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  • Need advice!

    Hi. I just came across this very helpful website today, and am hopeful that some of you might be able to help me with my decision to get Lasik surgery 10 days from now (or not ....) . I am what I would consider a mild dry-eye sufferer, and have been for a few years. I think it is caused by hormones (high estrogen) but I cannot be sure. I have never been an eye drop user, so that should give you some indication of how mild my case really is. I would say that every now again I will wake up and my eyes will feel dry .... I will sort of blink several times, and they just sort of clear up or moisten up on their own, or whatever. It is not an every day occurrence for me. So, fast-forward to my pre-Lasik consultation a few weeks ago. The doc's assistant (not sure what her medical title was) (not the opthamologist though) ran their battery of tests on me to determine if I would be an acceptable candidate, yada yada. Later, the doctor came in and examined me, then said "so do you have dry eyes?" I said "occassionally." (At this point, I was very curious to know how HE knew that, as I was unaware that any of the tests she had run was testing for that!) He said that one of my eyes showed mild dry eye, the other not so much so. He asked if I used drops of any type, I replied no, he said I was probably one of those people who could benefit from the occasional use of drops, for general relief. I had read before even going into this consultation that people with dry eyes were usually not candidates for Lasik -- and I want Lasik -- so I was thinking he was going to tell me "see ya" right then & there. He didn't -- at least not right away. He sent me away with the assignment that I had to use some eye drops he gave me 2x daily -- then come back the first week in January to have my level of dry eye measured again. I guess I'll find out if he'll do the surgery or not, based on what those tests reveal.

    My question to you guys is, after reading many of these posts, is how common is dry eye occuring after Lasik surgery??? I realize it has happened to a great many of you, but do you think that is representative of the population as a whole? I know LOTS of people who have had Lasik and none of them have reported dry eye as a result, but none (that I am aware of) went into it with a mild case of it to begin with either. So, my dilemma is whether or not I should do this at all ..... am I trading one set of problems for another (clear vision for dry eyes)?? Or is it possible I'd be like the majority of people out there who have little to no problems post-Lasik? I'm not trying to convince myself to have the procedure, nor minimize the horrific situations many of you seem to deal with on a daily basis, for which I certainly hope you all find relief. I just am trying to make an educated decision for myself .....

    Happy New Year .... May 2006 bring you all moist eyes & perfect vision!!

  • #2
    my advice

    Hi Ellen,

    Yes, you are correct, many of the people on this site have had very bad experiences with lasik and dry eye. I'll share with you my opinion on the matter. Dry eyes after lasik is very common, but is supposed to be temporary. Obviously, if you've read through this site, you realize now that it is NOT always temporary, but can be permanent and extremely painful and debilitating. As for percentages, I think that the numbers that I hear thrown around the most are 1-3% of patients that have symptoms persisiting past a year, and possibly permanent. If you do have dry eye going into the procedure, then you are at a higher risk for having more dry eye problems after surgery. It is impossible for the doctors to be able to tell exactly what your outcome will be no matter how many tests they do pre-op. There are people on this site, whose surgeons guaranteed them that they were good candidates and that everything would go perfectly, but they are now left with a life-altering dry eye condition.

    I think as far as lasik goes, there are good candidates, and there are not so good candidates. Having a dry eye condition pre-op would put you into the "not so good" candidiate category. That said, there are "not so good" candidates that have great outcomes, and good candidates that have bad outcomes. There is no way to tell for sure what your outcome will be. I think what you need to decide is if it is worth the risk, because even though you think "that would never be me", it just might be. That is what I thought before my surgery....."that would never be me". I am only 26, and thought my eyes were pretty healthy. I had problems with my contacts, but I never thought my problems were any worse than the numerous people I knew that had good lasik outcomes. My lasik place did not do dry eye tests, and I was not informed enough at that point to ask for them.

    Did I have dry eye before my surgery??? Due to my intolerance of contact lenses, yes, I probably did have some mild dry eye but never to a point where I was forced to use eye drops or was in any sort of discomfort with my glasses on. Do I have dry eye now??? Most definitely, and it is no picnic. I've just crossed 6-months post-op which is when I was told my symptoms should subside, and unfortunately they have not. So, I will continue to wait and hope for the best. 1-3% doesn't sound that scary, until you find yourself right in the middle of it. It is very obvious to me now, as I'm sure it is to many on this site, that lasik was NOT worth the risk, and I would give anything to go back to my comfortable glasses.

    Anyway, that is just my two cents. Good luck with everything.

    Michelle

    Comment


    • #3
      Thanks for the speedy reply. I neglected to mention that the main reason I'm leaning toward having the Lasik surgery (if my doctor deems me a good candidate when I go back next week after having used the drops for a couple of weeks) is that I'm hoping improved vision (corrected astigmatisms in both eyes) will contribute to a decrease in the frequency of &/or severity of migraines I get. Migraines are to me what dry eyes are to probably all of you!! Still, the dry eye thing with respect to Lasik is giving me pause...... I'm going to really grill the doctor about it when I go back in. Not that, as you pointed out, he can guarantee me any particular outcome, but some assurances would be nice. I never got the impression he was pushing Lasik -- not at all. This is a very reputable doctor in Houston, and he certainly doesn't need my business!! Thanks again.

      Comment


      • #4
        There's obviously a great deal here that I don't understand, but ... presuming that glasses and/or contacts correct you to 20/20, is there some reason to believe that LASIK would help with your migraines?

        As to the dry eye and LASIK, I think it's pretty clear that you'd be rolling the dice to some degree. If it were me, I'd definitely get a second opinion from a corneal specialist whose expertise is in dry eyes.

        Michelle, and others on this forum, can definitely tell you this much: if you already have mild dry, but it's manageable without the use of drops, you don't want it to get any worse. At the very least, you might want to talk with the ophthalmologist about putting in lower punctal plugs a few months in advance of any laser surgery. There have been some studies that showed that using plugs prophylactically helped reduce the incidence of post-operative dry eyes.

        People who don't have problem dry eyes don't think much about it. It's easy to dismiss the notion as "no big deal. So you put a few drops in now and then." It's not that simple, as you can quickly see by browsing this forum. Many of us suffer from constant pain and discomfort that drops barely help to ameliorate. Many of us have difficulty dealing with bright light, wake up with our lids stuck to our eyes, have to carefully control our very living environment to stave off infection or other ocular conditions.

        Tread cautiously. Do your homework. Make sure you're looking at this for the right reasons. Be realistic about the risks. Never fear second (or third) opinions, and ... if you proceed ... get the best refractive surgeon you can find.

        Best of luck!

        Neil

        Comment


        • #5
          How would you feel if the migraines did not subside AND you got stuck with painful dry eye for life?
          Another thing to think about. Certain medications can cause dry eye. Should your mild case of dry eye even get a touch worse due to Lasik, should you ever need any medication that contributes to dry eye, you could be in a bad place. If you take any meds for migraines, do they have any effect on your dry eye? You mentioned that SOMETIMES your eyes are dry when you wake up. Any correlation there?
          And from what I am finding out, many medications can cause even a mild case of dry eye to become severe.
          I, too, am curious as to why Lasik could cure your migraines when glasses and contacts don't. Is this a guarantee???

          Comment


          • #6
            Ellen Don't Do It!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

            Hello Ellen,
            My name is Delilah and you will find me posting often, I have Severe Dry Eye, MGD, LD and FK. I have not ever had Lasik surgery but I do not look highly upon it, its messing with your eyes, your taking a huge risk in becoming a dry eye sufferer and it becoming worse and worse and soon you will be accumulating so many eye drops you will not know what to do with yourself!!! Let me welcome you to this site, this site has helped me so much and the people are amazing, its like a big family
            If your eyes are not bad and if you have to wear glasses or contacts just deal with it, you will HIGHLY REGRET IT AFTER YOUR SURGERY!!!!!!!!!! If one of your eyes even shows the slightest in dry eye then that eye will become the WORST EYE after your surgery!!!!!! After your surgery you will most likely have to use drops anyway and that there can affect your normal tear production.
            Its just like getting breast implants, or any other cosmetic surgery, your dealing with a lot, its like a 50/50 chance and its not worth ruining your healthy eyes just to be able to see perfectly without glasses or contacts. Many people I know that have had Lasik surgery end up going again later on in life to have it again; as your eyes age, usually the second surgery really messes them up!!! Its your choice, I myself am suffering from so many things that I would never even consider the fact to have my eyes laser cut open and fool around unless I was almost legally blind!!!!!!
            Look how many people on this site REGRET THEIR SURGERY, now they are dealing with a load of problems, more than they had before their surgery and it sucks and now they wish they hadn't done it!!!!!!
            Im extremely un-happy with my breast size but I figure if I go and do it and they leak or they mess me up then thats more to deal with. I hope I am not sounding like a total rude person or trying to tell you what to do, Im just trying to give my opinion and you will get tons more but just take that into consideration. Again welcome to the site and whatever you choice is, we all will be by your side 100%. Happy New Year. Ciao Delilah

            Comment


            • #7
              http://www.lasermyeye.org/forums/forumdisplay.php?f=8

              http://www.dryeyezone.com/talk/showthread.php?t=839

              Or, dozens of threads on either of these websites will tell the story of lasik and dry eyes. Contrary to many opinions, dry eyes does not always clear up by the 6 month or the 12 month mark. Sometimes it clears up in the second or third year. Some of us are going on 6+ years.
              Last edited by Lucy; 31-Dec-2005, 18:35.
              Don't trust any refractive surgeon with YOUR eyes.

              The Dry Eye Queen

              Comment


              • #8
                Hi Ellen, welcome to Dry Eye Talk.

                Originally posted by EllenJ
                My question to you guys is, after reading many of these posts, is how common is dry eye occuring after Lasik surgery??? I realize it has happened to a great many of you, but do you think that is representative of the population as a whole?
                The best answers to this should be found in medical literature and surveys. I don't think it's really been adequately studied, myself. I will say that according to the annual surveys done by ASCRS (the American Society of Cataract and Refractive Surgeons), refractive surgeons consistently rank dry eye as THE most frequent problem experienced by their patients after surgery. Additionally, I would suggest you get a copy of your surgeon's informed consent paperwork. Usually such forms state this same fact unequivocally (even if not very prominently). Finally, as a merely anecdotal observation I would like to say that as one who frequents medical conferences on behalf of this organization, I hear constantly from optometrists and their technicians about dry eye amongst their LASIK patients being a very common and increasingly troublesome problem.

                So much for the "generic" risk. Then there is the possibility of any enhanced risk due to your personal situation. That's debateable. Personally, because of the extent of the suffering I have witnessed in so many people who had at most quite minor "red flags" for dry eye before surgery, my inclination is always to take a very conservative position. I couldn't bear to encourage someone to get surgery and then see them become one of "us". And of course my answer is predictable. When you come onto a bulletin board for people with serious dry eye, many of whom (I think it's around 25% or so?) have that serious dry eye as a result of LASIK, you're unlikely to get any encouragement to go forward.

                am I trading one set of problems for another (clear vision for dry eyes)??
                Boy do I wish I had that crystal ball. Unfortunately, none of us does.

                Or is it possible I'd be like the majority of people out there who have little to no problems post-Lasik?
                Of course it is possible - rather, probable - that you would "be like the majority". But "little to no problems post lasik" is not an objective category. You'd be amazed at what some people consider "minor", and you'd be amazed at what some people consider "major" when it comes to eye problems. Tolerance varies tremendously. But basically I think what you're looking at is a relatively substantial risk that you would need to use eyedrops periodically or regularly afterwards and a much smaller, but that is not to say trivial, risk of a condition that cannot be satisfactorily managed with eyedrops.

                May 2006 bring you all moist eyes & perfect vision!!
                Thank you and amen to that!
                Rebecca Petris
                The Dry Eye Foundation
                dryeyefoundation.org
                800-484-0244

                Comment


                • #9
                  Wow .... thanks to ALL of you for the wonderful posts, replies, insights, & commentaries. You've all given me to much to ponder, consider & deliberate!! I'll attempt to answer a couple of questions a few of you have asked. First, no, I'm not sure improved vision under Lasik will cure my migraines any more so than wearing glasses does. I do notice a distinct link between my vision & my headaches, though. The problem is, I'm not what you would call a faithful wearer of my glasses, as I should be. Lazy, irresponsible -- call it what you will -- but the truth is, I misplace them, or they ally get left in the car and it's 37 degrees outside and I don't feel like running out there to get them, or they get scratched ..... there are any number of reasons why they're not on my eyes as often as they need to be. Plus, as the mother of 3 very young kids, I'm always on the go. Half the time I forget where I put THEIR stuff, let alone have time to look for where I laid down my glasses. And lastly, as someone who tries to squeeze in a little time for fitness, the sweat pouring from my face as I jog or work-out doesn't exactly work well with glasses. And, I tried contacts .... I couldn't stand them in my eyes AT ALL, gave it about 2 months to get used to it, never could, went back to glasses. So, what all this means is I don't wear the glasses as often as I should, and although I'm never without them for more than a day or two, it's enough to where when I do put them back on, the vision is distorted (thank you astigmatisms) for awhile, while my eyes are readjusting, and hello headaches. (I should probably mention that my nearsightedness is not all that bad .... 20/80 & 20/90 .... but my astigmatisms distort the way I see everything and that's the main problem.)

                  I know this sounds horrible .... you're all probably thinking, "lady, just keep track of your glasses and just don't wear them for the little time you're working out or doing sports stuff." It's not that easy. If I couldn't water ski or snow ski or stuff like that .... things my husband & I are beginning to be able to do w/ our oldest 2 kids, I would suffer something worse than these migraines. So it's also a lifestyle thing to a big degree. The Lasik thing appealed to me because I wouldn't have to really keep up w/ the glasses, the vision & astigmatism thing would be corrected maybe altogether (if things went right....), and it might impact my migraines in that the vision/headache link should be broken (because the not-wearing-my-glasses because I-can't-find-them routine would be over). Is any of this making sense to anyone but me????

                  Still, the dry eye thing is giving me a great deal of pause, I must admit. I tossed and turned last night in bed and couldn't wait to wake up this morning and check this board! I am praying that God will give me the right answer. I do want so badly to be among the masses of people who have no problems with Lasik (for pete's sake, my own husband had this procedure nearly 8 years ago before technology was even remotely as advanced as it is today, and he still sees crystal clear, never had a bad reaction to this day .... why can't we all be like him??!!). I have 2 brothers who have also had the procedure recently, 2 sisters-in-law, and 7 close personal friends .... all of them would highly recommend it. Of course, none of them had a mild case of dry eye going into it (that I am aware of) either. SO, this is nothing to fool around with, that's for sure. I definitely will discuss this in great detail with my doctor next week, and if I do not like what I hear, I will probably just not have the surgery. Not yet, anyway. I cannot take the chance with my eyes. Migraines AND severe dry eyes? Are you kidding? Did I mention I have 3 YOUNG children?! Just lock me up now.

                  One last question, if I haven't overused my quota already..... Theratears Nutrition??? The capsules containing flaxseed & Omega-3? I have seen posts on here about them, but just passing mentions of them -- no ringing endorsement or opposite. Any testimonials to share? I'm all for tackling this via eye drops and systemically, and of course the ingredients in this are just good for you anyway.

                  HAPPY NEW YEAR EVERYONE!! GOD BLESS AMERICA!!

                  Comment


                  • #10
                    Originally posted by EllenJ
                    One last question, if I haven't overused my quota already..... Theratears Nutrition??? The capsules containing flaxseed & Omega-3? I have seen posts on here about them, but just passing mentions of them -- no ringing endorsement or opposite.
                    One reason you don't tend to see a lot of splashy testimonials for TTN or any of the other proprietary dry eye supplements on this board is that many posters here are veteran dry eye patients who are basically connoisseurs of dry eye products. If/when they find that a type of nutritional supplement works for them they often investigate and experiment till finding the optimal source for them. For example, many patients here take flaxseed oil in liquid form. If you browse through the forum on nutritional supplements and read some of the discussions, you'll see what I mean.

                    It's great to have proprietaries like Theratears Nutrition marketed specificially for dry eye patients because it increases awareness of the benefits of Omega 3s for us. But patients who are sold on the benefits and don't mind the effort of doing some research and experimenting often move on.
                    Rebecca Petris
                    The Dry Eye Foundation
                    dryeyefoundation.org
                    800-484-0244

                    Comment


                    • #11
                      If i were you, and you have mild dry eye, i would stay well away from lasik. I had mild dry eye, I could even wear contacts occasionally, I went on anti depressants for one month and now 10 months later I am still suffering with moderate dry eye. Which is enough to change, and turn your whole life upside down. If you think itís bad not being able to do some sports that require good vision now. Trust me it will be a lot worse when you do anything with bad dry eye. Not just sports things like: reading, sleeping, driving. The most simple/basic things, Which people take for granted. Plus, if you get depressed over it, that will prevent you from doing things as well.

                      Before i got bad dry eye, i was considering lasik. I got enoyed because i couldnt jump off a rock in to water in australia like a lot of people (my bf and friend) coz i couldnt see the bottom, that type of thing. But i wouldnt care if i never could do those types of things for my whole life. If i could just have my everyday comfort back.

                      I would watch out with the headache thing. Dry eye can cause headaches. I never used to get them, than started in last few years around my eyes so it does seem like there is a connection. It could be stress though. directly or indirectly dry eye might have some neurological impact.

                      http://www.dryeyezone.com/talk/showt...ight=headaches
                      I healed my dry eye with nutrition and detoxification. I'm now a Nutritional Therapist at: www.nourishbalanceheal.com . Join my dry eye facebook group: https://www.facebook.com/groups/420821978111328/

                      Comment


                      • #12
                        Ellen-

                        If you have that much trouble managing your glasses, imagine what a burden it would be to have to have lubricating drops at your disposal all the time.

                        Hmm. Don't like to wear the glasses that were prescribed for you and suffer from headaches. I'm no eye doctor, but I could probably diagnose this one for you.

                        Wear your glasses when you should. Wear your contact lenses for the outdoor activities that make glasses cumbersome, see if that clears up your headache issue.

                        If it does, maybe the change in habits is all you need. If it doesn't, at least it will take the pressure off of you to have a surgery that clearly involves some level of risk.

                        Best of luck, again, with your decision.

                        And ... bless all the people of the world, not just us. We're all spinning on this big, blue marble together

                        Comment


                        • #13
                          I got Lasik because of the sports things you mentioned. I am very active, and I like to ski and swim and snorkel. Did you know you can get prescription goggles for skiing, snorkeling and all that stuff? I wish I had done that! Now I wear them anyway to protect my dry eyes, although my vision is OK. Go figure!!
                          Also, there are many new contacts on the market recently. Just because you couldn't wear contacts before doesn't mean you can't now. Before Lasik, I would go to the eye doc and try a bunch of the new contacts and see if something works for you. Did you have problems with dry eyes and contacts? That's another red flag.
                          Would have been much cheaper than the Lasik and the addition thousands of dollars I have spent since then with medical bills/supplements/doctors etc. if I had bought the prescription goggles/masks. Most insurance companies will not cover Lasik complications, so keep that in mind also. Find out EXACTLY what your Lasik doc will do for you if you have vision/dry eye problems. Plugs and all this stuff can be quite expensive.
                          And, yes, I know what you mean by all the successful Lasikees. I knew so many people that just LOVED their Lasik. Many experienced no problems with it. However, upon questioning people further, I was surprised to find that the people who told me they LOVED their Lasik had minor problems. Starbursts at night, stars in the sky don't look the same, headlight glare, mild dry eye. To them it was a trade-off. I'm not so sure I would have thought looking at the night sky and finding it not nearly so enjoyable anymore would have been a trade-off for me. To each his own.

                          Comment


                          • #14
                            Hi Ellen,

                            Since you are in Houston you might want to go to Dr. Stephen Pflugfelder. He specializes in dry eyes and works with Dr. Koch, who is one of the best Lasik people in Houston. Maybe he could give you more detailed information and evaulation before taking a definitive step like Lasik.

                            http://www.baylorvision.org/

                            Tigs

                            Comment


                            • #15
                              how common is dry eye occuring after Lasik surgery?
                              One in four people who undergo LASIK will receive LASIK-induced dry eye, according Dr. Michael Grimmett, M.D. He ought to know. He is a consultant to the FDA.

                              Comment

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