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Yes, in fact, I'm going to switch this encounter from a chat format to a Q&A format where my responses to your responses will be heralded by an email that you'll receive, telling you there's a response from me. You can just click that link to respond in kind. Do you need to get back to me in a little while or are you okay to continue?
Do your eyes itch significantly?
I think that your eyes are dry.
Blepharitis is one of the most common reasons for dry eye, but any one person can have numerous reasons for dry eye.
There often is an inciting circumstance that sets the eyes off in someone who has dry eye. The tendency has always been there, but the eyes often times don't "declare" themselves until after some inciting event. Many times it is the stark change in environment that you have had with your travels.
I think one of the things to understand about blepharitis treatment is that it can take 2-3 weeks of doing the treatment consistently before a significant effect is noted. Even then, however, if the warm compresses and baby shampoo scrubs are not continued on a consistent, daily basis, and the treatment is stopped, then the effect is lost and it needs to be restarted again.
Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working. If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body). Because there are numerous reasons for dry eye, if not all the reasons that exist in one patient are treated, it can seem as though the ones that are being treated are providing no benefit. If you've tried these recommendations and still don't feel better then you should consider seeing a corneal specialist for a dry eye evaluation.
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Julie, I think there could be a couple of possibilities right now. It may be that you need an antibiotic/steroid combination in addition to the blepharitis treatment we talked about. This is quite a common need and would have to come from your eye doctor by way of prescription.
Of course, it may be that this is something other than blepharitis such as an allergic conjunctivitis or inflammation or infection in the cornea which also may need a prescription drop.
Because I can't examine you, it becomes much more difficult at this point to sort out what this may be just based on history. For this reason, I would recommend going to see a corneal specialist to determine exactly what the source of inflammation is.
Does this make sense?
Was this eye specialist a corneal specialist? What kind of specialist was he? If it was an ophthalmologist, an M.D. and not just an optometrist, that is good, but I really think you need a sub-specialist ophthalmologist called a corneal specialist.
It's not surprising to see something like FML not work to treat significant inflammation as it is a very low potency steroid.
Okay, while it is good you saw an ophthalmologist now that you're having more difficulty getting this thing under control, I think it is time that you are seen by a sub-specialist ophthalmologist that specializes in the diseases of the cornea and conjunctiva, which you are definitely suffering from.
In the absence of being able to get into see one of these, I would at the very least recommend a second opinion for an exam as often times it just takes looking at things from a different point of view to be able to figure things out.