Thursday, September 4, 2014

Dry eyes battle

I'm still fumbling through this dry eyes situation that I've mentioned a couple times here. I had never had an issue with my eyes (other than fairly terrible vision) until Thanksgiving of last year, when I noticed my right eye felt like I had an eyelash stuck in it, except there was nothing there. Turns out my cornea was scratched and as it continued to get worse I finally realized the underlying cause was dry eyes. It progressed over the next several months and I quickly graduated from my optometrist to an ophthalmologist.

fighting it
{fighting it}

I'm certainly not an expert, and I'm still struggling a lot. I have good days where I feel almost completely normal and then I have bad days where I can't see anything unless I hold it three inches from my face (works for a phone, not so effective with a computer screen) and I want to cry in frustration.

I've got my basic arsenal down and it's actually pretty simple for now. I'm attacking on a few different fronts. I did some frantic online research/shopping when I decided to get serious about this (oh, the irony of having to use the computer to find information about a condition that is worsened by using the computer!).

Humidifier - (x2 - one for my office, one for the bedroom). This one was the cheapest, simplest humidifier I could find and it's been great. The misty air is cold, which means you can have an unpleasant tendency to dampness if you aim it too close to your clothes. I'm honestly not sure if the humidifier is making a huge difference, but it's a relatively low cost, low impact option, so I'm sticking with it.

Eye drops - I use two different kinds of eye drops, a lighter one during the day and a heavy gel at night. They are both preservative free, which is critical if you're using them often. They come in individual vials, which are meant for single use but I can recap my daytime ones and get a few applications out of each one. I use RefreshPlus during the day, which I get from Costco for a little less money ($20 for 100 vials, which lasts me about a month) and before I go to bed at night I put in Thera Tears gel, close my eyes and sort of massage it in. Then I carefully wipe my eyes with damp washcloth, because I hate having gel all over my eyelashes when I wake up.

Omega-3s - I'm taking vitamins for the first time in my life. There is some evidence that omega-3s can help with dry eyes (some studies here). I figured I should be taking them for general health anyways, so that was an easy decision. And since I was already in for it, I added in a vitamin B complex and the vitamin D my doctor asked me to start taking 5 years ago. I'm basically the healthiest person alive now! Right now I'm just using the Thera Tears vitamin, because I was overwhelmed and tired of researching things. Since the omega-3 is the important part I'll probably save a little money and just start sharing the Costco fish oil pills that we buy for Circe (yes, our dog has been taking all her supplements daily since we've had her - not sure why it takes a crisis to convince me to do the same). It can take 4 - 8 weeks before you notice an improvement. Last week was my fifth week and I felt like I turned a little corner. It was the first week in months where I felt pretty normal all week. I don't want to jinx it, but I'm hopeful. This week I've had a little blurring but nothing terrible. I'm now obsessive about never missing my pills and I wish I'd tried this earlier.

Hot/cold compresses - There's some debate over compresses. People generally recommend a hot compress to help unplug (possibly) blocked oil ducts. On the other hand, some people swear by cold compresses to help reduce inflammation. I go ahead and do both. I store my gel eye mask in the freezer and when I get home from work I take out my contacts* and do a 10 - 20 minute cold compress. I leave the mask out and then right before I go to bed I'll heat it in the microwave and do a 10 minute hot compress. Again, not sure this helps but it feels good. The mask is relatively cheap and it's been holding up well so far.

Miscellaneous -

I've had temporary punctal plugs inserted twice now and they seem to help me quite a bit but I think the left one came out shortly after it was inserted this time around. My left eye (which was my good eye for the first few months) has been a disaster, way worse than my right. FYI - the punctal plugs aren't scary at all. Each one looks like a tiny grain of rice and it takes about two seconds for the ophthalmologist to pop it into the tear duct. They dissolve slowly and mine are supposed to last about 3 months but don't make it quite that long. I have a little discomfort right after insertion (not painful, but I'm aware of it) but they seem to settle in overnight and then I can't tell they're there.

Eyelid hygiene is usually recommended. I don't worry much about this, because I wash my face every night with gentle soap and do a pretty thorough massage of my eyelids to make sure I get all my mascara off.

Work habits are the toughest for me. The rule I keep hearing is take a break from computer work every 20 minutes and look at something 20 feet away. I don't know about you, but that's difficult for me. First, I guess I should be setting an alarm to go off every 20 minutes, but I haven't done it. Second, I tend to get really focused and then I hate being interrupted when I'm working on something. (I'm fully aware these are excuses - I'm going to set up the alarm on my phone now)

I have been trying to reduce my screen time as much as possible. I don't use the computer much for recreational stuff if I'm having a bad spell (hence, sporadic posting). Sadly, reading is sometimes difficult as well and I have to be more strategic about it. I'm going to look into checking out audio books from the library if I don't improve soon.

Upcoming - at my last ophthalmologist appointment he recommended permanent punctal plugs and Restasis prescription eye drops. I resisted because I felt I hadn't done everything I could on my end. But after 1.5 months of effort, I'm ready to go try anything. I'll probably take him up on those at my next appointment. But maybe not the permanent plugs because those still make me nervous (what if I don't have insurance at some point and that's when a plug decides to go rogue in my tear duct?!).




* And this is maybe where you want to yell at me, because I'm still wearing contact lenses against the advice of my ophthalmologist. He thinks that my dry eyes are caused by contacts but I'm not so sure. I followed his advice initially and went completely without contacts for a month ... and then another month ... and then another month. It didn't make an appreciable difference in my eye situation. I seem to have about the same number of good and bad days whether I'm wearing contacts or glasses. One side effect of the dry eyes is that I'm pretty sensitive to bright light and being able to easily slip sunglasses on and off is a huge benefit. I also just hate wearing my glasses, especially at the gym. I am extremely careful with my contacts, never sleep in them and change them out as scheduled. I feel pretty confident that this isn't setting me back, but who knows? One thing I've found really helpful - I put a daytime eye drop (RefreshPlus) in each eye right before putting my contacts in. Then I put an eyedrop in the contact lens before I insert it and follow the whole thing up with an eyedrop in each eye. My eyes don't dry out any faster when I'm wearing contacts (I have soft hydrogel lenses) and it's much easier for me to put eyedrops in because I'm not having to take my glasses off each time. Have I justified my vain and potentially bad decision enough now?

38 comments:

  1. I don't have dry eyes, but I have another eye condition where looking at the computer screen is pretty much the worse thing I can do to my eyes. 20-20-20 does help, but I agree it is so difficult to break away from the computer screen every 20 minutes, even if it's only for 20 seconds! My doctor keeps on urging me to find a new career (I am a graphic designer for The Knot), but what job isn't in front of a computer?

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    1. I know! The biggest recommendation is usually to avoid computers, but how many jobs are out there that I'm qualified for that don't involve computers?!

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  2. I have dry eyes; they started about 7 years ago when I was pregnant with my son, out of nowhere. I had worn contacts for about 22 years at that point, I used to wear the disposables day and night for a week and then throw them away. So I went from sleeping in my lenses to not being able to make it through the day. I have been on Restasis and I have had the temporary plugs, which seem to help when things are particularly bad. I didn't know about the permanent plugs - I might have to check that out. When my Restasis prescription ran out last time I did some research on alternatives, and basically found out that there are no great alternatives - the other drops fall way short and just soothe the symptoms. Pretty depressing that I will be using Restasis for the rest of my life! But I still wear my contacts every day (taking them out at night now) because I hate wearing glasses.

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    1. I'd be happy to just keep getting temporary plugs put in, but my ophthalmologist is reluctant to do that. He views the temporary plugs as a test, with the logical result being permanent plugs. I'm nervous, because there is a (very, very small) risk of something going wrong with the permanent plugs. They can migrate down your tear duct and possibly get infected (this almost NEVER happens, but I'm paranoid) and then they require surgery to remove. Creepy!

      Glad to hear you've had good luck with Restasis - I will definitely opt for trying it out.

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  3. This might not be relevant to your situation at all, but I recently started developing (VERY) mild dry eye after several years of wearing the same brand of contact. My optometrist suggested that, due to my various other allergies, I might have a mild allergy to silicone, which is is just about every contact out there these days. I was really skeptical (I've worn contacts for 15+ years), but apparently soft lenses of yesteryear (Acuvue, Acuvue 2, etc.) didn't contain silicone, thus the rise in some people finding their contacts uncomfortable/drying. I switched to Cooper Vision's Frequency 55 Aspheric and have never been happier!

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    1. Interesting! Thank you for letting me know - I'll ask my optometrist about this at my next appointment!

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  4. I'm kind of in the same boat as you. I have dry eyes due to some serious allergy to all things containing pollen, dust, mold and farming. (So everything outside in Illinois!) I take Patanol eye drops twice a day and use the preservative free eye drops throughout the day and I still have some issues.

    Since I have been battling it for about 10 years, I have found a few things that do work. When I'm at work or when I'm going to be on the computer longer than 30 minutes, I wear my glasses for two reasons: 1) My eyes don't get AS dry when I work at the computer and 2) I really don't want to wear reading glasses and take them off each time I get up. I hate my glasses but being able to see without splitting headaches is worth it. I also take a fish oil supplement every morning. It took a long time to notice a real difference (like six months) but now I can tell if I forget to take it in the morning. I am also a huge believer in walking away from my computer every 30 minutes. I set an alarm on my phone and when it goes off, I stand up and walk one lap around my (tiny) office. I also make sure I look out the window each time a train goes through. (My window looks over some train tracks and we usually have trains through town every 15 minutes so it's a good reminder to look away from the screen.)

    It's all a huge pain in the rear, but I've learned to live with it. I keep hoping that one of these days my eyes will just miraculously recover :-)

    Good luck and hopefully your dry eyes get much better for you!!

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    1. Oh, I'm so sorry you get headaches too! I find I get headaches more often with my glasses (so weird, maybe because they are heavy?), which is another point against them.

      The train sounds like such a good reminder! Makes me wish I had that.

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  5. Oh, dude. I feel you on this one. When I was 19 and working at a new research lab, I thought I had scratched my corneas, because when I closed my eyes it felt like there was something stuck in them. It meant I couldn't sleep. My mom eventually dragged me to an ophthalmologist who basically said, "I don't see anything except a little dry eye, why don't you try eye drops?" And some Bausch & Lomb Dry Eye Rejuvenation works for me, but I only use it when I get the dry eye symptoms. Which, since I left that job is probably only a couple times a year. Leaving the job was key.

    But my biannual dry eye experience terrifies me about getting laser eye corrective surgery. One of the potential side effects is permanent dry eye. DO THESE PEOPLE KNOW HOW MUCH IT SUCKS TO HAVE DRY EYES?! The answer is no, because if they did, they wouldn't risk it.

    Also, you don't have to set a phone alarm for your computer. Have you heard of "TimeOut" (http://www.dejal.com/timeout/) it's for Mac, but there might be some equivalent for PC.

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    1. I was seriously considering Lasik for a long time and figured I'd get it done in the next couple of years. My doctor thought I was a great candidate (before all this started happening). But now I'm just relieved the dry eye thing reared it's head before I got the procedure done!

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  6. I have dry eyes that were aggravated by LASIK, and I am still wearing RGPs post-LASIK so I share your pain on dry eyes. I've only heard good things about the results with Restasis (other than it's pricey without insurance). Also, have you tried using an air filter? My mom suffers from the same condition and nothing worked for her until someone suggested it and she says nothing has made such a marked difference.

    Last, maybe switching to RGPs would help? For me, soft lenses dry out my eyes way too much - my optometrist likened it to saran wrap over your eyeballs whereas RGPs allow much more oxygen flow.

    At any rate, I hope you experience relief soon. This is an awful thing to have that doesn't have an easy solution as people would think. Good luck!

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    1. I'm definitely going to ask about RGPs next time I'm at the optometrist. Thank you!

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  7. My comment disappeared!?!

    Anyway, your situation resonates with me, although my dry eye isn't as bad as yours. About 15 mths ago, literally out of the blue, I experienced acute eye pain so badly in my left eye that I ended up in the ER at Mass Eye and Ear - it felt like someone was pushing on the outside of my left eyeball. I was initially diagnosed with dry eye, and my ophthalmologist has diagnosed me with meibomian gland dysfunction (say that 3x fast!) but after getting many "second opinions," no one has thought that the dry eye is bad enough to be causing the pain. I haven't worn contacts since, and *HATE* wearing glasses! The pain has vacillated on and off, and I've tried tons of pain meds, etc. One recurring hypothesis is that it's referred pain from neck pain. Anyway, I will definitely try the masks that you recommended, and the vitamins. I've been doing hot compresses 2x day for months.

    One question I have is how you deal with cleaning the eye mask - my doctor recommended using cotton pads (the kind that you use to remove makeup with) for hot compresses so as not to spread bacteria...?!?!

    Thanks!

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    1. I don't know - that sounds worse to me! That pain would be awful!

      You bring up a really good point about cleaning the eye mask and I hadn't thought about it! So, I'm not cleaning it, and that could be an issue, I guess. I bet there are some masks with removable covers that could be laundered, which might be the best thing. It's also possible that doing a longer session in the microwave (and then letting it cool down before using it) would help sanitize it. Could also put a tissue on your face before using it! That might be the easiest thing, actually. A tissue would provide a barrier without diminishing the heating or cooling effect.

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    2. Thanks so much for the response - that's a great idea about the tissue, and I'll do that. I bought the mask and morning eye drops through Amazon - my eye drops aren't preservative free. Oh, and I bought the omega-3 supplements. One ophthalmologist recommended that I take them, but I read the article that you linked to, and the DHA and EPA amounts that I was getting weren't large enough, so I'll take the new vitamins. Your post was *REALLY* helpful to me! I'd love to wear contact again...

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    3. Good luck, lady! I hope you get some relief soon.

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  8. I went to the eye doctor and was told my right eye was dry and it would only get worse with age, ha! I've been using this drugstore brand eye drops that seems to be working for me - Systane Ultra high performance lubricant eye drops. And I still continue to wear contacts too!

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  10. Love your big justification about still wearing contacts :-) Can totally relate as the same thing happened to me (and I HATE wearing glasses and am super vain about it). But the ONLY thing that resolved my dry eyes was no contact lens wear at all for 18 months. It sounds extreme, but it fixed my dry eye problem enough that I became eligible again for LASIK, which I had done in April, and have never been happier! No dry eye problems (or any eye problems!) to speak of! It's so great to wake up in the morning with perfect vision!

    I had been a full time contact lens wearer for about 10 years. My eyes started getting uncomfortable after I switched brands (and I think the new brand had silicone in it! So Kim might be on to something...) I persevered with wearing contact lenses, albeit very carefully, but my eyes deteriorated extremely suddenly. One morning it was fine, and by that afternoon my eyes were so scratchy and uncomfortable that I couldn't open them. By the next morning I was so light sensitive and in so much pain that I went to the ER and the ophthalmologist there told me to never wear contacts again. I was devastated but tried to not get too frustrated with constantly pushing my glasses up my sweaty nose at the gym, or ruining a gorgeous outfit with glasses (haha) but I'm so thankful I pushed through because LASIK has seriously been great for me.

    GOOD luck! I really hope it gets better because I know how frustrating and painful it is, and constant trips to the ophthalmologist are never fun. But as someone on the other side it can get better, so hopefully you find out what works for you (I highly recommend giving the contacts a LONG rest).

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    1. Ahhhh! 18 months without contacts sounds like my personal hell, but I'm so, so glad it paid off for you!

      Super surprised that they gave you the go ahead on LASIK when you'd had issues with dry eyes. I thought that it was counter-indicated for people with a history of dry eyes, so I'd given up hope of ever doing it.

      So, so happy for you! Waking up every morning with perfect vision sounds like heaven.

      I'll keep this in mind, although I'm desperately hoping I can keep it under control without giving up the contacts. Obviously, I'm horribly stubborn. : )

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  11. One more question for you (sorry for the barage, but I don't know *anyone* with dry eyes!) - did you find that you experienced a skin reaction to any of the eye drops? I've been having some burning underneath both of my eyes for a week or so, and I *finally* realized that it's a side effect of my eye drops (Refresh Optive Lubricant Eye Drops, not Preservative Free). I'm waiting for the Preservative Free Refresh ones to arrive, but I also wondered if I should switch brands to one with a different active ingredient... the burning is really awful! I've been using these for about 8 mths, and it just started happening, which is odd... Thanks!

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    1. Don't feel bad! It's so helpful to hear other people's experiences!

      I haven't had any reactions to eyedrops, but I do wonder if it's the preservatives that are bothering you. How often are you using them? From what I've read, if you're using eyedrops more than 3 times a day they need to be preservative free or the preservatives will cause further irritation to your eyes.

      But re-reading your comment, is it the skin below your eyes that hurts? I'm not sure if that would be the preservatives or not.

      The fact that you were able to use them for 8 mo before developing any issues sounds like it is a sensitivity issue, but I don't know if it's the active ingredient or the preservatives. Hopefully the new ones you ordered work better for you, but maybe get a recommendation from your doc?

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    2. Thanks! I did call my eye doctor, and she said that I should be using preservative free drops - um, why didn't you tell me this when you told me to use the drops!?!? I did buy new drops so hopefully that will help, and my eyes feel much better - it was affecting my eyes and the skin under my eyes. Thanks again!

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    3. Ugh, so frustrating! Hope it starts to ease up that irritation!

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  12. just a quick note to be careful with cheap fish oil supplements. you really get what you pay for! nordic naturals and carlson's are two of the best brands out there, with much higher EPA and DHA content per serving. if you can stomach it, the liquid form is the best, because it is absorbed faster and better. both brands use small fish like sardines to decrease the mercury content in the fish oil.

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    1. Thank you, I'll look into this! Of course, if the cheaper ones aren't as good I don't want our dog taking them either! Maybe we just both need to start eating anchovies every day. Circe would love it, but I'm not sure I can handle 3oz of anchovies in a sitting.

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  13. Wow! I think I have the same issue as you! Or at least similar. I use the Systane High Performance vials. I go through several a day and even at night when I wake up. I should try your night time ones.

    My eye doctor recommended Restasis for me but even with my insurance, it was not something I was willing to pay for (maybe eventually). They said that tears are made of water, mucous, and oil, if I recall correctly, and that my tears are really low on the mucous and oil. I'm always afraid of them drying out because it hurt so bad and I couldn't see anything more than a few inches away!

    I'm so glad I came across your post because I've never known anyone else who's gone through this.

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    1. Oh, I'm sorry you're dealing with it too! Have you tried omega-3s yet? It takes a while to help, but if part of your problem is being low on oil, it's supposed to be particularly likely to be helpful to you. I swear it's the most helpful thing I've done.

      Good luck!

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  14. Have you looked into Seabuckthorn Oil? It is supposed to help with dry eyes. I just started taking them this week - I believe the brand is called Omega-7?

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  15. This is such an interesting post! And I bet you didn't think it was when you were writing it. But for people who battle dry eyes - and it sounds like there are plenty of us out there - it is a tough battle.

    I am in a very similar situation. My eyes only just recently started bothering me. I just turned 40, so I blame it on getting old. :-) I'm using regular drops in the morning and gel drops at night, and it's so far manageable, but I'm concerned with it getting worse over time. I feel exactly the same way about glasses/contacts. I take my contacts out as soon as I get home, but I do sometimes feel guilty about wearing them. I am also super anal about switching them out as scheduled and keeping them clean.

    My sister had LASIK as a result of getting a scratch on her cornea and she is super happy. I have friends who are super happy too. But I've always been scared of it, and now I feel like I wouldn't be a candidate for it due to the dry eyes. I guess it's worth asking, although I'd still be scared.

    I hadn't heard of the Omega-3 supplements being helpful, and I feel like I get enough in my diet (walnuts, salmon, eggs...), but I may check that out too.

    Thanks!
    Mary

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  16. Have you ever tried EZTears from the company Zeavision? I started taking the supplement 4 months ago and it has been amazing! My eye doc prescribed them and said it was just natural anti inflammatory vitamins in there so initially I thought it was just like a multivitamin. (Who knows if thats working!) It has been awesome and I even stopped taking Restasis. (There's also a money back guarantee on it as well) Check it out and I hope it works as well for you as it did for me

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  17. What worked for me is increase the intake of quality water and COCONUT OIL capsules. Oh my! The day after I started I woke up with tears in my eyes...then I cried for real :)

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  18. I have horrible dry eyes too and spend way to much time at the eye des because of it. However, I found what works wonders for me is taking a hot as I can handle wet washcloth and holding it over my eyes. I alternate with a couple of wash clothes and do this upwards of three times a day for five minutes a time. The relief was immense. And drops. Gel drops work the best.

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  19. Hi Rachel! I just read an article about dry eyes and remembered your blog post. I hope you are doing better, but if not, maybe this will help. I know that I'm going to give it a try for the eye lashes issue. :)

    http://www.natural-alternative-therapies.com/home-remedy-for-dry-eyes/

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  20. I gave one dry eye as a result of nerves being cut due to a brain tumor. This has been going on for 27 years, but I've had my worst bout ever this past month. I'm going crazy with pain! I have lived on Celluvisc for years, but I'm going through it like water with no relief. Have tried rest as is, but it burns my eyes. If anyone has any other suggestions I'm willing to try anything at this point. Warm compresses help only for a few minutes. I take fish oil.

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  21. Sunglasses are a great fashion accessory, but their most important job is to protect your eyes from the sun’s ultraviolet rays. Dry Eye Sunglasses are even more important for dry eye sufferers since they will add extra protection for you sensitive eyes.
    http://dryeyes-store.com/dry-eye-sunglasses/

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  22. This post is about explaining in a very simple way what you can do as home remedies for dry eyes to minimize your symptoms.

    http://dryeyes-store.com/home-remedies-dry-eyes/

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  23. Dry Eye Treatment – Here are some tips on how to reduce your dry eye symptoms and improve your quality of life

    http://dryeyes-store.com/dry-eye-treatment/

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