What have I done to myself?

[jax8it]

4 months post LASIK.....

Upper and lower plugs, fish oil capsules, restasis, humidifier, onion goggles, artificial tears, pain, guilt, sadness and anger. This is what I bought on Jan 21 for 3,000 dollars. Oh, but I have 20/15 now. Who cares when you can't keep your eyes open long enough to enjoy it. The upper plugs make my eyes water, but my tears aren't normal so my eyes are always irritated. I have been on restasis for a week now with no adverse side effect. Maybe it will help. Just needed to vent.

[sabine]

Same story as mine!

I also did lasik 10 years ago and not able to work since...
So your not alone.

BUT there is hope :

First you tear because you do have evaporative dry eye which is typical for lasik induced dry eyes, so that's why your tears sting with 4 plugs, but there is not an another option because two don't help because all the tears flow away throught the upper ducts.

Your eyes will adapt to the 4 plugs but it takes time. I recently discovered reservatrol which helps me alot and don't stop taking the fish oil.

Please try to get rid of the guilt feeling, that is a very strong advise I can give you because this will take you down and we don't deserve that! There is no possible way we could forsee (i don't know the word) this hell. Only few people can image the pain this brings alone. So it is important to talk about it on the forum because it is very difficult for somebody else to understand that eyes can hurt.

For the moment my rigth eye is almost pain free. My left eye is on the good way.
I still sleep with vit a pos salb but this will be for the rest of my life i think.

During this 10 years i have never give up hope and never stopped trying things and buying things.

The thing i noticed that omega 3 must be combined with anti-oxidants to be able to help me.


Sabine

[sabine]

grape juice

Hi,

I do understand you don't want to spend money again so you can try to drink grape juice for a week or so, if it doesn't improve things for you then you shouldn't buy resveratrol.

Do the warm compresses help? So they do with me, I still do this once a day.

Grt
Sabine

[SunshineinCalgary]

Trust me, Restasis should help. Give it 3-4 months. You WILL feel the effects. The effects come very slowly. I have upper and lower plugs too. And again this takes time because you have inflammation in the eyes.

[jax8it]

Thank you sunshine and Sabine for responding.

Sunshine are your eyes feeling better? How long did it take for you to notice the effects? My eyes became super moist when the upper plugs were inserted. That has tapered off, but my eyes are still very sensitive and irritated. I think my problem is tear quality rather than quantity. Will restasis help with this. All the doctors tell me I do not have mgd.
Thanks again for responding.

[SunshineinCalgary]

if my guess is correct, after three months you will post some good news here... But of course everyone is different. I got very frustrated with Restasis the first few months because my condition changed from day to day. I thought it was not working. My eyes were still very irritable. But came the beginning of the 4th month, I could watch a movie, I could look at computer for a few hours.......then I got too carried away and I removed the upper plugs. SO I'm back on the roller coaster again. But I'm patiently waiting. A lot of people on this forum are very helpful, and that means a lot when you are struggling everyday. Have hope

[DCRdryeye]

jax8it, apparently Restasis does improve tear quality. I'm on my third month with it, using it twice a day. I was recommended to use it 4 times a day but my eyes can't handle that. You're only four months post lasik, emotions are still raw, they eyes are still painful, we know how you feel, we've been there. Things will definitely improve, and like SunshineinCalgary says, "Have hope".

[Hopeful2]

I would have to agree with all the posts here. You are still very early in the healing process. I am now 11 months post lasik and no longer have a vivid memory of the pain that I went through in the first five months. I remember posting here that my eyes felt like I had shards of glass in them. At four months my eyes were still incredibly dry. I was emotionally devastated as well. The support and encouragement of people here on dry eye zone really got me through some very difficult moments.

I just started Restasis several days ago. I feel that my meibomian glands are somewhat less inflamed already, even though everything I have read has said it takes up to three months to have an effect. So. . . I am cautiously optimistic that restasis will make an impact on the quality of my tears.

My surgeon said he didn't have much success with restasis and didn't think it would be of help for me, however, that was in the early months. I think that over the course of 11 months the nerves have had some time to heal. Unfortunately, inflammation has set in as well. My new eye doc says that the restasis should be able diminish some of the swelling around the nerves so that the nerves can do what they are supposed to do, make good quality tears!

Take it one day at a time . . . definitely do not blame yourself, and if you are, then you need to move past the blame by acknowledging that you made the best decision you could have with the information that you had, at that point in time. . . forgive yourself. . . pamper yourself. You might want to consider going to see a therapist. I saw one that specializes in post traumatic stress. She did a great job of helping me come to a livable understanding of this trauma.

There is hope for both the emotions and the eyes. . . take one day at at time. . . moment by moment.

[jax8it]

Thank you all so much for your words of encouragement. A group of strangers have shown me more compassion and understanding than most of my friends and family members. Thank you again for all the responses I get kn this forum.

[robster]

Try not to not go down the self-blame route as it will only make you feel worse(I know I've been down there myself). I now realise I did nothing wrong and have nothing to feel guilty about. My left eye has improved to the point where I hardly ever use eye drops in it(though the dryness was never that bad in that eye) but my right eye is still giving me a lot of dryness issues.

As for buying things like humidifiers yourself I made my clinic pay for it along with my onion goggles. It did take a lot of e-mails, phone calls and arguments but they did eventually agree to pay for these items I think primarily just to shut me up. Could be worth a try.

[dijon84]

Hi
A book I'd recommend to anyone (but it might particularly help you) is The Power of Now by Eckhart Tolle. This book has helped me so much in my life - I read it before my eye problems started and it is even more helpful now in dealing with the mental side of these problems. Sounds like you are thinking about the past a lot (especially your decisions) and blaming yourself - so I think this book will help.
All the best
Dave

[Rebecca Petris]

Try not to not go down the self-blame route as it will only make you feel worse.... I now realise I did nothing wrong and have nothing to feel guilty about.

I want to echo this. Every time I see this thread pop up with the title "What have I done to myself?" I want to shout, "NOTHING!" You didn't screen yourself for surgery, give yourself informed consent, prep yourself, wield the scalpel (so to speak) or provide your aftercare. These things were provided to you. If one of the medical or other professionals in the process did an inadequate job (not uncommon in refractive surgery, especially at the informed consent part, and not infrequently the screening part) that is not your fault. If something completely unforeseen went wrong that no one could predict or prevent that is not your fault either. A bad outcome does not mean you made a bad choice. Of course these are things that are easier to hear and 'get' in a college logic class than they are to absorb emotionally when you're going through a hard time... which makes it that much more important to remind yourself. So add "IT'S NOT MY FAULT" to the daily or hourly mantra of "IT GETS BETTER... IT REALLY DOES".

[Rebecca Petris]

A group of strangers have shown me more compassion and understanding than most of my friends and family members.

We may be strangers to you as a person but we are intimately acquainted with your experience and that's what makes the difference. Anyway I'm happy you're finding support here...

I know it's hard not to receive the support we'd like from the people we'd like it from... For some people it's family or friends that don't seem to show compassion, for others it's eye doctors (or even mental health professionals!) who seem indifferent to the pain & suffering you try to describe.

I think it can be helpful to 'compartmentalize' your needs (medical, practical, and emotional) when you're experiencing this kind of eye crisis and just be really practical about seeking out the ones that can help meet each need the most effectively. Also helps to bear in mind that when someone can't meet one of your needs they might just be as aware of their failure and as frustrated as you are.

[peter56]

Hi jax8it,
since it is only 4 months after your LASIK, you should have a fair chance treating your ocular problems successfully!

What damage LASIK and mechanical refractive surgeries do cause:

The surgeons do cut corneal flap and then removing marginal small parts of the corneal stroma to get a better refraction - vision.
In the corneal stroma there are a few hundred extremly small nerves.
These nerves are controlling the watery tears production.
The nerves are the most important part of the neuronal tears reflex arc.

The refractive surgery does damage and destroy many of these nerves in the stroma.
In the majority of patients, the nerves do regenerate within the first 3 months.
If the tears reflex arc does not work after six months, it is very unlikely to restore the tears supply system without applying the necessary topical medications.

Two-three days after LASIK, there is frequently intensive reflex tearing.
In this phase the lipid layer can`t stabilize those many watery tears.
The lipid layer in healthy eyes is about 90-100 nm = 1/10000mm!
The the watery - aqueous - mucin layer is about 3-5 micrometers.
The nomal lipid layer can only stabilize the normal watery tears-mucin layer.

After the reflex tearing, the tear production goes down substanially.
In healthy eyes of younger people the tears are eq. 10-15mm Schirmer test.

If the Schirmer - watery tears layer goes down under 5mm, even the best meibum can`t spead over the unsufficient aqueous layer, to build-up a uniform lipid layer to stabilize the tear film.
Without such a stabilization, the small amount of watery tears will run down to the lower lid - sac and it is impossible to get a stable protective tear film on the cornea.

The upper eye lid will no more smoothly sliding over the cornea, but do rub over the cornea with every blink causing a microtrauma - irritation.

If the lid margins do rub on the ocular surface, they do cause many microtraumata - micro stretches at the orofices of the meibomian glands. Such mechanical irritations are then leading to inflammation and MGD.
That is the reason, why LASIK also does cause MGD as a consequence of the aqueous tears deficiency.

The only way to treat the LASIK induced dry eye, is to restore the neuronal tears reflex arc - system.
Steroids do have a very short residence time in the corneal stroma.
Therefore it is necessary to apply the new CyA-TAC formulations or steroid ointment.

It is essential to get the inflammation out of the corneal nerves and then treating the MGD.
Here I do know people, that successfully treated post LASIK dry eye 18 months after the surgery took place.
But here they do have the new CyA drops!

The LASIK surgeons will always tell their patients to wait one month more for an improvement. But in your case, it seems that you have sufferd more damage to your corneas than other patients did.

More than 70% of all LASIK patients did wear contact lenses before LASIK.
More than 35% of the CL wearers do develope MGD-dry eye.
So the LASIK surgeon will argue, that CL wear induced the dryness and not LASIK.

Unfortunately we cannot force the LASIK surgeons to prescribe CyA-Naltrexone on the first day of LASIK, so that there will be almost no inflammatory responce.

[Hopeful2]

Hi Peter,

I did ask my surgeon about restasis in the first two months post lasik. He didn't want to prescribe it because in his experience it did not work. Most lasik patients go to trust their surgeon with dry eye problems in the first three or four months. If they are still having issues, I think they lose faith in their surgeon and go see another ophthalmologist. This is certainly the route that I followed.

It appears that some lasik clinics in the US are advertising that they will treat preoperative dry eye with Restasis, prior to conducting lasik surgery. This seems to me to be a more humane treatment of patients . . . let them know they have a dry eye problem, treat the problem, and then offer them lasik . . . if they still want to take the risk of developing serious post lasik dry eye.

I appreciate your description of what happens to the corneal nerve during lasik suregery. I am at ll months post lasik and have developed MGD along with dry eyes. I was contact lens intolerant, although I did not realize that it was due to dry eyes. I developed some stromal opacities, which my ophthalmologist says is due to dry eyes.

I started Restasis about one week ago (after a course of dexamthosone drops) and notice that my meibum is expressed easily with very little pressure. I also notice more wetness when I blink. Do you think that treatment with a cyclosporine drug would diminish the corneal scarring? Is Modusik-A a type of steroid? Is CyA-TAC a steroid cyclosporine combination? How is this different from a steroid? Could a Canadian doctor order it?

Thank you for sharing the information.

Hopeful2