10 weeks post-op and want you guys opinion..

[bostonlover]

I had Intralase done 10 weeks ago yesterday and have dealt with dry eyes since. Sometimes worse than others. I generally get no relief from any drops except Dakrina/Dwelle until recently, my eyes seem to be irritated/burning almost all the time. So I stopped using it and went back to trying to use something like Systane again, I get no relief from Systane though. I feel like I have enough tears, but my TBUT seems really fast. This is just based on the fact that I can barely keep my eyes open long enough to put on some mascara without them really burning. I have tried warm compresses and they do feel better for a little bit. The first few times I tried it I got alot of oil secretions, but they don't seem to do that anymore. They just feel like they are benefitting from the warm moisture. Anyway, after a little explanation on my symptoms, my question is this: Do you think that givin the time frame since my surgery it is too soon to go back to my Doc and see if there is anything else they can do besides tell me to use Systane? I know they can try punctal plugs, Restasis, etc. at some point. Is it too soon to start asking for these more drastic measures? I am just so sick of being constantly in discomfort. It is very disrupting to my life. Especially in the evenings. I feel I can hardly keep my eyes open by that time of day!

Let me know what you think.

Thanks
Tera

[Flick]

Hey Tera,

I personally think it's better to treat earlier rather than later, because the longer your ocular surface is irritated and inflamed the more difficult it will be to return it to a normal happy state. The two treatments you mentioned, Restasis and plugs, have a pretty big potential upside and not much downside (ie they're pretty safe).

Did you have any symptoms of dry eye before you had LASIK? Contact lens intolerance?

Good luck!

[bostonlover]

Flick, Thanks for the reply. Yes, I did have contact lens intolerance. I informed them of this and they did a corneal stain test before and said the ocular surface looked healthy. This was my main concern going into the surgery. I was told that yes, I could have dry eye discomfort for a few months after and that they could manage it if needed. Well, the last time I went in and complained was about 5-6 weeks after surgery. They said that I just needed to keep on doing Systane every 2-3 hours and gave me a bottle of Vigamox (? I think thta is the name of it, it is a steroid drop) to use as I needed for times when they were really bothering me. Well, I have been scared to use them much because I haven't had my intraocular pressure checked since before the surgery. I have been using them on average 1-2 times per day for a day or two every week or two. I think it does help when I do. I am going to call today and make an appointment. I am a little apprehensive about telling them about using Dakrina as I was told no preservatives and I don't want them to think that is why I am still having problems. Do you think I should mention using them?

[shells]

Hi Tera,

Sorry to hear you are having problems. I agree with Flick though. I think you should go back to your doctor and see if there is anything else they can do for you. I certainly understand how frustrating it is to be told to just hang in there and wait it out. That is hard to do when it it disrupting your life! They waited till I was about 4 months post-op to suggest Restasis and plugs, but I know plenty of others who started it much sooner. If you have enough tears, and your problem is just tear quality, I'm not sure how much these things will help though. However, there maybe other things to help you. Have you been diagnosed with blepharitis or MGD? That might be the reason that your TBUT is not so great. Maybe they would suggest Doxycycline to get your oil glands flowing better?

Also, in regard to the steriods you are using. I think it is always safe to be under supervision from your doctor when you are on them, so if anything I would get an appt. just to make sure everything is OK there. I'm surprised that they just told you to use them "whenever" you felt you needed them. If they don't check your pressure, ask them too. Atleast it will give you peace of mind. I would tell them about the Dakrina as well. Just take the box in and show it to them as your doctor may not have heard of them. I have gotten mixed comments about them from the doctors I've seen....about the preservative that is. None of them had actually heard of the drops.

Also, it sounds like you are still seeing your lasik surgeon? In my experience I was pretty much brushed off and told that I would get better eventually and just to hang in there. It wasn't until I got a second opinion (and a third...and a fourth) that I finally found a doctor who understood that I just wanted to be comfortable!!! So, if the surgeon who did your lasik isn't keen on giving you any other advice, you might want to seek out another doctor who will be more willing to help. Good luck and keep us posted!

-Shells