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Comment by oidar | Hacker News Reader

I have dry eye as well. What have you done that helps? Omega 3 didn’t do anything for me either.

I'm about 10 years into this, and I've tried many many things. It's all about management now. It really depends on the type of dry eye you have, so I'd recommend seeing a dry eye specialist if you haven't. Getting a meibography done is really important for seeing the state of your glands.

The things that work the best for me currently are Systane Hydration PF eye drops, NuLids, Manuka Honey gel, OcuSoft lid scrubs, moving out of a dry climate, and limiting screen time. Inflammation in general causes it to flare up -- diet, lack of sleep, alcohol, stress, staying up late coding or gaming, all seem to cause inflammation and make it worse for me.

I've also done Restasis, Xiidra, Cequa, IPL, Radio Frequency, warm compresses, and punctal plugs, without much success.

I'd like to try autologous tear serum next.

I'm doing IPL/RF now which is theorized to help with inflammation, but now I know to be more careful with healthy lifestyle. Too bad this understanding of computer lifestyle and dry eye syndrome was that well explained and emphasizsd 15 years ago.

Have you noticed any improvement with IPL/RF? I've done 5 sessions - I saw improvement after the first and fourth, but regressed pretty quicky back after a few days. I've heard some people saying they had to do like 10 to start to notice a bigger difference. The problem is it's so expensive (I have to pay $750 for the combo session).

Wow you've tried the whole industry. The only thing I can recommend to you would be to try a brand of drops called Optase, they are more quality and thicker than everything else on the market.

Here's a HN post with a really good top comment that talks about psychological eye strain that really resonated with me, plenty of other advice in there too you might like: https://news.ycombinator.com/item?id=34518343

Good luck!

I haven't tried Optase, but it's worth a shot. Systane Hydration PF has been the best for me, and it is also a lot thicker.

Thank you for the link! It resonates with my experience. I do think there's a psychological aspect of it for me. When I'm depressed or disassociating (which is frequent) it's easy to just stare at a screen and not blink at all.

That’s a lot of different things to consider and try, thanks!

What worked for me was drinking massive amounts of water throughout the day.

Not so much to cause hyponatremia, of course, but it was a cheap easy way to establish a baseline for me (i.e. helps with dry climates, salty foods, dehydration, etc). And yeah, I tried some of those other things too.

If Manuka honey has helped, have you considered using other antiseptics or even probiotic eye baths and bacteriophages?

I used to have this problem too. Tried prescriptions, systane, hydration eye drops etc etc, but in the end but actually worked was baby shampoo rinsing my eyes twice a day and washing them it took some time but now it's completely gone. But for me I believe it was some sort of blepharitis that was blocking the glands that produced the lubrication my eyes needed, and now that I have a good routine, it appears to have solve the problem.

How much water do you drink and do you take extra salt?

    > Manuka Honey gel

What is special about this honey? Is there any science behind the extravagant health claims?

I think Manuka Honey's claims to do anything that normal honey wouldn't do is bunk, but it seems to be relatively skin safe and tolerated so it's not harmful.

However, it seems to have a lower PH than regular honey and exhibits antibiotic properties (which most honey does as honey doesn't typically go bad), so maybe there are some topical applications that make sense for it.

https://health.clevelandclinic.org/manuka-honey-benefits

I have had dry eyes, still occur in the summer when AC is blasting and right before winter. My solution was seeing an eye doctor, which recommended cyclosporine drops (I took them for 2 years every night), mediteranian diet, Omega3. Also cleaning my eyes with soft tooth brush and child shampoo (tearless) every night.

Naturally you have some little bacteria called Demodex on your eyelashes, but they might cause problems. The only way to get rid of them is clean your eyelashes with Teatree extract. I was recommended Blephademodex wipes, which I had to warm up in microwave and then clean my eyes.

All this solutions together made my dry eyes more manageable.

Here is what I've learned about honey. Honey is a good source of antihistamines, because the bees who collect pollen are constantly powdered all over with it. Therefore, they produce natural antihistamine to protect themselves and the hive when they return.

So, the best honey, especially for someone who has allergy symptoms, would be honey that's produced and harvested locally, reflecting the pollinated flora in your area. I purchase "Local Hive" brand, which offers several regional varieties from around these United States, as well as Wildflower, etc.

Mānuka honey would originate Down Under, although it seems that it's produced elsewhere now, but what are the chances that allergies are sensitive to the mānuka tree alone? That being said, I received some from a friend as a gift, when I was singing in choir but throat pain was acting up. It's exotic, it's thick and rich; it tastes really, really good. I'm not opposed to enjoying it as a treat!

I had agonising pain from dry eyes when I woke up. It felt like my lense was scratched, but it wasn't. An eye specialist told me that in fact my eyelid pores were bunged up and weren't release enough moisture at night. A predisposition that years at the screen not blinking enough made accute. He advised eyelid wipes morning and night and it cleared the issue. he told me that instead of eyelid wipes, to keep the costs down, I could use bicarbonate of soda (medical grade) boiled in water (about a teaspoon to 500ml I think, and then just dip qtips into it (cooled of course). Keep that mix in the fridge for no longer than a week before making a new batch.

I have a nearly identical issue. Do you recall the diagnosis? Also, when you do the wipes how "deep" do you go when wiping the lids?

Sorry to hear that. I forget exactly the diagnosis but maybe it was meibomian gland dysfunction and/or blepharitis? How deep? Basically with one hand pull your eyelid up or down (depending on which one) and then while keeping your eye open, which I find quite hard, wipe along the pink line of the eyelid with the eyelid wipe backwards and forwards ten times. It has to be along this line as that's where the glands are. Do this for both top and bottom eyelid. If it's really bad like mine was you might need to take some medication - I was put on steroids I think. Sorry memory not serving me hugely well here but good luck! I'll check for comments in case this wasn't clear enough.

I have uveitis and it certainly helped for me. I think what happens is a lot of people don’t lower the amount omega 6 and just increase omega-3 by a small amount. It took a drastic reduction in omega 6 for it to help.

Perfluorohexyloctane helped me quite a bit. You can ship it from Europe for something like $20 per vial (EvoTears), or get in the US for $700 (Miebo). The vials are literally identical.

Nifty but perhaps distressing. A brief search found nothing about what happens to it after you put it in your eyes. I assume a bunch of it ends up in your tear ducts, to your nose, and into your stomach. And then?

It'll diffuse out eventually. It's metabolically inert, and it's been used as a vitreous humor substitute for quite a while.

For me, Xiidra combined with once a day Pataday (which actually dries the eye, but for me helped stem inflammation that was harming my ability to form a tear film), plus this iTEAR device (https://olympicophthalmics.com/itear-100/), was incredibly helpful.

I’d also recommend getting a humidifier for each of your main rooms and using distilled water with it.

I cured mine bc I figured out it was related to LPR/reflux which was causing dry eyes along with some other crappy stuff.

What was the cure?

LPR is really tricky because weeks of "good behavior" can be undone very easily with one wrong move. It also took me years to figure out it was LPR because it doesn't have traditional acid reflux symptoms and can also look a lot like allergies or other things my doctors labeled it with instead. For me it was especially debilitating because it inflamed my Eustachian tubes, which meant my middle ears filled with way too much fluid, and i'd have 5+ hour long vertigo attacks where i literally could not move a single inch and was vomiting the entire time and sometimes only had a few minutes of warning before this started. if this happened in public, which it thankfully never did in a way i couldn't get home or to my car quickly (to pass out in the back seat and barf out the window), it would have been absolutely awful. the other shitty symptom as i said was extremely dry eyes, like painfully dry, which i think was actually more just them stinging which feels identical to dry. no amount of eye drops helped, and i tried like 6 different types.

anyway lots of tips online for LPR that are true for me:

* nothing carbonated. this is one of the worst things i can do

* nothing acidic. some fruit juices like pineapple in particular are really, really bad for me. coffee, even with milk and ice and sugar, is also really bad for me. overly acidic foods (vinegar, tomato based stuff, etc) are also bad.

* anything spicy is really bad too

* no caffeine

* stopping eating before i feel full. this is hard for me because i've been a "eat until i'm stuffed" person my entire life and it's really satisfying for me to do so.

* stopping drinking helps but i got symptoms to go away pretty well even with moderate+ levels of drinking. but mostly just sticking to liquor and no cocktails or beer or seltzers. wine seems okay.

* sitting upright after eating for at least an hour or two

* not eating for at least a few hours before bed

* exercise helps a bit but isn't critical for me

* daily allergy pill and nasal spray, even missing one day sucks

dry eyes are my first symptom that i did something "wrong". once i learned to listen to that it helped a ton. if i do "wrong" things for like a week straight, the constant dizziness starts, and if i go on much further than that then the vertigo attacks start.

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