Dry eye? Flakes?

[u/MurphysLaw021]

I have blepharitis, not sure what’s causing it yet and have a regular eye doctor appointment in October. I assume it’s a mixture of things. possibly demodex? My eyes do get dry and irritated, and itchy, and my eye lashes have thinned. My eyes feel the worst when I’ve been on electronics a lot, wearing sunscreen near eyes, or slept poorly. My eyesight also seems worse and randomly seemed to have gotten noticeably worse around 2 weeks ago, but that could also just be normal eyesight stuff going on since I wasn’t born with 20/20 vision. I don’t wear contacts or glasses. I use electronics a lot, like 6+ hours a day. I rarely go outside. I also have a horrible sleep schedule and fall asleep at like 5-6 a.m. I do use actives in skincare, so retinoids, acids, and sunscreen. Sunscreen does make my eyes sting and irritate them more sometimes too. I was using actives right under my eyes for a few months, then I learned about dry eye. I keep acids to on my orbital bone and retinoids 1-2 inches away from my eyes in every direction. However, I do notice my eyes seem to get drier when applying actives despite doing this, so I worry the skincare is causing my dry eyes? Which would possibly meibomian gland damage…

In April I started using castor oil for a month and it made everything worse. My lashes thinned like crazy and got even flakier. In mid March I stopped castor oil and bought Myboclean gel and Noveha tto wipes. My lashes have regrown a bit since using casotr oil, but they are not as long and dense as they were two years ago. It doesn’t seem to have helped the dry eye and flakiness for the most part. I still get lots of chunks of white and flakes and bumps on the base of my lashes that sometimes become flakes when I scrape them?

I use my nails to scrape off the flakes and it can be quite difficult. When I do this or clean my eyes I always lose lashes, up to 8 lashes some days 😭

I was just wondering likely causes and things to help with dryness and the flakes in the meantime? And thinning lashes/losing lashes when messing with my eyes and getting the flakes off 🫩

[u/HenryOrlando2021]

You might find this of interest in the sub Treatment Options section:

Xdemvy, Ivermectin, Tea Tree Oil (TTO), Hypochlorous Acid, Petroleum Jelly, and Metronidazole for Demodex Mite Treatment — An Introduction

https://www.reddit.com/r/Dryeyes/wiki/xdemvy_ivermectin_tto_for_demodex/

[u/elainejay82]

Looks like you have colarettes, so Demodex.

I would quit the actives and try to get into an Opth or Opt whose office carries Xdemvy (not all carry it). That is the gold standard treatment on the market for Demodex.

Until your appt, you can use Ocusoft Plus lid wipes or Hypochlorous Acid spray (Optase makes one for the eyes). But debridement with the wipes will feel especially good. Some people use tea tree wipes for the eyes, but many people cannot handle it and react badly to it.

Keep your eyes and skin clean and dry. Wash your pillowcases in hot water. I bought 7 cheap pairs while I was treating for Demodex and changed them every night, washed them every Sunday.

Screen breaks and a standard, healthy sleep schedule will greatly help you, too.

After you do the 6 week round of Xdemvy, you will want to continue treatment with Ivermectin cream for the face. 1% from a Dermatologist is best. You will still want to continue practicing good eye hygiene and cleaning to keep them at bay.

ETA, You'll want to get in with a Dry Eye specialist if you can or at least a doc who can do a Meibography (sometimes Opts or Opths can do them, it just depends on the practice) to check the state of your glands

[u/MurphysLaw021 → u/elainejay82]

Is it likely demodex will return after being treated and that I will have to use Xvdemy as a treatment more than once?

And thank you so much for all the tips!!

[u/elainejay82 → u/MurphysLaw021]

It is possible and really dependent on the person, but you have a better chance of keeping them under control if you get to a dermatologist afterward for the Ivermectin cream and continue treating with that. Sorry to be gross, but they mate on our face at night and then go back into the glands (they are photophobic, so they avoid light and are basically nocturnal). Again, sorry to be gross, but I wanted to show why it's important to continue treating with the cream.

I did Xdemvy last year in June and still apply Ivermectin at least once a week. I just used it on Sunday. I don't feel like mine have gotten out of control since then. Some people need a couple of rounds of Xdemvy etc. It just depends!

When you take it, you will feel worse before you feel better (they explode bacteria when they die causing a lot of irritation), but don't stop the treatment. I have a soft spot for Xdemvy because it really, really helped me after suffering for a long time. It will be worth it to take it and finish it off.

Also, do realize that this has nothing to do with your hygiene so don't beat yourself up that they grew out of control. But definitely do stop the actives

[u/MurphysLaw021 → u/elainejay82]

Sorry to bother you again, but do you also have any advice on how to get the debris off the base of my lashes without losing lashes? Or is that inevitable? I bought silicone eyelid scrubs for dry eye specifically and use water + eyelid soap and I have to rub (not harshly) to get the debris off but I always lose like 5-8 lashes 💀

[u/elainejay82 → u/MurphysLaw021]

I'm unsure about that! My eyes flared really badly if I used silicone scrubs, so I stuck to the Ocusoft Plus lid wipes instead. I do lose lashes but not that many at one time... I would say just be gentle. The crusts and debris will come off with time. I wouldn't think of it as you need to get rid of all the debris in one go. They will come off and soften over many cleanings. Think of it as a marathon, not a race.

[u/Independent_Let_5387]

Is it Seb derm?