Question about Healing the Mucus Layer

[kanon]

Hello all,
I understand that the eyes need a healthy balance of aqueous, lipid and mucus layer. My eyes are really hurting/burning lately, especially the left one, and it all started with a bout of conjunctivitis in February (I had a predisposition to dry eyes, which was "fixed" many years ago with cautery of my upper punctum...since then I have been doing well- until this Feb.). I, and my doctor, who specializes in dry eyes, understand that the mucus layer of the tears comes from the conjunctiva- or white part of the eyes- and that when a person has conjunctivitis that part of the eye is infected and harmed. A normal person will rebound from conjunctivitis, but a person who has a history of dry eyes can be made worse from it.
So if my mucus layer was "harmed" by the conjunctivitis, what is the best way to heal it and get it free flowing again?
My doctor has me doing warm compresses and TheraTears drops, but as I understand, warm compresses help get the lipids out. I don't know if it helps the mucus layer.
What would help my mucus layer?
Thanks! Ashley

[indrep]

Ashley,
The mucin layer is produced by the goblet cells in the conjunctiva. I would look for an artificial tear that contained long chain, high molecular weight sodium hyaluronate/hyaluronan/HA (it goes by many names). This molecule is almost an exact replica of the mucin molecule. It binds to the cornea and hold many times it's weight in water (over 1000 times). These types of drops are available in Europe and Japan fairly readily, I am not familiar with what might be available in Norway.

[Rebecca Petris]

IndRep do you happen to know if Hylo-Comod fits that bill? (I was just reading an abstract on that drop but... I don't know one HA from another )

[indrep]

Rebecca that product has only a .1% concentration. that could mean that it is a high molecular weight because the higher the concentration the more difficult the manufacturing process is to make it a drop. I will do some research and get an answer. The truth is there are only a couple HA drops available that meet the criteria to truly be an HA drop. Your shop carries one.

[kanon]

THanks! Yes I understand that the mucin layer comes from the goblet cells in the conjunctiva and I guess those cells were damaged by my conjunctivitis. The drops that you mentioned, do they actual HEAL those damaged goblet cells or do they just mimic the mucin? I will ask my doctor- who, thankfully, is a specialist in dry eyes- about the artificial tears that you mentioned. I can't believe a bout of conjunctivitis so severely messed up my dry eyes! Thank you!! AShley

[Súil Eile]

Hi Indrep, you wouldn't know the name of those drops off hand would you?

[Rebecca Petris]

Suil Eile, he means Oasis Tears and Tears Plus. I don't have them available right now but you can get them direct from Oasis - see oasistears.com or give them a call. There are also a couple of other online retailers that ship internationally (google it). I generally shy away from eyedrop recommendations (esp. if there is a financial conflict of interest) but I must say that having dealt with Oasis Tears Plus for some time now I've been quite impressed at the number of veterans I know who have done well on it, consistently, for an extended period of time.

[Súil Eile]

Thanks a mil, Rebecca. I've been finding Artelac the most effective, but I'm still looking for something to ease that eyelid scratching against eyeball feeling.

[kanon]

So Oasis Tears, Tears Plus, or Artelac, do these drops HEAL the conjunctiva or mucin layer so that it can start functioning properly again, or do the drops just soothe or mimic the natural mucin that we are supposed to have? Thanks, Ashley

[Dog2012]

So Oasis Tears, Tears Plus, or Artelac, do these drops HEAL the conjunctiva or mucin layer so that it can start functioning properly again, or do the drops just soothe or mimic the natural mucin that we are supposed to have? Thanks, Ashley

I also would love to know that .

[Ro dri]

Hello,

I have a problem with my lipid layer and also some problem with my mucin layer. I have been reading about restatsis and I might give it a chance. If you google -"goblet cells" restasis/cyclospiron- you can see several results that say that goblet cells increade with the use of restasis. Goblet cells are the ones in charge of producing the mucus.

btw, as I said I have mainly a lipidic problem (I have meibographies done and they show I have atrophied or at least partially atrophied meibomian glands) even though ophtalmologists say than when they squeeze they see the lipids coming out and a mucous deficiency. Recently started using conservant free drops that contain sodium hyaluronate (hialuronato de sodio in spanish) (4.0 mg) and they are really comfortable and I haven`t had my eyes so white in years (unless I used vasoconstrictors which are not recommeneded).

I`m interested also in hearing other opinions regarding restasis and the mucus layer as I`m thinking of giving it a chance.

[indrep]

Kanon,
Studies of artificial tears containing at least .15% concentrations of HA have been shown to increase goblet cell density and health. The HA molecule itself is very near the mucin layer molecules and adhere to the corneal surface holding up to 1000 times its weight in water. The HA tears also have been shown to promote epithelieal cell healing. All of these things help the cornea and tear film to become more normal.

[Ro dri]

Indrep,

what do you think about restastis and its potential capacity of promoting the growth of goblet cells, thus helping to recover the mucous layer?

[jax8it]

Ro dri and/or Indrep

I have been told by my newest doctor that I have non obvious mgd and mgd drop out ( I had LASIK 7 months ago and that is when this nightmare began). This doc took me off of all drops for two weeks and pulled all four of my plugs to see if I could auto regulate. My left eye is coming along better than my right. Don't get me wrong, my eyes are still painfully dry most of the time.So my doc said that I have evaporative dry eye. He said I could start using systan balance 3 to 4/day. Does this drop contain HA? Ro dri, what is the name of the drop you use? The doc said I most likely had mg dropout before LASIK. My contacts would become bothersome as the day wore on. I just don't understand if I had mg drop out before LASIK and my eyes were fine why can't my eyes return to what they were?
Thanks

[Gabriel]

Next month will be two years post lasik for me. All I can say is quality of life has hit the basement, my eyes hurt every day. So, my biggest problem is mucin layer and lacking some of the other two layers. I had a trial pack of like four vials of oasis and didn't think much about it. Is this a drop that gets better with time? Also could you alternate them with another otc drop? At this point I don't think my eyes are going to get better. I just pray they don't get worse.

[indrep]

Systane balance does not contain HA. IT is designed as oil based product to act as a tear evaporation regulator.

[indrep]

Most people find the initial dosing with HA drops is what it is. Then around 8-12 weeks will notice significant improvement and a need for less drops. My wife went from 6-7 drops a day to now, 36 months later needing only one drop some days. Other days she no longer needs a drop.

[Ro dri]

Jax, I don`t think LASIK caused your problem with the Meibomian Glands. I think LASIK usually affects the production of the aquous layer of the tear film. I also have the MG atrophied or partially atrophied.

The drops I started using are Lagricel, from Sophia Labs. I`m from Uruguay, South America, and those drops form what I`ve seen are available in Latin America but I bet they must be commercialized also in the U.S. Or at least I`m sure there must be a drop with HA. Just google "Lagricel Ofteno" and you will find plenty of results. Maybe someone from the US in the forum can help you.

The Systane Balance drops you mention I`ve tried them but I didn`t like them, I didn`t found them useful.

[jax8it]

Ro dri,

Thanks for the info. What does your doctor say about getting better? Does he/she think your eyes will ever feel better even with the atrophied glands? Are you doing any other treatments and do you have plugs? Sorry to ask so many questions. You are the first person I have talked to with my problem. Thanks again.

[Lea]

Most people find the initial dosing with HA drops is what it is. Then around 8-12 weeks will notice significant improvement and a need for less drops. My wife went from 6-7 drops a day to now, 36 months later needing only one drop some days. Other days she no longer needs a drop.

Just wondering if Fresh Kote contains HA? I guess I didn't give Oasis Tears long enough and have just started Fresh Kote.Now I'm wondering if I should go back to OasisTears. Thank you for this very helpful information!

[Ro dri]

Ro dri,

Thanks for the info. What does your doctor say about getting better? Does he/she think your eyes will ever feel better even with the atrophied glands? Are you doing any other treatments and do you have plugs? Sorry to ask so many questions. You are the first person I have talked to with my problem. Thanks again.

I tried plugs (just one) and even though the doctor said (and I could see it too) he could see (I could see it too) more hydratation I didn´t feel it better. I don´t have a big problem compared with the stories I have read on this board. My left eye is pretty ok even though sometimes it can bother or get irritated. The right one is the "bad one" and usually bothers more specially when I use the computer or when I wake up. But apart for that I make a normal life without big problems. Doctors said that atrophied glands are irreversible. I don´t know, I hope something can appear in the near future regarding for example the use of blood plasma or something like that in order to regenerate them. What helped me at the the start was omega 3.

btw, just one hour ago I discovered a little chalazion on my upper right lid. I feel really nervous and anxious. I am thinking if these HA drops that I mentioned (as they are thick) could have obstructed the meibomian ducts or maybe I used a contaminated drop and got an infection (as they are preservative free the can get contaminated). Anyone can help me with this??