my eyes were some of the driest he'd ever seen and he immediately started me on tear drops and put in punctal plugs. My condition was far from being under control (after all, it was just a few short months into it!) So, on Christmas Eve I was at my friend's house with her family and mine. We're Jewish but they invited us to come for the holiday. Her mom had a cat, and when my eye started hurting I thought it was just because maybe I got a cat hair in my eye. I flushed and flushed and flushed with tears all night, but it just kept getting redder and more painful. The next day was Christmas and I was too stupid to go to the emergency room. I really thought it would get better on its own. My eyes have hurt before and gotten better on their own, so why should this time be any different? But by that night I was getting worse, so I called and left a message for my doctor with his answering service. They told me he wouldn't be in until December 27th. My pain was worsening considerably, and they never gave him the message that I called. I could not believe that he was not going to be back until two days after Christmas. So I decided to call again on the 26th and leave another message. But when I called, the phone was not answered by the service, but by the office! They were in! I got an immediate appointment. I had to wait a long time, but they took care of me while I was in the waiting room. The assistants came out and sat with me, and they brought me cool compresses. My doctor happened to walk out to show a patient to the door and he saw my eye. He did a complete turn around, walked over to me and said "come with me" and took me by the hand and dragged me into the exam room. He said I had the worst ulcer he'd ever seen. It was covering about a third or more of my cornea. He had to send someone out to the lab to get a culture kit so he could take a scraping of my cornea. He said that my eyes were so dry that I just blinked and I rubbed off the surface of my cornea. I was on anti-biotic drops for about a week but instead of getting better the eye kept getting worse. So he sent me to Ny Eye and Ear Infirmary to get specially made, fortified anti-biotic drops. They took the anti-biotics right out of the IV that they would put into a patient's arm and made drops for me. I was on Fortified Tobramycin drops and Vancomycin drops for a month, around the clock every two hours. Vancomycin is one of the anti-biotics they give to people who have uncontrollable Pneumonia. I had to get up every two hours even in the middle of the night and put these awful, awful drops in for two months. I think I wore a bandage lens for the second month and used regular anti-biotic drops that you can get at any pharmacy, also every two hours, then every four hours, then every six hours, etc... Then came the steroid drops. 4-6X a day for another two months. Then finally, I was able to stop treatment. But my eye was so photophobic that I had to get my eyeglasses made into transitions lenses so I could see in the sun.


When I had my bandage lens in my eye it was also a regular contact lens, not a special bandage lens. But the thing that makes our situation different is that my cornea was so fragile that I was not allowed to touch the lens myself to clean it once a week. He used daily disposable lenses and I had to come in every day and have him change the lens and examine my eye for any signs that the ulcer was getting worse. Plus, my eyes are so dry that I cannot wear contact lenses. So he would put the lens in and sometimes it would fall out a few hours later and I'd have to call him and go back.
Purple,

Sure sounds like a terrible experience with the ulcer. It blows me away.

My main doc is going out of town and need someone to treat my eye. Went to a guy I had been to one other time and he refered me out because I showed hesitation at taking restasis. He also would not precribe doxycycline, said he saw no reason for it. And he said he would not remove filaments outside of office hours. Would not put in a bandage lense either. I feel quite along with this eye problem and pain. I have read that restasis can cause immunal problems, is often not successful, and I do not like the side effect profile.
You are right. Taking Restasis is only going to mask the problem. If there is any inflammation it will help with that, but you need to find out the reason behind having one dry eye.
[QUOTE=purple2067]You are right. Taking Restasis is only going to mask the problem. If there is any inflammation it will help with that,[B] but you need to find out the reason behind having one dry eye[/B].[/QUOTE]

Do you have any idea how I find that out? Because I have been to three doctors and the only corneal specialist in town that takes Medicaid, and all say there is no way to know for sure. I did get a script of Doxymycine. The doc also said that I am sensitive as he has seen people with similar tear films problems and filaments and they were not experiencing near the same degree of pain I am...
You've got to see someone who specializes in dry eyes. If you contact the ophthalmology department at your local hospital they should be able to help you find someone. Or look up eye hospitals and see what is in your area. (where do you live?) A hospital should take Medicaid. Now, do you have any tears at all? Or do you just have tears that are deficient in one or more of the necessary layers. If your tear break-up time is fast like you said, then it indicates a problem with your tear film.

Each patient is different. What bothers you might not bother someone else. My doctor said he has seen people in my condition who are crying in pain, but my eyes are a little desensitized from all of the problems I've had that a lot of times I don't feel things that someone else would Yet I am highly sensitive to chemicals, wind, certain preservatives that are used in eyedrops, and some other things that people with normal eyes are not sensitive to at all. He once prescribed me a non-steroidal anti-inflammatory drop that a lot of people have good success with. I had such a severe allergic reaction to it that my eye was swollen shut for the rest of the day. (I wasn't stupid enough to put it in both eyes!)

Remember that the cornea is a particularly sensitive area. It has more nerve endings than any other part of the body.
I have been to an eye hospital and seen a prominent corneal specialist many times, and he says there is no way to know for sure what is causing the dryness in one eye. Two other eye doctors say the same thing. I believe them, and I have found no studies on the net to contradict them. You are free to believe what you will. There are mysteries in medicine, and it can be like diagnosing an automobile, you troubleshoot... I control it best by minimizing use, am trying the oral antibiotic, will be taking the herbal supplement and fish oil, all while hoping for the best, and an end to abrasions and filaments. Last resort will be restasis, some time off Klonopin may help.
It's unfortunate that Medicaid is so constricting with who they will allow you to see.


Is your dryness in that eye a *quantity* problem or a *quality* problem? In other words, do you have enough tears and they just don't stay on your cornea, or do you not produce any tears at all? If you have a *quantity* problem then it is because your lacrimal gland is not producing enough of the watery layer of tears. If you have a *quantity* problem then you have enough of the watery layer but the Meibomian Glands in your eyelids are clogged or not producing a sufficient amount of oil and mucus for your tears to be able to stick to your cornea and the watery layer just rolls right off.

It's good that you are trying to attack this from all ends. Have you started the Doxycycline yet? Doxy is a good drug, but it will only help if you have a problem with your tear *quality*. It will help open up the Meibomian Glands and ger rid of any bacteria in them to allow the oil to flow more freely. It will not make your lacrimal gland produce more of the watery layer of tears. I wish it would! For me, the problem is both. I produce very few of my own tears (that was happening long before I started using artificial tears, so it's not from a dependency on them) and I have almost no oil or mucus in my tears because all of my Meibomian Glands are clogged. Basically, my eyes would be shriveled up like raisins without my Bion Tears!
Quantity or quality? That was one excellent post and rest assured I was ask the corneal specialist about it, will be seeing him for a while. Will also see what I can find on the net. So it would be one gland or another? Then that leaves the question, what is cusing the gland to maljunction? Example: inflamation... Okay what is causing the inflamation? And why just one eye? See what I mean?

Medicaid is not restrictive at all about who you see. It is fantastic insurance and pays for most anything, including full prescription drug coverage. And they pay off well! Who has more money than the govt? The issue is that a whole lot of docs do not want to take it. Not sure why. Maybe they do not like our "element" sitting in their offices... :rolleyes:
[QUOTE=Jonny412]Quantity or quality? That was one excellent post and rest assured I was ask the corneal specialist about it, will be seeing him for a while. Will also see what I can find on the net. So it would be one gland or another? Then that leaves the question, what is cusing the gland to maljunction? Example: inflamation... Okay what is causing the inflamation? And why just one eye? See what I mean? [/QUOTE]

That is *EXACTLY* what I am talking about! You need to know if the dryness in that eye is being caused by an inflamed Lacrimal gland, or by clogged Meibomian Glands or by something else entirely (which I don't know what that would be exactly!). Only then can you get the right treatment. It is possible to attempt to figure this out on your own. You just have to pay careful attention to your symptoms. If you have dryness because of clogged Meibomian Glands in your eyelid (they are teeny little glands all along of your eyelashes that produce the oily component of your tears) then you could possibly have *enough* tears, but not the right kind. In that case, any tears that you do produce would be overflowing your eye because they can't stick to your cornea. If you've got dryness but your eye waters, then it could be from clogged Meibomian Glands. On the other hand, if you have absolutely no tears at all then you know it is a problem with the watery layer produced by the Lacrimal Gland and you know to start investigating that. An anti-inflammatory drop like Restasis would certainly help any inflammation in your Lacrimal Gland and possibly let you produce more tears. Producing more tears means that you would not have so many filaments sticking to your cornea because they'd be washed out by your tears.

Another important question to ask the doctor is whether or not you have dry spots on your cornea. That would let you know just how damaging the dryness really is. (if you do have dry spots, they will go away with a lot of lubrication but can eventually lead to permanent damage.)

And *if* you have inflammation you need to know what is causing it and what makes this eye different from your healthy eye.

Hope I have been helpful and I'm not confusing you even more! :)

I think part of the reason why some doctors don't want to accept Medicaid is that Medicaid may not pay the doctor very much. The doctor has a set price that he charges for a visit, but insurance companies also have set price that they will pay for such services and if the doctor doesn't want to accept what the insurance is willing to pay him, then he just doesn't take patients with that insurance anymore.
Okay well maybe that is why I am not getting much more than a quick eye exam and a few answers to questions while they jot down their notes. Medicaid does not pay them what they want. Money is what everything comes down to anyway.... I do have tears, just a fast breakdown time on the right eye. Maybe they can deduce what gland is not functioning properly, but again that leaves the question as to [U]why[/U] the gland is not functioning properly or why it is inflamed, etc. Could be a multitude of causes. And frankly, I am too ill with something else to go all over town, sitting in waiting rooms and lobbying doctors. I have a severe drug induced anxiety disorder and am surprised I have been able to do as much as I have. Will tell you this though, if what you saying saying is true, that there is a whole lot more medically that these docs could have done for me over this last 4 months, this angers me all the more...
I don't know if I am correct or not with my "diagnosis". But it would just anger me very much as a patient if I were having a problem and the doctor that is supposed to help me didn't try to get to the bottom of things. Just because you are on Medicaid doesn't mean you are of lesser importance than a patient with private insurance. (well, I guess to some doctors it does mean that.)

If it is really Meibomian Gland Dysfunction, I guess I could see how it might only occur in one eye. But really, I am just guessing here. MGD is just something else to look at as a possible cause.

Now remember that you have more than one Meibomian Gland. You've got dozens of them in each eye. They are tiny and run along the base of your eyelashes. Do you have any bumps on your eyelids? If you pull down your lid and look at the inside can you see any white or yellow or green dots along the lashline? If you gently squeeze or press on your lower lid, do you see any yellow or white or green stuff coming out?

Don't take my word over a true medical diagnosis. I could be right, I could be wrong. But it is definitely worth looking into. The method of treatment for MGD and Blepharitis (which it does not sound like you have) is to use hot water compresses and then massage the lid gently to expel the clogged oil after it has melted. Don't do it if it irritates you though. That might be one way to either prove this theory or disregard it. If you do this for a few weeks (usually twice a day for ten minutes or so each time) and you notice some improvement then maybe you have hit on something.

Also, my doctor always tells me that if I have a lot of mucus floating around in my eyes to use a compress (either warm or cool, your choice) to moisten the eye and bring the mucus to the front so I can get it out. Do you ever get noticeable strands of mucus in your eye? (They would look like little white strings and would hurt and feel like something is in your eye until you get it out.)
[QUOTE=purple2067]I don't know if I am correct or not with my "diagnosis". But it would just anger me very much as a patient if I were having a problem and the doctor that is supposed to help me didn't try to get to the bottom of things. Just because you are on Medicaid doesn't mean you are of lesser importance than a patient with private insurance. (well, I guess to some doctors it does mean that.)

If it is really Meibomian Gland Dysfunction, I guess I could see how it might only occur in one eye. But really, I am just guessing here. MGD is just something else to look at as a possible cause.

Now remember that you have more than one Meibomian Gland. You've got dozens of them in each eye. They are tiny and run along the base of your eyelashes. Do you have any bumps on your eyelids? If you pull down your lid and look at the inside can you see any white or yellow or green dots along the lashline? If you gently squeeze or press on your lower lid, do you see any yellow or white or green stuff coming out?

Don't take my word over a true medical diagnosis. I could be right, I could be wrong. But it is definitely worth looking into. The method of treatment for MGD and Blepharitis (which it does not sound like you have) is to use hot water compresses and then massage the lid gently to expel the clogged oil after it has melted. Don't do it if it irritates you though. That might be one way to either prove this theory or disregard it. If you do this for a few weeks (usually twice a day for ten minutes or so each time) and you notice some improvement then maybe you have hit on something.

Also, my doctor always tells me that if I have a lot of mucus floating around in my eyes to use a compress (either warm or cool, your choice) to moisten the eye and bring the mucus to the front so I can get it out. Do you ever get noticeable strands of mucus in your eye? (They would look like little white strings and would hurt and feel like something is in your eye until you get it out.)[/QUOTE]

As to the docs, Medicaid, well, you got more faith in mankind than me. With few exceptions, life is all about money... One`s own personal pleasure comes first, and people rarely have compassion for suffering they themselves have not experienced.

Negative to all your tests, lids look fine, no bumps, no strange liquids oozing out. I have though seen white liquid a few times when the eye was very swollen and irritated. Yes I have had strands of mucous on my cornea. Filamentary Keratitus, is why I started this thread! :) But I cannot see them, not even close. I suspect they are there though when I have the foreign body sensation and nothing relieves it. I go see the doc and sure enough, filaments. I am there twice a week for the last 4 months to have these removed, except when a bandage lense has been on. That has been the only remedy and docs are reluctant to use it due to infection and edema risk. Do you know any safe way to get the filaments out yourself at home?? Thanks.
I don't know how it would be possible to remove filaments yourself. How can you see them? What sterile tool would you use to remove it?

When I say that I have strands of mucus in my eyes I don't mean from my occasional filamentary keratitis. I mean that I have BIG pieces of mucus that are 100% visible when I look in the mirror. They're not filaments. They're strings of mucus that are caused by my dryness and allergies. They're usually about the thickness of a piece of a thin piece of yarn, and are sometimes double the length of my thumb. (they wrap themselves all the way around my eyeball.) I have to get them out or it will eventually scratch my cornea, so when I feel it I flush and flush and flush with tears and when I can see it in my lower eyelid I take a q-tip and gently touch it to the mucus and it pulls the whole thing out, inch by inch! They are very thick and glue-like.

The filaments that I have had stuck to my cornea would not be visible to me. It's also not safe to remove them yourself because aside from not being able to see it clearly, you could give yourself a much worse corneal abrasion if you do it the wrong way. They're stuck to your cornea. You could take off a piece of your cornea if you do it the wrong way. And I don't know about you, but I don't have a steady enough hand to do eye surgery on myself! :D
Purple,

It sounds like you got it worse than me and I do pray for you. I do not have those strands you talk about. Okay I will keep doing what I am doing, managing the pain as best as possible and getting my "surgery" twice a week. One doc uses forceps, the other a cuetip. I prefer the cuetip method, much less nerve racking. I got to make it all weekend and the eye is acting up this afternoon. Last night it was awful and wet ice cold folding bounty paper towels helped a lot. Heat does not help. Just closing my eyes, no computer or tv helps. I am taking the doxycycline and herbal supplements. I just want to manage the pain, will be content with that for now. Have strong painkillers if all else fails.
By the way? How is anyone expected to just live like this, like there is a stick jammed in the edge of your eye all day month after month? I mean anyone freals out when something is stuck in their eye... Imagine this all the time! It has been flaired up for hours now, nothing relieves the pain, and my doc that will see me after hours is on vacation. I may take an opiate painkiller. The ease it a bit, not much. But I am running real low on them and no one wants to prescribe more. My doc said that I must be extra sensitive as he claims to have seen many others with similar eye problems and they reported less pain.
Sometimes putting in a thicker eyedrop or ointment can help heal the cornea and alleviate the discomfort. Try getting an over the counter artificial tears ointment such as HypoTears or Bausch & Lomb MoistureEyes. Sometimes just the thickiness of an ointment soothes a sore eye. It certainly can't hurt.

You also may need to use the cold compresses regularly several times a day to get more relief in the long run.

Hopefully you won't have to live with this forever. For most people like myself, this is just an aoccasional thing. I know how much it hurt when I had a lot of filaments last year, so I really feel for you. I'll be praying for you too. Really, the only thing that helped me get rid of this when I had it was to get the filaments removed (my doctor numbs the eye and uses a forceps with an almost microscopic head and I don't even feel him touching me.) and then to lubricate the hell out of the eye. I mean, for a few days after I have an episode of this, I have to use tear drops at least two or three times an hour just to make sure there are no more extra sticky filaments sitting around in there. Then the problem is gone and it doesn't come back for a few months.

I don't think my problems are worse than yours. Just different. I only get the filamentary keratitis occasionally, so in that respect you have it worse than me. But I get these huge strands of mucus (or "goop" as I like to call it!) that I have to pull out on my own or they cause immense discomfort. They're not stuck to my corneas though. (It feels like there's a really, really big hair in my eye.) I also have terribly severe dryness in both eyes, but at the same time my eyes water and so I have extremely sore eyelids. I have to use steroid ointments on the skin irritation around my eyes. I also get chronic eye infections because my resistance is so low. (dry eyes means I don't wash out any bacterial or viral invaders. That's a big reason for using artificial tears.) But, I am not in *pain* most of the time. My eyes burn and itch and water and get dry and I get bad sticking sensations, but I am never in agony like I would be if I had an abrasion. And I do get some relief with all of my treatments.

Have they ever treated you with anti-biotic drops after removing the filaments? My doctor always has me use anti-biotic drops for 3 days because he says that removing the filaments usually creates a microscopic corneal abrasion that in someone like me with dry eyes and low resistance would turn into something much more serious without anti-biotic treatment.

Did they ever tell you that? Did anyone ever tell you that when they remove a filament that is stuck to your cornea, it takes an equally tiny piece of your cornea with it (cause it was stuck to it!) and it can take some time for that to heal?

If you are getting so many filaments that you have to get them removed twice a week, maybe part of your pain is from the removal itself! Even a microscopic abrasion hurts a lot, and you've got more than one! That might be something to consider.

Have you ever tried going on a mild steroid drop for just a few short weeks to help reduce any inflammation in your cornea? (It's got to be inflamed with all the filaments you've had!) That could help with pain too. Mine help me immensely!


Doesn't it feel great when the doc uses the numbing drops on your eye before he does any sort of procedure? I look forward to my dr checking my intra-ocular pressure every two weeks because he has to numb my eyes in order to be able to do it! He says the numbing drops are only supposed to last for 10-15 minutes, but for some reason my eyes just suck them up! It usually lasts anywhere from 30-45 minutes! Oh, what a nice break that is! I BEGGED him to prescribe some for me to take home, but he said that constant use of them would eat a hole in my corneas. Oh well. :rolleyes: Anesthetic eyedrops. What a neat invention. Sigh.
Purple,

Yes to all your questions. All rings true, filaments, abrasions after, have tried all the drops, branks, thick ones, oinments, yes I have taken the antibiotic drops. Artificial tears only agravate it more when it is flared up. No sooner than an abrasion heals more filaments arrive. I deal with this all the time and am running out of fight, has gone on 4 months. They keep saying it should resolve but it never does. It hurts like crazy right now and am trying not to take another pain med, do not want to get tolerant or addicted to them. this is torture, cannot imagine a worse thing upon a person than chronic corneal pain and weekly surgeries. The only thing that has helped is a bandage lense but I got a severe corneal edema with one on and they do not want to use it. Poeople say "God will not give you more then you can handle." I used to believe that but no longer do.
I'm so sorry you are dealing with this. Nobody realizes how much the eye can hurt if they have not had it themselves. Chronic illness is a very difficult thing to adjust to. I am most certainly not trying to make light of what you are going through, because i know how painful corneal abrasions and filaments can be. It's probably one of the most painful things a person can ever experience. Having that corneal ulcer that I had was the absolute worst experience of my life, hands down. I've had a lot of other bull to deal with too though. People ask me how I can have such a good attitude, but I think it comes from knowing I am going to be OK in the long run, and that even though it may seem bad at the time, nothing lasts forever. I am doing very well now (except for my persistent, chronic, painful dry eyes that will probably never go away.) A person can go through a lot and still come out on top. There have certainly been times in the last 5 years that I have asked myself what I ever did to deserve all of this, and I have thought that I must have been a murderer in a previous life! Nobody deserves the health crisises that I (and you) have had to deal with. But I just keep telling myself that I am doing the absolute best for myself as far as getting top of the line medical care, and that eventually whatever the newest episode is will pass. Your filamentary keratitis has got to get better. It won't stay like this forever. Remind me again though, how did it start?


I have had a lot of crap to deal with, with my health. I am not one to say "woe is me". I am the type of person to just pick up and trudge on. Like I said, I would never make light of anybody else's situation. You have been going through a lot of horrible pain with your eyes, and I feel awful for you. I wish there was something more I could do to help.

But listen to me. I got through all of my health problems, and you will too. And don't be afraid to take a pain pill when you need one.

My dry eyes have been here for the last 5 years or so, but I have to say that the last two years were really my biggest hurdle. I was diagnosed with MS in late 2003. In early 2004 I fell and broke my kneecap. That took 3 months, plus physical therapy to get back to normal. In August of '04 I had an MS attack that put me in the hospital for 5 days of IV steroid treatment. In January of '05 I fell at work and broke a bone in my foot into 5 pieces. 3 more months. Then I got a strep infection that ate away at my tonsils. I started having to deal with chronic tonsil stones and infections. In January, a new IV drug for MS came out and they wanted to put me on it immediately. I have very difficult veins, so I had surgery in February to put a catheter into my chest so they would have easy access. two days after the surgery, the new medication was taken off the market and now I have this useless catheter in my chest. Then, in April I had another MS attack. This time they treated me at home, but I nearly lost the vision in one eye and I was out of work for two weeks. (thankfully my vision returned to 100% with treatment.) Dealing with my chronic tonsil infections, I took an anti-biotic that caused such a severe allergic reaction that I nearly went into anaphylactic shock. Had the ambulance arrived a few minutes later they would have probably had to resuscitate me. So then in August of 2005, I had my tonsils taken out and wouldn't you know it, the hospital didn't sterilize the equipment well enough and since it was resting on my tongue during the surgery, I got an infection on my tongue. I couldn't eat anything but pudding for weeks. In the midst of all of this, I was at the ophthalmologist every few days with a new eye problem.

All this was while going to school part time for my Master's Degree and working full time. Now, FINALLY, I am on the right medication for my MS and am not having any more attacks. I don't have my tonsils, so I have no more throat infections, and because my MS has stabilized I am not falling down and breaking bones anymore.

I kept thinking to myself "how much can God throw at me?" I used to just sit down and cry hysterically for hours. I was terrified that this downward spiral would never end. But with diligent care and A LOT of faith in myself and support from family, friends, and doctors, I got through it. You will get through your crisis too. A lesser person would have crumbled by now under the circumstances. Chin up!
Purple,

Thank so much for your story! I have been sick for 2 & 1/2 years now. I have dealt with Klonopin withdrawal which is horrendous and am nowing going through that again, PLUS the eye, which has not improved at all in 4 months, has gotten worse if anything. I have no support. My family lives out of state and thinks it is all drama, or that is what they suddenly chose to think when confronted with the prospect of sending $.... They do not speak to me. I have tried to develop relations with churches but they do not return calls or keep commitments. I am not a good prospect for them, cant pay the "church tax" and my precense is not pleasant. I am well educated, had a good career, was reduced to govt aid with other health problems and now this eye! It is a nasty looking mess, should see the looks on people`s faces when they see it. I am a modern day leper. I do not know what i would do if i did not have some strong painkillers, but I am running low on them. Eye docs will not presribe but my GP may again.
Nooooo, you are not a leper! My right eye was like that for a while too, bright red and bloodshot and oozing green stuff when I had the ulcer. I had to reassure a lot of people that it wasn't contagious. My eyes still look pretty bad. My students always ask me why I am crying, but I'm really not. My eyes are watering.

I guess your docs won't prescribe narcotic pain killers because 1) they don't want you to become addicted to them, and 2) they don't think your pain warrants it. I don't think they should try to decide that for themselves though. How do they know how much pain you are in? Pain tolerance varies from person to person. What might be just a mild pain to one person may be agonizing to someone else.

Try using ice cold tear drops as a sort of anesthetic eyedrop. Put them in the refrigerator. It helps me immensely when I have pain. Cold deadens the nerves.
I think I missed one of your questions.

This all started when I had dry itchy eyes then I noticed I was seeing very blurry out of the right eye. Went to the doc, he said "corneal abrasion," gave me an antibiotic drop and sent me home. Checked it 3 days later and the eye was all clear. 4 days later it is dripping, hurting, and blurry. He then saw 3 "abrasions," was surprised. I assured him again that I had not been rubbing my eye. He then investigated further and identified filaments. It has been that cylce ever since, 4 months now. My greatest relief was when I had a high water bandage lense in 3 weeks, eye completely healed, vision perfect, so doc decided to take it out, see if it would hold up. 3 days later I am back in serious trouble. He then put in a prescription contact, much thinner. 4 days later I developed a full blown corneal edema and the lense was bad, fell apart on my hands. But now they are real hesitant to put in any kind of lense so I have been roughing it 3 weeks. On the pain pills, well when I run out will find a way to get more, but from a GP. Will at least get some Tylenol 3s. Did you ever take pain meds for eye pain? I just took one and it wiped out 90% of the pain. But they hype me up some...
My eye doctor offered to prescribe me Percocette when I had the corneal ulcer, but I was stupid and didn't want to take it. I have since not had anything else that I would need pain medicine for. I have had corneal abrasions and things like that, but those heal within a few days and the cold compresses seem to help a lot. I was never offered any pain medicine when I had the filamentary keratitis. Although I do remember sitting in the waiting room in agony and the technician went and got my doctor for me and he put in some numbing drops while I was in the waiting room. Then once he cleaned up all the filaments and got all the junk out of my eye, it felt much better.

I have taken pain meds for gallbladder problems both before and after surgery. I also took a lot of Tylenol W/Codeine after my tonsil surgery. Of course, I also took pain meds for my broken bones. I've also taken them for severe headaches. Maybe in my whole life I've had 8 times where I've been prescribed prescription pain meds. I could have taken them when I had the corneal ulcer, but I knew it wasn't going to go away anytime soon and I didn't want to become dependent on them.

I am sorry that your family is not being more supportive. I hope they will come around.

Can I ask how old you are? I am 25.
Purple,

Yes you can! :) I am almost 47. 25... You are so young, mature, and very brave. I know God has a lot of work for you. I hope you keep your eyes on this thread when you have time. I was a teacher also by the way, for 8 years. I was very good by all reports. Have not taught since 2004 nor worked at all.

Maybe I was paranoid, but could swear I could hear one of my docs (former doc) and his assistant "talking shop" about me before coming into the examining room, thin walls.... He said something to the effect, "yea this is that guy with the corneal abrasion wanting the pain pills." The tone was if he was scoffing. I do not think some of these docs read up enough. More than one study on the net says filamentary keratitus can involve "severe pain." I obviously have a severe chronic case. Yet I seemed to be viewed by some as a joke, with my swollen leds, redness, rapid blinking, watering and all. I suppose it is really true, people cannot have adequate compassion for suffering they have not experienced themselves, docs included.

I do not want to be dependant on pain meds either! But there are times I must have a vacation from the pain. Cold compresses only help while they are on. Hydrocodone eases the pain for 6 hours, Tylenol 3, only 3 hours! Well of course you cannot take too many Tylenol 3s in a day as ou do not want to be loading up with too much Tylenol. I am going to the doc tomorrow, am sure I have had filaments all weekend. But, when I fully discontinue the Klonopin and may well be shaky and unable to handle sitting in doctors offices twice a week and getting my eye worked on. Or, perhaps, I`ll manage it anyway! Tranquilizer withdrawal is another whole matter that you aren`t going to be able to relate to...





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