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Dry eye from LASIK eye speculum

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  • Dry eye from LASIK eye speculum

    Last week I finally figured out what is different about the left eye that’s draining tears so much faster than the right. Indrep got me thinking about the speculum they use to keep your eyes open during the surgery. I went to the mirror to compare both eyes and noticed a slight difference. When I blink the lower lid of the left eye pulls in to the corner of the eye more than the right eye. On closer inspection I found that when I close my eyes and carefully pull down the lower lid, the left lower punctum pulls right in to the corner of my eye where all the tears pool but the right punctum stays 6-7mm further away from the little pink thing. (lacrimal caruncle)

    So when I blink the lower lid of my left eye moves in, bends the lower canaliculus and causes the punctum to move right up to the lacrimal caruncle draining the tears pooled there. When the right eye blinks both canaliculi stay straight moving in a scissor motion pushing the tears towards the punctum, then the punctum seem to scrape the tears off the surface of the eye. I made a little picture at the end of this post since this is extremely hard to explain.

    I’ve been experiencing this extreme drainage ever since the night after surgery. I discovered the steroid drops would drain immediately out of the left eye and into the back of my throat tasting horrible, but when I put them in my right eye I couldn’t taste anything. I also experienced some minor twitching in the lower left lid a few weeks after surgery.

    I’m fairly certain the eye speculum used during the surgery disrupted the structure of the lower left canaliculus or slightly pulled a muscle in the lower lid causing it to close differently. I believe the extreme drainage is cause by the extra motion of the canaliculus in combination with the new location of the punctum when my left eye is closed.

    Reasons I’m certain it was the eye speculum

    1. I currently use 8-16 vials of Theratears per day depending on how much I use my eyes. Each pouch contains 4 vials .02 FL OZ each or 2.4ml per pouch. I use 2-4 pouches or 4.8ml to 9.6ml per day and this is almost entirely for the left eye only. I’m not exaggerating here, every drop in those vials goes through my tear duct. I carry a little pocket mirror around with me since I put in drops so much. Now from what I can find the average person makes about 1ml of tears per day and my left eye is drinking almost 5-10 times that much. It’s physically impossible for me to put that much fluid through the right tear duct without the drops spilling out of the eye. There is no way my left eye was making 4.8-9.6ml of tears prior to the surgery.

    2. The way the left canaliculus bends suggests that it may have acquired a small tear during the surgery and no longer has the structure to stay straight when I blink.

    3. You honestly think stretching the eye like this doesn’t pose any possible risk? Keep in mind I had PRK though not LASIK, the following link is a picture of an eye during LASIK surgery if you’re squeamish don’t look. LASIK eye

    Last edited by PRK; 21-Apr-2011, 18:19.

  • #2
    Thank you...

    for taking the time to write and post such great information on this forum. We all learn when people share.

    Your theory makes sense. When I had my lasik done three months ago, the sculptom or whaterver that thing is called, slipped from my left I and the surgeon had to do it again. For one week, that eye was very, very blood shot. I wonder sometimes if that contributed to the issues I am having now. I don't know.

    There is so much none of us know and can only speculate on.



    • #3
      Youíre welcome, I know how hopeless things can feel when you have no idea whatís happening to your eyes. To be honest this forum has been ten times more helpful than any of the doctors Iíve had so far. One other thing I just thought of was that my eyes are somewhat more squinty than usual and the doctor always has to hold my eye open to see the entire cornea so that probably put me at a higher risk for something like this happening as well.