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  • Confocal laser scanning microscopy

    I have been told I have corneal neuropathy but no tests done to prove this.
    If there is anyone who has had confocal laser scanning microscopy, I would be interested to know what this involves.
    Also for anyone from the UK who has had this done, is this something you asked to get done, or did this come from the ophthalmologist?

    I feel like because the signs do not look too bad, the doctors just try and fob me off when I tell them that my eyes are burning because I cant prove it.

  • #2
    I feel like you need to find a better dry eye specialist. Unfortunately, I am not familiar w the UK scene. Perhaps try flying to a different country (and pay out of pocket) for better drs?

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    • #3
      Hi Alix, I am from the UK and had this done a couple of years ago. It doesn't take long. The doctor puts anaesthetic drops in your eyes so it doesn't hurt. They place something on the eye and move it around to get images I think. My eyes did feel a bit irritated afterwards but my eyes are pretty bad. The ophthalmologist recommended the procedure and as far as I know there are only 2 places which have the equipment to do this - Moorfields and Queens Medical Centre in Nottingham. I did get immediate feedback afterwards.

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      • #4
        Originally posted by holly123 View Post
        Hi Alix, I am from the UK and had this done a couple of years ago. It doesn't take long. The doctor puts anaesthetic drops in your eyes so it doesn't hurt. They place something on the eye and move it around to get images I think. My eyes did feel a bit irritated afterwards but my eyes are pretty bad. The ophthalmologist recommended the procedure and as far as I know there are only 2 places which have the equipment to do this - Moorfields and Queens Medical Centre in Nottingham. I did get immediate feedback afterwards.
        Thank you Holly, I will get this done at Moorfields then which is my local hospital. Good to know it does not hurt!

        As I wont be able to get this on the NHS since my condition is not considered to be "serious", I will have to see a private consultant there but am wondering who to book an appointment with. Do you know if this machine is something that any opthalmologist can use, or do you have to be a specialist?

        My insurance company say they are happy to cover all the costs, as long as the consultant deems it necessary, so Id rather see someone who is very familiar with confocal microscopy.

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        • #5
          Hi Alix. I saw a Professor Sharma at Moorfields once. His speciality is dry eyes and he will be familiar with the procedure I am sure. If you ring and make an appointment make it clear what condition you are seeing him for, as when I went I saw him at the wrong clinic where they didn't have all the diagnostic equipment. He is a really nice man and will spend a long time with you.

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          • #6
            Thank you Holly. I just looked him up and he is familiar to me - funnily enough I was going to go see him last year since as you say he is an expert in dry eye, but because he works at the hospital in Bedford which is far away from where I live, decided to see another doctor on Harley Street instead. This was a mistake as this doctor thought there wasnt much wrong with my eyes even though my TBUT is 3 !!

            I ll definitely go and see Professor Sharma and make it clear that I would like the confocal microscopy done at my first appointment. Thanks again!

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            • #7
              Alix. Professor Sharma has been involved in the blood drop for dry eye research. Be interesting to see how his research is going. I did e.mail a while ago to see if they needed anymore participants but the dais they didn’t.

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              • #8
                Originally posted by LindaDawn View Post
                Alix. Professor Sharma has been involved in the blood drop for dry eye research. Be interesting to see how his research is going. I did e.mail a while ago to see if they needed anymore participants but the dais they didn’t.
                Thanks Linda I will ask him about it and see if he is working on anything else. Ive already tried PRP drops from Spain so I wont be doing the blood drops.
                All I need at this stage is for him to confirm whether or not I really do have nerve damage.

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                • #9
                  Alix, did you have any improvement with the PRP drops? I am seeing a new doctor who is wanting me to stop autologous serum and do PRP instead because he thinks I have corneal nerve damage from LASIK.

                  Comment


                  • #10
                    Originally posted by brokenbbyblues View Post
                    Alix, did you have any improvement with the PRP drops? I am seeing a new doctor who is wanting me to stop autologous serum and do PRP instead because he thinks I have corneal nerve damage from LASIK.
                    Hi there unfortunately no they didn’t work for me. Initially the doctor I saw - Professor Alio a world class ophthalmologist who is a pioneer of PRP, told me that most of his patients with corneal nerve damage were pain free after 6 weeks of using PRP drops 4-6 times a day. When I told him at the follow up appointment they had had no effect whatsoever they re-did the meibography which showed I had hardly any glands left after all, therefore there was no point carrying on with PRP as it was not going to bring back my glands which is the root of my problem.

                    Not sure where you are based but it is worth trying PRP if its available as even though it didn’t work for me it has for others.
                    Last edited by Alix; 04-Jan-2020, 21:04.

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                    • #11
                      Originally posted by Alix View Post

                      Hi there unfortunately no they didn’t work for me. Initially the doctor I saw - Professor Alio a world class ophthalmologist who is a pioneer of PRP, told me that most of his patients with corneal nerve damage were pain free after 6 weeks of using PRP drops 4-6 times a day. When I told him at the follow up appointment they had had no effect whatsoever they re-did the meibography which showed I had hardly any glands left after all, therefore there was no point carrying on with PRP as it was not going to bring back my glands which is the root of my problem.

                      Not sure where you are based but it is worth trying PRP if its available as even though it didn’t work for me it has for others.
                      Thank you for sharing, Alix. I am based in the central U.S., and the PRP drops are available to me. I am hoping to get started on them in the next couple of weeks. I have been told my main problem is aqueous deficiency due to corneal nerve damage, rather than issues with MGD, so I am really hoping I have quick improvement with the PRP drops.

                      Comment


                      • #12
                        Originally posted by brokenbbyblues View Post

                        Thank you for sharing, Alix. I am based in the central U.S., and the PRP drops are available to me. I am hoping to get started on them in the next couple of weeks. I have been told my main problem is aqueous deficiency due to corneal nerve damage, rather than issues with MGD, so I am really hoping I have quick improvement with the PRP drops.
                        Hi if you have aqueous deficiency there is also the possibility of injecting PRP directly into the lacrimal glands to kick start the tear production process.

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                        • #13
                          Originally posted by Alix View Post

                          Hi if you have aqueous deficiency there is also the possibility of injecting PRP directly into the lacrimal glands to kick start the tear production process.
                          I have heard of the injections but read negative reviews about side effects and risks, so I thought the drops would be safer. I might still ask my doctor about the injections. So far he has only proposed the PRP drops.

                          Comment


                          • #14
                            Originally posted by brokenbbyblues View Post

                            I have heard of the injections but read negative reviews about side effects and risks, so I thought the drops would be safer. I might still ask my doctor about the injections. So far he has only proposed the PRP drops.
                            Yes absolutely. In Spain they told me they inject PRP into the meibomian glands in extreme cases of MGD, but they were not prepared to do this on me as they didnt think my eyes were bad enough - I had no dry spots and my corneas were damage free. They didnt not think it was worth the risk. There are horror stories out there, and I was told the effects are not permanent, so its definitely best to discuss with the doctor and get second opinions.

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