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Glasses for dry eyes/ review of options

I went 'blind' from dry eyes in 2016, and recovered Jan 2017.
All pictures shown on this page are items currently used at my home, or used previously during the search to solve a case of severe dry eyes.
Several eye doctors told me that people do not go blind from dry eyes. That turned out to be false when talking to more experienced eye doctors. Personally I experienced constant pain, and could only open my eyes a few seconds at a time. I wore the dry eye glasses shown lower on page all day. This page chronicles my first-hand experience, and repeats what several highly-experienced physicians have told me.
Cause of dry eyes:  injury, medicines, working conditions, environment, disease, old age, computer use etc. Signs could include chronically red irritated eye, light sensitivity, and squinting even in normal light.
Dry eyes can lead to blurred vision, damaged cornea, and in some cases blindness.
Eyesight is important for everything you do.

Consult an
Ophthalmologist.
The doctor might suggest less computer use, more blinking, warm washcloth over eyes, or massaging eyelids for mild or temporary cases. Or suggest humidifier, over-the counter eye drops, fish oil supplements, or in more serious cases, a prescription for Restasis or Xiidra.
Other recommendations can include 'plugs' in corner of eye. Prokera, sterile saline, 'blood tears' or autologous serum eye drops, Scleral lens, dry eye glasses.
Please follow through on doctor's recommendations and be vigilant.

Treatments I currently use or used:
Humidity.
Eye doctor will recommend keeping a humidifier next to bed.
I also put a humidifier in the bathroom to create a sauna room when the shower was going.
I discovered that household and outdoor humidity is extremely important. HVAC system with humidity control is handy. Above 50-60% humidity is noticeably more comfortable than 35% and below. Living in a damp region is probably better than living in dry desert.
Forum for sharing resources:
Dry eye forum
Dryeyezone.com talk
Baylor School of Medicine in Houston, Alkek Eye Center, is the leading research institute for dry eyes in the world. 713-798-6100


Supplements
Dry eye specialist recommended 100 mg Zinc once a day and 1000 mg fish oil 3 times per day
Prescriptions for dry eyes
Research shows that Restasis can restore some tear production gradually over 6 week period, but does not work for every dry eye condition.
If no results are observed after
6 weeks of 2-doses per eye per day, keeping the Restasis in eye for at least 5 minutes, the likelihood of success is reduced. However if eye moisture is restored, then continued use is required, with possible improved results after a year of use. Several doctors told me that Restasis will not work if 'plugs' have been inserted into the drainage duct located in corner of eye. One doctor told me that Restasis did work with plugs, but the manufacturer didn't spend research on the topic, and had to say the product didn't work with plugs.

Xiidra, recommended by several eye doctors I encountered, is marketed as a faster-acting version of Restasis. However, I was told by dry eye specialist at Baylor Alkek Eye Center in Houston, that according to research, Xiidra 'is not for restoring tear production like Restasis, but is for treating inflammation.'

I got no results from Restasis. I am currently using Xiidra for my specific condition. It stings very harshly, while Restasis was only mildly irritating. None-the-less, my eyes worsen when Xiidra is stopped, becoming both more irritated and more sensitive to light. For me, the Xiidra causes a temporary release of mucus that is rinsed out afterwards with preservative-free sterile saline and removed with sterile q-tip, shown below.
Over the counter eye drops come in two basic flavors:
1) Overpriced bottles of eye moisture containing preservatives that have shelf life of months after bottle is opened.
2) Extremely overpriced boxes containing 20-40 individual vials of
preservative-free eye moistures. Once opened, these are recommended for single use only and cannot be safely stored for length of time. This product is ideal for dry eyes, even severe dry eyes, and is very soothing, adding both moisture and oil to eyes, except for the tiny quantity and high price. Refrigerating open vial might be safe way of extending the vial throughout a day.

Over counter products work fine for ordinary cases of occasional dry eyes. The preservatives can be extremely irritating for people with severe dry eyes, while the preservative-free vials are very soothing but do not contain enough fluid to provide long-term help for severe dry eyes.
Consider using sterile saline shown below as possible solution for the problems of cost and preservatives.
Sterile saline
To avoid overpriced products, and preservatives, you can use 3 oz vials of 0.9% NaCl sodium chloride, which is sterile saline. Usually sold as children's inhaler for use in a nebulizer, sterile saline is prescribed by dry eye doctors as a source of moisture and eye flushing.

Sterile saline contains only moisture for the eye, but is missing the oils found in natural tears. The single-dose over-counter eye drops shown above contain both moisture and oil, but are often too expensive for frequent use throughout day.

I use sterile saline for my particular condition. Available by prescription at pharmacy, 100 vials per box.  Or buy 0.9% NaCl without prescription online. Does not need refrigeration. Shelf life 2 years.
Buy: Box 100 vials .9% sterile saline
0.9% NaClSterile saline is portable. These vials do not have preservatives, but are safe to re-use throughout one day if tip of vial stays clean. Do not keep open vial of sterile saline more than one day.

Clean out a prescription bottle with alcohol, and drop vial into bottle, making sure never to touch the tip. Carry extra unopened vials with you. Cannot be left inside a hot car, and must be stored at room temperature.

I picked up this information from more than one dry eye doctor, and shared with other eye doctors that I encountered during my search for relief.
Infection:
Sterile saline moisturizer refreshes the eye, but it can also be used to flood the eye with saline to flush out potential causes of infection. Saline is NOT a treatment for infection, just a way to help prevent.
Dry eyes are prone to infection because natural moisture is not present to flush away everyday accumulation of particles in eyes. Avoid dusty, dirty and polluted environments.
Eye squeeze
Flushing eyes with sterile saline followed by squeezing eyes tightly together in a series of ten repetitions three times per day can help clear eyes, and prevent possible infection. This might also open clogged areas of eye that cause a lack of natural tears.
Infection: Steroid and antibiotic prescriptions
Steroids are a treatment for inflamed or swollen eyes. Some eye conditions cause both dry eyes and inflammation. Infections cause inflammation. The inflammation can be treated with steroids after infection clears up. D
o not use steroids if infection is present. Using steroids can make eye infection worse. Never use steroid or antibiotic without doctor consultation and approval.
 
Vigamox is an antibiotic used to treat eye infection.
Pred Forte (not shown) is the strongest steroid at 1%.
Zylet is the medium strength .5% steroid.
FML and non-generics like Alrex are milder .1% steroids.


Steroid use in eyes, or as a treatment for other illness, can cause cataracts.
Severe dry eyes and other eye problems such as infection might inhibit ability to have cataract surgery.
Flush eyes frequently with sterile saline to help prevent infection.
I was fortunate that the eye inflammation in my case was on the outside of eye, and not inside the eye. The scleral lenses, shown below, that solved my dry eye problem also resolved the chronic inflammation and swollen eyelids caused by dry eyes.
Sterile Q TipsSterile Q Tips
Sterile Q tips can be used to help clean eyes. These are single-use. After using a Q tip for both eyes, the Q tip must be discarded. Typical box contains 100, sometimes wrapped individually, or by twos or by tens. Leave unused Q tips inside the opened wrapper.

Eye mucus or infection
General rule of thumb, mucus is stringy and not a problem, while infection is not stringy. Mucus is whitish or semi-transparent and gradually accumulates in eye, while infection is whitish or yellow and constantly drains from eye. Eye infection might give illusion that eye is producing more moisture, except the discharge is white-yellow and not clear like normal tears.
A doctor must be consulted immediately if there is any suspicion that eye is infected
Eye specialist is not needed. Any certified medical doctor can diagnose eye infection, but your eye doctor should be notified and perform a follow-up.
Buy:
Sterile Q Tips
Plugs.
Treatment options can include plugs or sealing lower puncta, a tear duct or drain opening located in the corner of each eye nearest to nose. Plugs are inserted to stop moisture from draining from eyes.
Plugs do not always remain in place, and might need to be reinserted. The puncta can be permanently sealed with a quick-n-sharply-painful heat treatment by eye specialist.

The long wait time to see a premiere specialist is lesson to act immediately when signs of serious dry eye appear. Older people are prone to dry eyes, including post-menopausal women. Computer use and eye strain can contribute to dry eyes. People with certain diseases, such as Rheumatoid Arthritis that can destroy the tear-producing lacrimal gland, should be vigilant and seek help as soon as possible.
Picture source: Dryeyezone
ProkeraProkera is available at some eye clinics and will repair damaged cornea.
Severe cases of dry eye can cause 'scraping' marks across the cornea, or simply cause the cornea to 'melt' away.
The
cornea is the covering over the center portion of eye. Cornea damage can result in blurred vision, sensitivity to light, and blindness. Severe damage can be irreparable. However, there is a treatment.
Retina specialist  deals with interior of the eye, but can also treat other eye issues.
Cornea specialist can install a PROKERAŽ in the eye to restore cornea if the facility offers the service. Prokera is a thin plastic ring with a membrane stretched across the center, as shown in simulated image. The prokera is set into the eye, and the eye is taped shut for one week. The body then repairs the cornea. When finished, the doctor removes the plastic ring.
The Prokera specialist told me that 'prokera in a bottle' was being discussed at a meeting with other eye doctors. She thought it might provide relief for more serious conditions, but in 2016 the product was elusively unavailable without literature or
internet reference. If and when available, expect price to be beyond reach of most people, even many who donate, pay taxes and college tuition that supports research to find cures. Offsetting that is the amazing miracle of modern medicine.

The prokera must be kept in a freezer at very low temperatures until needed. The expense and risk of storing prokera might make it difficult for some eye clinics to offer the service.


Severe dry eye patients can 'burn' through the prokera in 1 day, requiring repeat applications.
My condition caused me to burn through 7 prokera, each in 1 day. My cornea was restored and light sensitivity dropped to zero. My eyesight returned to 20-30, but the treatment did not solve the problem of dry eyes. Before receiving the prokera, the doctor said my cornea looked like it had scrapes over the surface. Shortly after treatment I could see well enough to assemble the dry eye glasses, shown lower on page, by opening one eye
at a time for a few seconds.
blood tearsBlood tears
Research shows that 'blood tears' or autologous serum eye drops help dry eye conditions, such as sensitivity to light. 
The cost of this is very high, and generally not covered by insurance. 

Blood test is done to ensure no infection. Several large vials of blood are drawn, then processed into '3-month' (480 tiny drops) supply of serum shown in photo. 
The serum is divided into several small vials that contain no preservatives, and must be stored upside down in freezer for up to 6 months. 

Individual vial is removed and stored upside down inside a purple-colored container that comes with the serum. The individual vial can be kept in the refrigerator for 7 days. Each vial supplies 14-15
tiny drops, which yields exactly 1 drop per each eye per day for 1 week. (I use 14 total drops per week).

Typically, 2-4 drops per eye per day are recommended (28-48 drops per week). According to dry eye specialist, using more drops multiply the success (and expense) of treatment. 
I use one drop per eye per day (14 drops per week), which is less than recommended amount due to cost.
Does it help? Research says yes. I received this treatment shortly after discovering the scleral lenses shown below that helped cure my problem. I currently use one drop of blood tears inside each lens. I have not experimented with eliminating blood tears from treatment, and probably will not for fear of worsening my dry eye condition. However the price increased 20% last time the drops were purchased, maybe because some guy needed a bigger boat, so the situation might change for me.

Problem: aside from high cost and risk of freezer malfunction, the vial is so soft, it is easy to squirt out contents of a vial with one squeeze. Care must be taken to administer only 1 drop. People with disabled or shaky hands will find the task difficult.
Baylor School of Medicine in Houston, Alkek Eye Center, is a source for autologous serum. 713-798-6100
Scleral lensScleral lens is a large convex-shaped lens that is filled with sterile saline. The careful fit and convex shape hold moisture against the eye while keeping the lens from touching center of the eye. In addition to providing moisture, the scleral lens is made to prescription and functions like a regular contact lens for vision correction. It helps some patients with dry eyes but not all.

Each lens is carefully fit to the individual eye by an eye doctor trained for the work. Not all eye doctors have the capability
, or are familiar with the lens. The lenses are expensive and not always covered by insurance. people with some eye injuries can also benefit from scleral lenses.

To insert the scleral lens into eye, the lens is cleaned throughly two times using contact lens cleaner and rinsed with sterile saline, then placed on a contact lens inserter. The lens is filled with sterile saline. The person leans head forward and lifts lens into the eye using the plunger while fingers on other hand hold eye wide open.
People with disabled or shaky hands will find the task difficult. Stabilizing the hand against table and lowering head to meet the lens is possible solution.
The sterile saline keeps center of eye covered with moisture. Lenses are removed and cleaned once or more each day using a small plunger (with tiny suction cup) that you stick on edge of lens.
According to doctors, the scleral lens is not worn at night. Remove lens before using Restasis, Xiidra, or steroid. Eyes can be flushed with sterile saline with lens in place. Rubbing eyes will dislodge scleral lens and cause air bubble that obscures vision until lens is removed and re-inserted.

Pictures in this section show the scleral lenses that solved my dry eye problems. Dr Yee in Houston fit the lenses over a period of three sittings. Several other highly-respected eye doctors were unable to find a solution despite 7 
Prokera by a previous doctor that restored the severe corneal damage caused by months of extreme dry eyes.
A month later (after 5 month wait for appointment), we finally got in to see Dr Pflugfelder, the premiere dry eye specialist in the world at Alkek Eye Center in Houston. We were fortunate to live within an hour's drive, but people fly in from around the world to receive help. He confirmed that scleral lenses help 90% of people with my specific dry eye condition, Meibomian Gland disease, a common condition where oil-producing glands in lower eyelid stop functioning or get clogged. Specialized heat treatments might solve problem of clogged glands, but recurrence within months is common.
The cost of re-treatment make the scleral lens much better value.

My brother in law had his lens made at the Optometry School at Indiana University in Bloomington. His condition was due to other causes than mine, yet the scleral lens had same positive result as my experience. He wears the scleral day and night, removing briefly to clean in the morning. I have also worn the lens at night, and concluded that taking a nap with lenses on eyes is not a problem for me.
Any ulceration or infection requires removal of scleral until eye has healed. Severe cough or exertion while wearing lens might rupture blood vessel in the eye, which usually repairs itself after a week.

Baylor School of Medicine in Houston, Alkek Eye Center, does the scleral lens and is leading research institute for dry eyes in the world. 713-798-6100
Buy:
Scleral lens insert plunger
Plunger for removing scleral lens
sceral lensImage shows plastic box I use for scleral lens. I have extra box with supplies in the car if the lenses need to be removed or cleaned. It's unlikely I could drive far without lenses, so I am very protective of the lenses and my eyes.
The mirror is set on my lap to help remove and install lenses.
Scleral lenses are very expensive, but cheaper than buying a year's worth of some over-counter products. Despite the high cost, I bought extra pair of lenses, stored inside the green lens case. This is preventative if I lose a lens.
At night, my daily lenses are stored in the blue lens case filled with lens cleaner. I place the plastic box next to bed, so if emergency requires exit from home, I can grab the lenses and preserve eyesight.
The lens case is rinsed out each day using sterile saline, and replaced once a month. Each lens has different fit, so keeping the right and left separate is important. The right lens is marked with a black dot. The brightly-colored lens cases sold at box store might be difficult for people with eye problems to tell right and left apart. The clearly identified blue-white and green-white cases are better choice.
Buy: Lens case
magellan sleep maskSleep mask
Wearing a
tight-fitting sleep mask might help some people with dry eye problems.
There are many types and fits of masks, but the brand that we found fit best was Magellan.
Other brands fit loose or didn't fit shape of face very well. None of the local store brands offered the same fit as Magellan.
The mask does two things for me: it helps hold in moisture at night, and prevents anything from getting into eye that might damage or cause infection.

Wash periodically by soaking in distilled water and vinegar for an hour.
Buy:
 
Sleep mask
All the commercially-available dry eye glasses recommended by eye doctors were designed as a wind-break or partial protection from drafty conditions.
NONE fit tightly around my eye or held in the moisture. Costing $100+ each, they did NOT fit tight against face except across the top. The sides were open, offering a wind break along the side but not a complete seal. The commercially sold dry eye glasses will help many folks, and do not fog up as badly as a tight-fitting design. The commercial glasses are available at the some optical stores, but not at the big box store operations. The dry eye doctor can recommend a source.
Dry eye glasses with 'side shields'
Side shield glasses

More than 1 person suggested swimming goggles, which would work, but could not be worn in public.

The following innovations were discovered by my wife and I over the course of several months before finally discovering the Scleral lenses that actually restored my eyesight. 
Lab glasses or construction safety glasses are a good way to hold in moisture.
Advantages: cheap
, widely available, space for regular corrective glasses underneath while no other pair we discovered allowed that.
Disadvantages fogging over, short strap for head,  tight fit, sharp edges that cut into face, poor seal on outside edges, cannot wear in public.

Buy:
Lab glasses/safety glasses

Soak glasses to clean: use a half-cup of vinegar or a few drops of clorox mixed with distilled water.



This is a concept for attaching humidifier to the safety glasses.
The humid air would travel up the plastic tubes and puff moisture into the glasses, thus keeping the eyes moist.

I never finished the project because I found the solution shown next, and because my eyes were so bad by this time that I could only keep them open a few moments at a time. This left me without ability to innovate the humidifier plan.

The humidifier could be plugged into a twin timer to turn humidifier on-and-off at specific intervals say every 15 minutes or every half hour etc.

I want to present this project as an option for future development by somebody else.


Resource: How to wire twin timer


Dry eye glasses that work !!!!
dry eye glassesFinal result: DeWalt safety glasses with rubber cushion. These glasses were altered to seal completely around eye and hold in moisture.
Some people may discover these glasses work fine for dry eyes, without alterations shown below.

More than one eye doctor told me I
probably would have gone blind without them. My cornea would have totally melted away.
Each doctor was impressed with the glasses yet none took note. It was disappointing that specialists in the field would remark that the
 glasses saved vision, yet none appeared interested in forwarding the information to next person. Each of them sold or recommended the commercially made glasses that served only as an air shield or wind break. I'm sure they had reasons, and my extreme dry eyes were rare, but they told me that dry eyes are a real problem for people.
Buy:  DeWalt Safety Glasses
dry eye glassesMy wife discovered DeWalt glasses with rubber cushion at the local home center.
They fit pretty good to begin with but there were gaps around the edges that allowed moisture to escape.

Using Liquitex heavy gel and carefully fitting the glasses around the eye I was able to make a good seal around my eyes


These have a slight tint. Doctor recommended glasses without tint so eyes become less sensitive to light.
Buy:  DeWalt Safety Glasses
dry eye glasses
To begin alterations, p
ut glasses on and check how they fit. For me the gaps were along the bottom and along the outside edge.
The rubber can be pulled up from plastic frame. 
I used 1" long 8-32 bolt as spacer. Insert spacer, put glasses on, and then use eyes to see the gaps. Slide the bolt until the rubber touches against face. Remove glasses carefully with the spacer in place

Buy liquitex matte super heavy gel
The next step is to fill the gap made by bolt with matte finish heavy body gel.
The gel, sold online and at art supply stores, is commonly used for architectural models and art projects.
Super durable and strong, this is great adhesive for paper and cardboard projects.
Thin applications of the gel dry very quickly and eliminate need to support pieces while waiting for white paste or other glue to dry.

The dry eye glasses alterations shown here require a thick layer of gel, which takes overnight to completely dry.
Buy: Matte finish heavy gel from Liquitex
Matt finish from Golden
Apply piece of tape behind the spacer so it does not fall over. Put this piece on first and do not remove when other tape is pulled off.

Cover both the rubber and plastic frame with tape. 
Apply tape carefully so only the gap is open.

Once tape is in place, use finger to apply the gel. The gel dries fast on your finger. Keep paper towels or damp sponge handy.
Make sure the bolt is not surrounded by gel or it will be difficult to get out later.
Buy:
Matte finish heavy gel from Liquitex
Matt finish from Golden
Once the gap is filled with gel, immediately pull off tape but leave the spacer bolt. Leave a piece of tape to hold the spacer bolt.
After the tape is removed set the glasses on a shelf where they cannot be disturbed overnight

Buy:
Matte finish heavy gel from Liquitex
Matt finish from Golden
Adhesive has dried fully overnight without shrinking.
Notice the white gel has turned into a semi-clear color. This means the gel has completely dried and become very hard.

It is now okay to remove bolt and handle glasses without affecting the work done so far.
Continue fitting: Move bolt as needed so glasses touch against face.
Add tape so only gap is visible

Images below show continuation of project:
Apply gel to fill gap, remove tape, leave bolt in place, let gel dry overnight.

The process is repeated until glasses fit the shape of face. The result will be a damp and foggy environment surrounding eye.
Before getting scleral lenses, I wore the glasses every moment of the day, and made 4 pair, cleaning the unused ones with alcohol wipes before use. Currently, I wear the glasses whenever the scleral lens is not in my eye.
dry eye glasses
Image shows finished pair of glasses (bottom) and a new pair (top).

The finished pair has gel between frame and rubber cushion that pushes cushion toward face.
The finished pair of glasses touches my face around the entire frame, making a moisture seal.

Many folks may discover that the new pair of DeWalt safety glasses hold in enough moisture, without adding the gel.

The lens of the glasses is made of plexiglass that has a surface coating. The surface coating can be damaged by soaking in diluted vinegar or other substance. The glasses will get dirty. I clean with alcohol wipes.
Another issue is longevity. The lenses will get dirty and/or scratched. You might need another pair within a couple months.
The plastic frame is not robust. I've used mine for months, and am careful not to bend the frames. The strap is held onto the frame using 2 pieces of plastic that tend to slip and eventually break.
Overall, these safety glasses are designed to be re-purchased periodically.
dry eye glasses

The DeWalt safety glasses can be worn in public without a lot of notice

The following is a concept idea for prescription dry eyeglasses that fit tight around face

The problem with glasses shown above is they are not vision corrective, nor can you wear glasses.

The following concept is a possible path for solving problem in the future.
The glasses would be prescribed and lenses cut.

Your head would be placed into a stabilizing support.
Frames would be test fit onto the face just like ordinary glasses.
Once the frames fit in the correct position, a laser would measure the exact shape and location of the frames across your face.
The frames are removed and laser makes a second measurement of your face without frames.

The two laser measurements are compared. Additional material is added to the frames so they touch against face, forming a moisture seal. The prescription lenses would correct vision, the glass lens could be cleaned, and frames would be robust enough to endure daily usage. Weight gain or loss could affect fit, and I suspect the product would be immensely more expensive than DeWalt solution offered above. Maybe DeWalt could build a design that allows insertion of glass lens.
I considered cutting away the plexiglass lens on the DeWalt and gluing regular eyeglass lens over the opening.
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