dry eye after several years post surgery??

[patrick]

hi,i'm a bit confused about the dry eyes bothering me for some time now.
i'm 39 years old and had lasek surgery almost 5 years ago. my vision is perfect (is that 20/20 in english?,sorry for my somewhat bad english i'm dutch) and i do not have any of the complications like halo's starbust and so on. right after surgery i had dry yes for some time,but i was told this is normally to be expected. and indeed after a couple of weeks i could stop with the eye drops provided by my surgeon. my dry eyes cleared up very well in the next period and have been really okay for the next few years. a bit dryer than before surgery,but nothing too bad. it didn't bother me at all. but since the last two years my eyes seem to become increasingly dryer,and now it really limits me greatly in doing the things i want to do. (like working in an office environment). does anybody here recognize a situation like this? here in the netherlands nobody seems to have any answers for my questions. i'm confused and scared as well. recently i went to an optometrist and told here my story. she did some tests and said i have dry eyes (tbut 5 and 6 seconds and osmolarity 293,this was 8.30 in the evening)due to meibomian gland disfunction. i now do warm compresses and eyelid compressions on a daily basis for two months.i also take 2 spoons of flaxeedoil per day. i do not experience any improvement. my optometrist tells me it can take some time for this treatment to notice any relief so i just continue. is it possible that my eyesurgery could have caused the meibomian gland disfunction over the last 5 years? could something else have caused thre dry eyes in the course of time? maybe due to a decreased blink rate or so? isn't it so that lasek is less suspected for causing a decreased blink rate or any complication than lasik because of the simple fact that a lasek procedure damages far less nerve endings than a lasik procedure? thanks for reading! i hope to get some reactions from the people here.
kind regards,patrick...

[Sammy B.]

Hi Patrick,

First off, as I am sure many others will tell you - welcome - you've come to the right place for answers!!

Secondly, I had LASIK so I cannot comment directly on LASEK, but we do have some post-LASEK people on the board and perhaps they can help you a bit more than I can, although it seems that the majority were dry from day one, not going dry years later like you/me.

I do think that, over time, something like MGD could develop post surgery and it could be that you were destined to get an MGD problem later in life anyway - the surgery just accellerated it. I also think that stress and life changes can trigger or exacerbate issues like dry eye. So, watch that stress level...

The warm compresses are a good start. Do you know if you sleep with your eyes cracked open? Are you sleeping enough every night? Do you consume enough water? These are basics that I've been trying to instill in my regimen and so far they have done me well (drinking more water & getting more good quality sleep are EXTREMELY IMPORTANT!). When my eyes were at their worst, so was my stress level and sleep deprivation level.

Finally, what are your exact symptoms?

- Rose

[patrick]

hi rose,

thanks for your reply. i'm sure that i've come to the right place for answers. lasek is indeed the kind of method known to be less dangerous than lasik.still i've developed dry eyes over the past years. maybe you're right and probably i would have developed some sort of mgd anyway and the surgery just accellerated the proces. by the way i had my eyes treated by laser due to a contactlensintolerance. i do not sleep with my eyes open i've had this checked by my wife. at this time i do not get enough sleep due to stress. when i go to bed i fall a sleep very quickly,but after about 4 hours i wake up to stay awake untill the morning. this really stresses me out! all this is exacerbated afer i was diagnosed with a burn out 4 months ago. my sympyons are: tired red eyes in the evening after watching tv. sore eyes,and eyelidmargins.crusty eyes in the morning.(currently a lot less due to a blepharitis treatment). painfull eyes anywhere near a heater,airconditioner or in windy warm weather and so on. strangely there are also many moments per day that my eyes do not bother me at all.obviously i really enjoy those moments.

patrick...

[Sammy B.]

Patrick,

It is good to hear you say that you have periods of normalcy during the day - I think this should make you feel very hopeful about your condition.

Have you tried anything other than the warm compresses? What kind of drops are you using? Are you taking any omega 3 or 6 supplements?

I am very wary about your high stress level/burnout/lack of sleep. These three things can DEFINITELY exacerbate any type of health problem - especially dry eyes. I can speak to that - earlier in the year I was extremely stressed out and like you, was waking up after about 3-4 hours of sleep (sometimes less than that). My eyes were at their worst, by far.

Please try to look into something that will help you to sleep at night, either via a medication or an elimination of the stresses in your life. Dr. Latkany, a poster on this board and an author of a great book on dry eye syndrome, has said that a good night's sleep is the #1 weapon against dry eye symptoms, and I believe this to be 110% true.

- Rose

[patrick]

hi rose,

thanks for your interest! i indeed am still hopeful that my eyecondition can improve over time.(my schirmers are ok,and the tbut in both eyes is about 6 seconds in the evening). i'm diagnosed with mgd and blepharitis.my optometrist claims that the condition is marginal and not too severe,but still needs treatment. she also says there is still a lot to gain,but she also says that reversing this condition can take a long time. and one must pe patient. we're working on it. what are we doing right now: hot compresses 2x p.day. at least 10 min. expressing the eyelids and eyelidscrubs (very gentle) every other day. taking 2 spoons of flaxeedoil p. day, i had collagenplugs installed just a week ago, a vitamin a oitment before going to bed, i use a preservativefree eyedrop every 2 hours (hylo comod). thats about it for now. my optometrist doesn't want to rush in using any antibiotics and that sort of medicines too early,she is not very fond of using this kind of strong medicines in this early stage. and i think she is right. it is funny you mentioned dr. latkany,cause i just finished reading his great book. it is an enormous source of information for me. have you read it? he claims that regenerating of the severed nerve endings after a lasik/lasek surgery can take up till about 5 years! i find it hard to believe,but i hope he is right. i think that not regenerating to the baselevel of the nerveendings is the main cause of dry eyes. he also speaks very highly about resistas,but we here in europe don't even know it. it is not available and approved here. (only for the use on animals). you're totally right on the stress part. if i could only handle that a bit better that would be wonderful. i'm working on that as well. my sleeping has improved a bit over the past few days,so that is a hopeful sign. ok,thats it for now. by the way i want to appologize for my english. it is a bit rusty i know.

patrick...

[Sammy B.]

Patrick,

If my Dutch was half as good as your English I'd be thrilled!

Sounds like you have a very knowledgeable doctor, which is huge. And I would agree with her that once we have found ourselves here (in a situation with dry eyes), it takes a long time to climb back out of the hole, but it's possible to do so. Especially if your problem is not overly severe, which it sounds like it is not.

Yes, I've read Dr. Latkany's book and would love nothing more than to fly to New York to see him!! But for now I will stick with my great local doctor.

I do think that the severing of the nerve endings it the #1 problem with our eyes. I am also hoping that they grow back to the baseline level. Fingers crossed.....

Reducing or eliminating stress can be nearly impossible. But if you could find a way to either avoid the people who make you stressed out or switch jobs to something less stressful - whatever the situation may be - I think you would be better off. But I would also say that it is important to get your sleeping habits back under control before you do anything irrational. When I was losing great quantities of sleep, I was ready to run screaming out of my office with my arms flailing. Now that I am back to sleeping 8 hours a night, I feel much more sane here....

- Rose