Nerve regeneration after lasik

[Hopeful2]

At five months post lasik, my eyes are still dry and I am developing inflammation. I am aqueous defeicint and have mgd (with expressable clear oil). I am trying to understand how nerve regeneration after lasik works. From my understanding dryness after lasik is due to the flap cutting the nerves that control the blinking that results in basal tear formation.

I find that I am blinking a great deal, probably more than people who have not undergone lasik. So . . . I am puzzled as to why my eyes would still be dry.

Can someone explain how the nerve regeneration works to create more tears.

[Hopeful2]

Does anyone have any ideas??

[Lacey1]

From my understanding, the blink reflex helps the MGs secrete oil. The nerves are also needed to send the signals to the lacrimal glands to say "hey I'm dry, send down some more aqueous tears." I kind of think the signal is required for MGs to make oil too, but I really don't know. So blinking is good for oil, but doesn't really help out the watery part. I've read somewhere that it can take up to 5 years for the nerves to regenerate. Again, I may be mistaken so if anyone has better info. please correct me.


As a side note, I know you are suffering Hopeful from reading some of your other posts, but you still are in the window of time that it can improve. Please don't give up hope

[Gabriel]

yea, the way it works is the nerves send signal to brain saying eye is dry so brain sends signal to eye glands to lube up. After severing the eye nerves depending on how many grow back depends on dryness. September 20 was one year for me and I still have painful dry eyes. I do know what your going through. On a positive note there is still a chance for you to improve more. Some people healed closer to eight or so months. I hope you fully heal. Hasn't gone so good for me.

[Rebecca Petris]

Studies have shown it can take as long as 5 years before those nerves are back to baseline after LASIK. I remember back in the early days of LASIK none of the studies ever extended beyond 6 month follow-up, but as the years passed and more, and better, studies were done with more long term follow-up, there's more information.

[Hopeful2]

Thank you everyone for the explanations.
I guess I understand that the nerves can take some time to regenerate and I guess up to five years. What I am wondering about is, exactly how the nerve regeneration can increase tear production. If the nerves control blinking, it would appear that mine have healed, because I blink a lot. Is it rather that the nerves somehow control aqueous and lipid production, and if so, is there a simple way that this can be explained?

[Gabriel]

Its like I said in my first post. It's not as much about the blink rate. When you have healthy nerves they send signal to the brain saying hey I'm dry I need lubrication. At that point the brain sends signal to your gland to produce lubrication for the eyes. So, when you cut these nerves off at the flap there's lack of nerves letting the brain know the eye is dry. Now I feel for the ones with such dry eyes after lasik we where already some what tear quality issues and didn't really know it. What gets me is that I had no tear test before lasik but had one after and then was told here's some drops and restasis. They said other than that there's no cure for dry eye. I hope its true about the 5 year growth. Only time can tell.

[Hopeful2]

Hi Gabriel,

Sorry to hear you are experiencing dry eye pain at one year . . . Looks like there is hope that the nerve regeneration does happen, albeit at a later time for some people. I am still trying to come to terms with it all . . . realizing it may be better to accept that this may be a permanent condition for me : (

[jimi51]

Hi,
I am sorry to hear you are suffering after LASIK as many of us are. I am almost 3 years post and without all the help I don't think I would have made it this far. I have tried just about everything including sclera lenses but the only help for me is plugs and recently I have been on Azasite daily where I think I have had some minor improvement but it is still to early to tell. But, there is still hope that with more time things will improve, I remember some people coming to the board after LASIK and now there gone, I assume for them there was the healing we all want. Don't give up, you are still early as far as this mess goes and this is the best place to come for help!

Brad

[Hopeful2]

Thanks so much Brad!

I find the symptoms change so much that it is so diffiuclt to gauge any kind of progress. My dry eyes started about 1 week after surgery. I remember waking up on the couch after falling asleep for two hours with the sensation of my lids rubbing over my eyeball. I became familiar with a dry, foreign body sensation. Also in the early months I felt 'shard of glass pains' over my corneas. These feelings have passed, gradually. Now, I just notice that my vision is blurry in the middle of the night (halo around led light of clock). For the past month or so my eyes have been tearing in the morning and I have a menthol feeling. I also have dry, salt like deposits in corners and lashes. When my eyes tear, the tears feel 'sticky'. I am trying to sort out what all this means in the light of corneal nerve reguvination. Is it progress, or just a worsening of 'dry eye'? I use drops maybe a little bit less. I don't find they offer the same degree of relief as in the early days.

[jimi51]

Hi,
I could not say what is going on with your eyes other than I think that the LASIK casues a great deal more trauma then they tell you. I have never had any relief in the almost three years since I have had the surgery but I also realize I am of the "smaller" precentile of patients. I just read a nice post from a post LASIK on the triumph page who actually got better after a while, read that and think on the positive, it helps a great deal and stick with or find a Dr. that will listen to you and not ask you not to wear your dark goggles in the waiting room! Stick with a good routine and as I said before, this is thhe only place on the web you want to be. God Bless!

Brad

[Guest]

...stick with or find a Dr. that will listen to you and not ask you not to wear your dark goggles in the waiting room!

OMG! Seriously?!?! They had the NERVE to SAY that? Wow... that's ridiculous...

[jimi51]

It happened on my 6 month follow up, the Dr. said, "you can't be wearing those dark glasses, you are scaring my patients!" You can imagine my rage at the Arcadia, California eye Dr advertising "New Vision with a laser." Very poor excuse for a human let alone a Dr, obvioulsy I have never been back. I am having a bad eye day today so I always remember that moment.

[Guest]

Wow... he sounds like a very self-absorbed individual... all he cared about was the business of selling more LASIK procedures and obviously not one bit about your comfort. It's not like you were walking around his office with a sign saying LASIK sucks for goodness sakes...

[jimi51]

It was a she, and I was very sweet to her as I kept thinking I would get better, when I showed some anxiety, she recoiled and basically told me that she could not help me anymore as my insurance (HMO) would not cover the treatment and to go to my HMO and get help! Now I'm not a violent man but I sure had thoughts, I still feel that if I ever get any better I could forgive her, that's how I am but nothing yet....