the best products for dry eye, blepharitis and MGD

Sharing the best products for dry eye, blepharitis, MGD (I’ve tried it all!)

+ the Great Eye Saga

Hi friends! How are you? I hope you’re enjoying the morning so far. The girls are at a half-day camp and I’m here doing discovery coaching calls, podcast editing, and getting a quick workout before pickup.

For today’s post, I have the post no one asked for, and the post I DEFINITELY didn’t ask for:

my Great Eye Saga, finding out I have severe blepharatis, and mild MGD (meibomian glad dysfunction)… and all of the products, strategies, and treatments I’ve tried, along with my routine.

the best products for dry eye, blepharitis and MGD

OG readers of the blog (Hiiii and thank you so much for being so awesome and for your constant support) know that my eyes are delicate petunias. I’ve written about my woes with previous infections, eyelash extension nightmares, and finding out the hard way that certain eye makeup will ruin my life lol.

The latest eye misadventure has been the longest and most inconvenient experience yet, but in my determination to look at the bright side, now I know more about my eyes, WHY I struggled so much with certain things over the years, have a routine and care plan, and my eyes are the whitest and happiest they’ve been in years. 

So, buckle up, and I’ll tell ya a story.

The Great Eye Saga

In April, I got the worst pink eye that I’ve ever seen or experienced. I’d been out gardening the day before, and woke up with neon red eyes that were covered in mucus (I’m sorry, it’s true) and almost swollen shut. I rushed to urgent care, where they prescribed me antibiotic drops, and was sent home. It didn’t get better within a few days, so I went to a new eye doctor. (My precious eye doctor had retired.) He said the infection was viral and prescribed a steroid drop, which calmed down the inflammation. The following week, he said I could go back to my contacts, so I did. Within a few weeks, the redness and goo was back.

*It’s worth mentioning here that I washed my pillowcase and any towels I used every single day, threw away all of my expensive makeup and skincare (WAH), and washed my hands so often all of my knuckles were cracked and bleeding. I was so frustrated that somehow, I had pink eye again.*

I started the antibiotic drops again (the same ones, since it had only been about a month), they did nothing, and I went back to the eye doctor’s office.

I saw different eye doctor since my previous doctor was booked – she was horrible, talked the entire time about nonsense and didn’t answer my questions – and she said I had extremely blocked glands, severe MGD, no infection, bad allergies, and threw the kitchen sink at me. She wanted me to go back on the steroid for two months, 4x a day, along with an antihistamine drop, artificial tears, antibiotic drops, a prescription drop for dry eyes, and a supplement (that had corn oil and sunflower oil in it).

After that, I ended up seeing three other eye doctors + my primary care provider, because I wasn’t confident in the info she gave me.. I felt like I didn’t have any answers as to why this happened so suddenly.

In the meantime, I started my own research and read articles, blogs, watched YouTube videos, and decided to try a combination of the most common tools that were recommended for red, inflamed eyes that weren’t infected: warm or cold compresses, eyelid cleansers, eyelid massage, supplements, and artificial tears.

(This was maybe half of it. Our bathroom counter looked like the eye section at your local Walgreen’s. Initially I was concerned about ingredients and tried to scour the safest options, but as nothing improved, my care meter decreased exponentially. I was like, “Just give me whatever chemical soup will make this go away.”)

I also had to stop wearing my contacts – my eyes were way too red and inflamed- which has been extremely difficult for me. I’ve worn contacts without many problems since I was 11 years old and have a hard time functioning in the real world without them. For the second time, I also tossed all of my skincare and makeup (I started buying cheaper stuff), and was still washing my pillowcase and towels every night.

In between seeing doctors and trying all of the strategies, I also wasn’t sleeping through the night. I’d have to wake up at least once to clean out my eyes for many weeks, and my eyes felt thick and gummy during the night. In the morning, they were red, swollen, and would eventually look fairly normal for the rest of the day. This was a pretty low point for me; I was so sleep-deprived and frustrated, and since I have no foresight whatsoever, I was convinced that my eyes would never go back to normal.

TBH I was horrified to go on our cruise. My eyes had gotten much better by that point, and I knew the infection was gone, but I was really worried they were going to flare, especially with the air travel and time change. Thankfully it was all ok.

Finding a dry eye specialist

Here’s what the doctors said:

Eye doc #2 (the office said she was an ophthalmologist when I booked the appt, but she was an optometrist):

It was probably something in the environment that triggered the response. No infection. Go back to wearing contacts and use the steroid drop on as needed. I really liked her and thought she was knowledgeable, but I didn’t like the idea of depending on the steroid as a crutch when we didn’t really know why my eyes were so inflamed and dry all night, and ok during the day.

Eye doc #3 (medical optometrist, my new regular eye doc):

it was likely isolated virus in my cornea. No contacts until the redness and inflammation was gone. Stick with artificial tears, compresses, and wean off the steroid drops.

He got me off the the steroid drops right away and has been monitoring my progress this entire time. I’ve seen him three times so he could make sure my eyes were indeed healing and the inflammation was going down. I also like that he didn’t rush to prescriptions when he wasn’t fully certain what was causing it, since functionally, my eye looked healthy. He’s also shown a lot of care in my situation and has made consistent appointments to monitor my progress.

Primary care:

Did an exam to make sure nothing else was awry. Ran a bunch of labs for me to check inflammation, hormones, A1C, Sjogren’s, thyroid, etc., since so many different things can affect eye health. Thankfully, all of the labs came back with good markers.

Eye doc #4 (dry eye specialist):

By the time I saw the dry eye specialist, my eyes were already looking so much better. I was FINALLY sleeping through the night, had almost no redness during the day, and just a little bit of dryness. I was just looking for answers, an action plan to get back to my contacts, and she told me, “I will get you to the finish line.” I wanted to cry. She knew RIGHT AWAY what was going on with my eyes, and did a thorough exam with tons of photos to show me.

The verdict:

severe blepharitis, which explained why my eyes were so red and gross in the morning. They had improved with the lid cleansers and compresses, but it absolutely made sense. I also have mild to moderate MGD (meibomian gland dysfunction), which means that some of my glands are clogged with oil. I also have mild to moderate dry eye from the blepharitis and gland dysfunction.

It explains SO, so much, especially when my eyes have been more susceptible to infections over the years, why I can’t tolerate eyelash extensions or wear certain eye makeup, and why my eyelids would sometimes be red and swollen in the morning. When we lived in San Diego, I’d get tiny oil balls on my lower lash line and the eye dr simply told me my eyes were oily and to do a better job washing my eyelids and lashes. I wish I would have known it was a first indication of gland dysfunction.

What I’ve learned about dry eye

So as you guys can imagine, I’ve been learning as much as possible. Dry eye can be caused by a variety of factors, including age, gender (it’s more common in women), contact use, and hormone fluctuations. Certain autoimmune conditions can affect eyes, as well as thyroid disorders, menopause, and diabetes. Dry eye can be either evaporative or inflammatory; meaning that your tears may not be correctly balanced, or they evaporate too quickly. Usually it’s a combination of these two things. (The dry eye specialist took a tear sample to check if my tears were inflammatory and her machine also checked how quickly they evaporated, as well as which spots evaporated first!)

Dry eye can be exacerbated by blepharitis, which is inflammation of the eyelids. It can cause redness, crusting, and dryness. It’s an overgrowth of bacteria (usually Demodex mites.. I know) feasting on the biofilm of your eyelids and lashes, and they can get overrun and make the problem worse. As they crowd the base of your lashes and work their way out, they can also clog the meibomian glands, leading to Meibomian Gland Dysfunction.

We have these Meibomian glands that run perpendicular to our eyes, inside our upper and lower eyelids, which secrete oil that coats our eyes and comprises our tear film. If they become blocked or clogged, this affects the tear film, and can cause dry eyes. Glands can also atrophy and die, which is why it’s important to get treatment and do warm compresses if these glands are compromised and keep healthy oil flowing!

You can see how all of these work together!

It’s also worth mentioning that there’s no cure for these things, but you can find a routine to HALT their progress, especially since dry eye and MGD are progressive diseases. If you suspect you have any of these, I would see a medical optometrist or ophthalmologist to make sure that there’s nothing functionally awry, and a dry eye specialist to get the ball rolling on your treatment plan. 

My blepharitis and dry eye routine (for now!)

*NOT medical advice, just sharing my routine!

– Eye health supplement. This is the one I use!

– Omega-3s.

– Lots of water, minimal processed foods, sugar, and alcohol (<— the alcohol part has been pretty easy, but after our cruise, I’ve been a bit of a sugar monster).

– Eyelid wipes and cleanser with tea tree oil: these are a GAMECHANGER and I noticed a huge difference when I first started using these. I’ve tried so many brands, but my favorites for my unique situation are Ocusoft Allergy (before bed) and Cliradex (in the morning)

– Hypochlorous Acid: it sounds scary, but it’a naturally-occurring acid. I use the Thera Tears brand. This one also has excellent reviews so I might switch to this brand.

– Warm compresses: the Rest Cornea Care mask (It’s disposable, which makes it ideal for travel) and the Bruder mask. 7 minutes in the morning and 10 minutes before bed.

– Artificial tears: I’ve tried EVERYTHING and it’s worth mentioning that different drops work better for different types of dry eye. I like a lipid-based one, like Refresh Mega-3 before bed and in the morning, as well as Boiron Optique1 (order from Thrive Market) or Refresh Relieva PF if I need something during the day. The dry eye specialist told me that these are band-aids and eventually you want to get to the point where you only need them in the am and once at night; not all day.

– Treatments: The dry eye specialist used a treatment called Zocuzest to clean all of the biofilm off my lids and lashes. TBH, I HATED it. It was so uncomfortable, but I needed it. My eyes looked awesome afterwards and she’ll check them again in a couple of weeks. I’m also getting a MiboFlo treatment, where she’ll heat up my eyes using a wand and gentle massage to get the oil flowing, and then manually express the clogged glands. It’s a series of three treatments and she says I’ll notice a huge difference after these.

She also offer LipifFlow but it looks a little more intense, so I figured I’d try MiboFLo first. TearCare and IPL are also common dry eye treatments; see what your doctor recommends. 

(RX sunnies since I’m in this for the long haul and they’ve been a little boost)

Daily routine: 

I wake up, clean my face and eyes, and add two Refresh Mega-3 eye drops to each eye. After being awake for a little while, I’ll do a Rest compress while I meditate and pray on my PEMF GO Mat. Next I do a quick eyelid massage, and clean with Cliradex wipes. (Note: I’ll prob swap to the Bruder mask in the am. I LOVE the Rest one but since it’s disposable, I’ll just use these for travel going forward.)

During the day: A Boiron Optique1 drop or Refresh Relieva PF drop if I feel like I need it mid-day.

Before bed: wash face and do a Bruder mask (with an eyelid sheet to keep it clean) for 10 minutes. Clean with SteriLid on a cotton pad and let dry. Read for about 30 minutes, then clean with OcuSoft Allergy and add two drops of Mega-3 before bed.

It seems like a lot when I write it out, but it used to be so much more!! There’s a sheet in my Notes app with the date for the past 8 weeks, and everything I’ve tried, along with the results (how many times I woke up, how my eyes felt in the middle of the night, how they felt in the morning, and level of redness). It’s been a giant experiment.

The good news is that my regular eye doctor (the one who has been monitoring me this whole time) checked my eyes and said they look the best they have this entire time. He said I could start to wear my contacts again 2-3 times a week for 6 hours and see how they feel. I wore them for the first time on Saturday and they felt great while I was wearing them. I also felt like a human again. When I removed them, the lenses were pretty dry, so I’m going to try a rewetting drop next time before I remove them.

So there’s my eye story for now! If you’re going through this, you’re not alone!!!!!! There are tons of options out there and apparently they have some new treatments on the way, too. Hang in there <3

xo

Gina

Some of my favorite resources:

Dr. Eye Health

Dr. Eye Guy

Eye School with Dr. D