We just returned from the ophthalmologist. He is suggesting we try ONE more medication, an oral for this time, Pilocarpine hydrochloride 2%. We go back in 2-3 weeks to recheck.
He was honest and stated that he was not optimistic this would work since there has been NO improvement with Cyclosporine or Tacrolimus. Today her tear production was still decreased in her left eye.
Here is the sad part. He said he believes Maddie was born without the lacrimal gland. Otherwise the previous medications would have stimulated it to produce glands. These medication work in 95% of the time. The other cause is a decreased neurological stimulation. That is why he wants to try the Pilocarpine. This medication is supposed to increase neurological stimulation. If this doesn't work, either Maddie will have to have drops placed in her eye at least once every 1-2 hours. or He suggested a surgery: parotid duct transposition. Basically, in case anyone is unfamiliar with it like I was, he will make a small incision on the side of her face and re-route saliva into her eye.
We could do an MRI to try find see if the gland is missing, but he said this is often costly and not always possible to see.
I am freaking out on what to do!
Anyone have any experience with this? He did discuss some possible
minor complications with the surgery but stated it
is usually successful.
My poor baby girl.