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Hi,
I have been diagnosed with posterior blepharitis and meibomian gland
dysfunction. This resulted from the use of a drug called finasteride,
which inhibits the conversion of testosterone to DHT. I stopped using this
drug approx 7 months ago, but my eyes have yet to improve.
My Schirmer scores (from Oct. 2003) were 15 in both eyes (with
anesthesia). In June 2003, they were 8/10 (with anesthesia). When my
doc tried to express oils from the meibomian glands 4 weeks ago, he got little
if any out.
My eyes hurt the most first thing in the morning and at various times
during the day. If I use the computer for extended periods that can sometimes
makes things worse. My eyes feel much better outdoors, rather than indoors
(regardless of the season).
My current treatment regimen is below.
1) Hot compresses (2 min/eye, twice a day), lid scrubs (2x/day, water only
- baby shampoo is too irritating), and gland _expression_ (lower lids,
2x/day).
2) NAC (600mg/2x/day). I found this study on Pubmed. Just
started this about a week ago. No improvement to date.
3) Doxycycline Hyclate (100mg, 1x/day). I'm not sure if the Hyclate
version is better or not. Just started this a week ago. I had tried
doxy for 6 months late last year and didn't notice much of a benefit. I
did read that it can take many months to get the full effect though and that's
why I decided to go back on it. I am careful to take the NAC and doxy at
different times of the day, since the doxy can be adversely affected by
it.
4) Restasis (one drop/eye, 2x/day). I've been on this for just over 2
months and have not noticed significant improvement.
5) Omega 3 fish oils. Using Omega Rx, which results in 1600 mg EPA
and 800 mg DHA per day.
6) Punctal plugs in all 4 ducts. This does help greatly and was done
2 years ago.
Is there anything else I could/should add to this treatment regimen?
Is there anything I should not be doing/using?
I appreciate your help.
Thank you.
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