Lasik induced dry eyes

[Cristi]

Thank you Fiddle
The fact is according to the blood results the rheumy doctors say I surely don't have sjogrens. All my tests are ok.
So I am wondering is anybody here on the forum with a case similar to mine and don't have sjogrens? Had lasik 6 months ago, previous I never had any problem with the dry eyes or other type of dryness. I had blefaritis with no symptoms. According to the tests my reflex tears is turning to normal post lasik but my basal tears seems non existing. I do not have corneal and conjunctiva staining anymore although in the first months after lasik I had some staining. My symptoms seems to be getting better (I manage well with my ziena oasis and thera tears 4 times a day and one drop of gel before I go to bed).
I imagine that according to the schirmer result I would have some staining and a lot of pain.
I really don't understand what is going on.
I would appreciate your answers.
Cristina

[Hopeful2]

Hi Cristi,

Your description of what you are experiencing with reflex tears and basal tears is similar to mine. I have never had an anethetized schrimer's test. I do feel like my reflex tears are improving. I did read somewhere, that there is no such thing as basal tears, that all tears are due to blinking and therefore due to reflex. Also, keep in mind that the anesthetic drops are VERY drying. They could potentially dry cause any amount of tears that are formed to dry up.

I too no longer have staining on the conjungtiva, although I did in the early months. I am ten months post lasik now. I think the dryness problem now is due to poor mucin layers. The goblet cells that make the mucin get damaged with dryness (inflammation). The theory is to manage the inflammation and treat the dry eyes with drops (and ointments if necessary). I use gel before bed and wake up at least once to reapply drops.

I think the recovery process can just be really loong. I read on the 'laser my eye' website that someone had dry eye for two years following PRK, and then it went away. So there is lots of hope that things will get better.

Do you notice that you no longer get crust in the inside corners of your eyes in the morning?

[Cristi]

Thank you Hopeful2
I was fitted with 2 permanent plugs in the bottom punctum and it surely feels better. I do not need any artificial tears but I still to wear the moisture chambers when outside or at work. I guess I definitely have aqua deficiency but it is clear that I produce some tears otherwise I would be much worse.
If the theory with no basal tears is true I wonder how come the normal people do obtain scores of 10 mm at the schirmer with anesthetic? Wouldn't their tears dry up as well?
Ever since my lasik nightmare I have salt white deposits at the top of my eyelashes. Do you experience that too? Do you know what these are? Are a result of the dryness resulting for the increased osmolarity or it might be a result of the MGD (I have posterior bleph)?
As for the morning crust I do have a lot but I'm sure it is all due to the gel residuals.
Cristina