ARCHIVE – The remedy in a nutshell – for the vast majority of dry eye sufferers

One of the most critical aspects of dry eye therapy is correct diagnosis. [Source]

Most cases of eye-strain/ dry eye are because of the BLOCKAGE of the oil secreting eye glands (Meibomian glands). In almost all cases there is inevitably an associated bacterial infection and inflammation – which might not lead to visible signs for a long time. This discussion (and remedy) is for those vast majority of dry eye cases [evaporative dry eye, or Meibomian Gland Dysfunction/Disorder, i.e. MGD).

However, it appears that using TheraTears is vital to the recovery (since goblet cells are likely being destroyed by increased saltiness of tears). [Listen to Dr. Gilbard of Theratears] 

TheraTears that rehydrates the tear film, lowering elevated tear film osmolarity, and provides the tear film electrolytes that are crucial for growth, maintenance and repair of the eye surface.  In peer-reviewed studies TheraTears has been shown to provide cumulative dry eye relief by promoting healing of the eye surface as evidenced by restoration of the goblet cells and glycogen that have been lost in dry eye.  [Source]  

Also read his article on dry eyes: At 1 week and 1 month after surgery, respectively, 87.5% and 100% of dry eye patients who received TheraTears were free of dry eye symptoms, whereas only 12.5% and 20% of patients in the control group were symptom-free. In addition, goblet cell density measured by impression cytology 1 month after treatment showed that TheraTears significantly restored conjunctival goblet cell density, whereas the control treatment didn't.

This video shows the location of these glands. I've not been able to "express" oil from my glands. However, this is a useful educational video:

This one shows how it is done:

The GOOD NEWS IS THAT THIS PROBLEM CAN BE EASILY FIXED (It took me nearly one year to figure out this cure but now that I've figured it out completely, it is not only working, but should work – instantaneously – for you, too). [See Addendum]

How computers can aggravate an underlying dry eye problem

Computer use aggravates eye strain but DOES NOT cause it.

In my case the cause was the excessive use of antihistamines which dried out my eyes by reducing tear flow, and thus providing relief from hay fever. This reduced tear production from the Meibomian glands. That would have rebounded once the antihistamines were stopped, but it did not.

When you use a computer (unlike reading a book, when the eyes are more relaxed), the surface area of the eye exposed to the air increases, thus speeding up the evaporation of tears. Reduced blink rates also mean faster evaporation. Normally, this doesn't matter, but when your eyes are already dry for some other reason, this can become a big issue.

Note that the purpose of the tear film is two fold: (a) to lubricate eyeball movements and (b) to remove bacteria (to which the eye is constantly being exposed).

Once the tear film has already been weakened,  bacteria are not killed and washed off quickly, and grow INSIDE the tear ducts – thus blocking them. Once a blockage starts, for whatever reason, a VICIOUS CYCLE sets in. Dry eyes lead to greater dry tears. 

Note also that the cornea is flooded with nerve cells. As a result some of the most bizzare and horrendous sensations (including severe pain/ burning  and worse) are experienced. The pain you experience indicates that the tear film has BROKEN UP and is not repairing itself. No tests are needed to prove it further. 

The remedy (cure) for dry eyes (17 September 2011)

Because the underlying cause is the blockage of Meibomian gland (there are about 100 of these, combined, in both eyes), the solution must unblock these, AND kill any bacteria. Reducing computer use is NOT the remedy. The following remedy, discovered by trial and error, and MUCH thought, both unblocks the Meibomian glands and kills bacterial.

Disclaimer: Note that I'm not a medical doctor (I've got a PhD in economics) and don't take any warranties for my recommendations. This much I can say, that the remedy has been FULLY TRIED AND TESTED by me, and has significantly helped me. Please try this remedy at your own risk. Since most of the stuff I use is natural, it is not going to harm you. I've used it for a long time now, so I know that it doesn't harm.

In the bathroom:

Use Dove anti-bacterial soap to wash the face – and make sure you rub the eyelids gently with this soap [This, or Gamophen. Avoid using much since these contain Triclosan which is harmful]

The daily regimen (use it till the problem resolves)

(After I discovered my own cure – below – I came across this CONSENSUS VIEW OF THE MEDICAL PROFESSION. Do read it as well.

Do this daily as many times as needed. This will take 20 minutes. Note that I think steps 1 and 2 are less relevant, and perhaps using once in a week or so is sufficient to get the benefits of honey and aloe vera. (6 October 2011)

Step 1: Apply 1 drop of honey (preferably Manuka honey) INSIDE each eye for about 2-3 minutes. The eyes will water as the anti-bacterial properties of honey kick in and also motivate greater production of tears. After 2-3 minutes, wash the eyes.

Step 2: Apply the viscous gel of a FRESHLY CUT aloe vera plant on the eyelid margins – doesn't matter if it touches the cornea. This will have a cooling effect. The plant has significant anti-inflammatory and anti-bacterial properties that will add to the benefits of the honey treatment. After 2-3 minutes, rinse the eyes.

Step 3: Put about 10 drops of raw lemon into a small container and fill it with water. Dip your eyes into the FRESH diluted lemon drops (keep them open under the water) for about 5-10 seconds each. 

STEP 3A – experimental stage: It is possible that squeezing cabbage juice and applying to the eyes will help. Need to try [See my analysis here].

Step 4: Take LidCare (or like), apply it to your finger and rub it. Then apply it to the eyelid margins and rub gently. Rinse. 

Step 5: Now you are ready to apply hot compress. Make sure it is fairly warm (42 degrees C or thereabouts, i.e. warmer than the skin). Dip a towel into the water and apply it over the eyes. Now SCRUNCH your eyes tight (squeeze eyelids together tightly) and release. Also press the towel gently on the eyes (bottom/top) so as to EXPRESS the oil from the oil glands. Try to make a pulsing movement. Repeat with warm towel for 12 minutes. Make sure you have massaged the eyes so as to express any stale oil from the eye glands. (You can't make out whether this is actually happening, but a gentle massaging motion on the eyelids, and SCRUNCHING them tightly and relaxing them, will help).

Step 6: Now massage the eyelid as shown below

you heat it, then the butter will soften enough to come out of the tube, but pressure on the tube (squeezing) would still be necessary. Going by this analogy, after warm compresses, the turbid meibomian gland secretions are more fluid, but massage is necessary to express them. Therefore after every 1 minute oGently close the eyelids. Put your index finger on the outer corner of the eyelid. Pull the eyelid towards the ear, so that the eyelids are stretched taut. Next use the index finger of the opposite hand to apply direct pressure to the taut eyelids starting at the inner aspect of the eyelid near the base of the nose. Sweep with firm but gentle pressure towards the ear. Repeat this maneuver four to five times. Remember that the goal is to apply gentle pressure to the eyelids – so just rubbing the eyelid surface will do you no good (Ophthalmol Clin N Am 2003;16:37-42) [Source]

This should significantly improve the quality of tears produced by the eyes. 

Thereafter, apply PRESERVATIVE-FREE eye drops as many times as needed [I prefer Thera tears – I'm also trying Systane BALANCE – that seems to help a bit, too]

PERIODICALLY, through the day, tightly scrunch your eyelids to express oil, and then relax. Do this particularly when facing the sun, to get some additional warmth into the glands. This is a standard yoga exercise. And it is VERY HELPFUL!

Other things to do:

Apply a drop or two of Triphala drops instead of eye drops, if you need them (see this).

Take sufficient nutrients, including iodine. (And GRAPES.) The nutrients will ensure that the tear glands have sufficient "STUFF" to produce high quality, oily tears. 

At night:

Apply a drop of castor oil/ pure ghee (melted in your hands).

Apply a small dab of neosporin antibiotic ointment on the eyelid margins (on the eyelashes). Neosporin is what I have – but recommendations on websites are more commonly for Erythromycin eye ointment or Tobradex eye ointment (steroid-antibiotic combination) [Source]

Change your computer use

AVOID staring at the computer with wide open eyes. Ideally, the eyes should be relaxed, looking downwards. That helps reduce the surface area of the eyes in contact with air and slows down tear evaporation. This is done by ensuring that the top of the monitor is BELOW the eye level, and not using the computer as frequently as you might have otherwise done.

Best of luck! Doing these things should help ease the problem very significantly (assuming the cause is blockage of the oil glands of the tear system), and bring it to manageable proportions.

How did I arrive at this remedy?

It has taken me nearly one year of SEVERE PAIN and suffering to work out this remedy. For more details, please see this and many other blog posts I've published over the last year (also download this Word document). I now understand the cause, and also know why some things have helped me and why others have not. That's how the theory and practice have come together.

Addendum

The solution is fine, and works. However, in the case of those who, like me, have suffered for very long without the right treatment (since doctors don't seem to know much about this extremely painful disease), there is a risk that some of my Meibomian glands have atrophied and died. I don't know. (If they are ALL 100% atrophied, yes, you're in a pickle but this is quite rare. Furthermore, if they do have some function – or can be coaxed & coached back into partial function through proper care  – Source.) [On the other hand, permanent atrophy is not totally uncommon. Source] I suspect that a 100% cure is not going to be possible at this stage in my case. But fingers crossed. However, even a 95% cure is good enough to bring significant normalcy to my life (and to yours), as you'll readily agree if you have been suffering this problem.

Gadgets (I've not tried them)

These might help:

Hot Compress Facial/Eyes Masks (also here and here and here)

Multi-frequency eyes circulation massager

Lipiflow (if your doctor has it)

Videos that might help