DrG, plz help me find the right lens!

[lilhoser]

Hi,

About 7 years ago, I gave up wearing contacts due to mild/moderate dry eye pains and have tried to tackle the problem on and off with various opthalmologists/optometrists. I have used many different solutions for cleansing and storage (thinking an allergy to a preservative was the problem), numerous wetting drops, and several Acuvue lenses (two-week and daily disposables, Acuvue 2, Acuvue Advance, Acuvue Oasys, and most recently Acuvue Moist). I had two bottom puncta cauterized and also started on Restasis. I still cannot wear any of these lenses for more than a few hours before the symptoms set in - rubbing, burning, foreign object sensation, etc.

I have learned a great deal just reading the posts in this forum topic, and wanted to see what advice you have for myself and other users that may be as lost as I am trying to find a comfortable contact lens that won't irritate my eyes. Is the solution as simple as trying a hydrogel lens such as Proclear? Which lenses should I try next?

However, I'm the type that wants to know WHY something is happening - the root cause of the problem. I just learned of Corneal Desensitizing through this forum - how is this diagnosed? Up until now, I have been convinced that my puncta were the culprits, but since cauterization and plugging have failed, I'm losing the faith. I'm ready to just go to Lasik and be done with contacts!

Thanks for your time,
Aaron

[DrG]

Aaron,

I have previously addressed the subject of dry eye and contact lenses in this forum. The dangers of LASIK for people with dry eye have been documented both here and in the medical/scientific literature. Given that you have dry eye, wearing contact lenses will only increase your discomfort, and LASIK may prove disastrous.

Until your doctors get this figured out and find a treatment for your condition, you are better off staying with eyeglasses, IMHO. Contact lenses have never been better, but there are still people who cannot wear them successfully, sorry to say.

[lilhoser]

You have made suggestions to others in the forum for types of lenses to try based on the summary of their condition, I was hoping you could attempt to do the same for me. I consider my case fairly mild to moderate, so I don't think I'm to the point where I should give up on contacts.

Thanks

[DrG]

Aaron,

It sure doesn't sound like you have "mild" dry eye. It sounds a bit worse than that. If you were my patient I would probably give you a sample of Proclears to try.

After 7 years without contact lenses, I doubt you have "corneal desensitization" syndrome. There seems to be renewed interest in some circles to implicate contact lens wear in the development of chronic dry eye. While it makes good copy, it is currently not good science.

[lilhoser]

Just wanted to provide a follow-up.

For the first time in roughly 10 years, I am able to wear contact lenses comfortably for a full day, and many days in a row. My doctor had me try PrecisionUV, Proclear and Vertex 55. Turns out, vertex 55 is the most comfortable. Which is strange, because it has a higher water content and is a hydrogel lens - bad things, according to the article you posted recently and other discussions about how low water content is better.

I wonder how long this will last

[DrG]

That's good news. I hope it continues. The Vertex 55 would not be on the top of my list of lenses to try, but go with what works as long as it doesn't hurt you.