Hi. I'm online and happy to answer your question today.
I'm sorry that you have been suffering so long with this issue.
You are correct. Drops can't be used forever....the antibiotics loose their effectiveness and the steroids have a lot of bad side effects.
I was working in a hopsital setting when i first suffered with this. I have been using artelec drops which is for dry eye only on demand. what do you suggest i do next
I think using the dry eye drops is an excellent idea. I am wondering, however, if this has caused your eyes to not only become dry but to become sensitive to allergens.
Also, I wouldn't be surprised if you didn't have an issue with blepharitis
what is blepharitis
It is a chronic inflammation/infection of the eyes and eyelids. This may be why you have been experiencing a temporary improvement in your problem when you were on antibiotic eye drops and/or steroid drops.
what is the best treatment for same
The good news? I have a home therapy that has worked will for my patients like you. It is not high tech and it takes time to kick in but, given time, I think it will help you.
Here is the handout that I wrote:
It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.
When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.
Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.
The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.
Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.
Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.
Does this make sense to you?
If this doesn't work for you, and since you have suffered for so long, I think the next step would be to consult with a cornea/external disease specialist.
You may have stepped away from your computer.....
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles. Thanks in advance, Dr. Rick