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Hi guys,
I'm trying to understand my dry eye condition - I had lasik in 2005 or sth, and was fine for a few years - just some minor dry eye in the mornings. Then, two years ago I started to become photophobic, and this summer everything went completely downhill. I thought I had some kind of corneal neuralgia (I didn't get any examination done by anyone knowledgeable in that field though, so it's just my theory). I do have a pain in my left eye that is more of a "pain pain", apart from the dry eye pain. It has become much better with treatment though (serum tears and antiinflammatory drops) and now the dryness is a much bigger problem. For a while it has been more or less managable, but now it has gone downhill again.
Anyway, I'm trying to understand this thing and I find it hard to, so I wanted to ask you: If nerves are severed during the Lasik surgery - howcome severe symptoms show up only after several years? I'm only 31 so I haven't hit menopause or anything. I had a confocal done after using serum tears for two months and the doctor said I have "normal looking nerves". Using serum for almost two additional months hasn't done anything for my dry eye condition as far as I can see though, and this has been a huge disappointment for me.
So what's happening? I guess it can be many things, like an underlying condition such as autoimmune disease, but I don't really have any other signs as far as I can see. Or is it vulnerable nerves growing out after Lasik shutting down/changing receptor expression etc as the years go by? Or the corneal environment is compromised and you get an inflammation which never resolves, which produces pain-producing cytokines etc and compromises nerve function and creates a vicious circle? Or - is there something strange happening in the areas of the brain involved in the tear reflex arc, which makes it shut down tear function?
I'm grateful for thoughts. I studied a few years at medical school, and when I was hit with this I got very motivated to go into research concerning this topic. Unfortunately, I don't have the strength right now. But it would be nice to have some ideas on plausible mechanisms. I mean - it's not hard to understand why you would get dry eye immediately after Lasik, when the nerves are severed, but... I started thinking about whether I had quite dry eyes all these years but only recently got symptomatic because inflammation reached a treshold.
Recently, my main interest has been in reading about small antiinflammatory lipid mediators, like neuroprotectins and resolvins, which are synthesized from omega 3 fatty acids like EPA and DHA. There are some animal studies on dry eye models which sound promising, and I'm thinking about ordering this compounds myself to create my own eye drops, since they don't seem to hit the market anytime soon.
http://www.ncbi.nlm.nih.gov/pubmed/19797230
http://www.ncbi.nlm.nih.gov/pubmed/22257864
And for you Sjögren's sufferers out there - if you have Sjögrens, can you still cry normally, or is that function compromised as well? I have no trouble crying.
I'm trying to understand my dry eye condition - I had lasik in 2005 or sth, and was fine for a few years - just some minor dry eye in the mornings. Then, two years ago I started to become photophobic, and this summer everything went completely downhill. I thought I had some kind of corneal neuralgia (I didn't get any examination done by anyone knowledgeable in that field though, so it's just my theory). I do have a pain in my left eye that is more of a "pain pain", apart from the dry eye pain. It has become much better with treatment though (serum tears and antiinflammatory drops) and now the dryness is a much bigger problem. For a while it has been more or less managable, but now it has gone downhill again.
Anyway, I'm trying to understand this thing and I find it hard to, so I wanted to ask you: If nerves are severed during the Lasik surgery - howcome severe symptoms show up only after several years? I'm only 31 so I haven't hit menopause or anything. I had a confocal done after using serum tears for two months and the doctor said I have "normal looking nerves". Using serum for almost two additional months hasn't done anything for my dry eye condition as far as I can see though, and this has been a huge disappointment for me.
So what's happening? I guess it can be many things, like an underlying condition such as autoimmune disease, but I don't really have any other signs as far as I can see. Or is it vulnerable nerves growing out after Lasik shutting down/changing receptor expression etc as the years go by? Or the corneal environment is compromised and you get an inflammation which never resolves, which produces pain-producing cytokines etc and compromises nerve function and creates a vicious circle? Or - is there something strange happening in the areas of the brain involved in the tear reflex arc, which makes it shut down tear function?
I'm grateful for thoughts. I studied a few years at medical school, and when I was hit with this I got very motivated to go into research concerning this topic. Unfortunately, I don't have the strength right now. But it would be nice to have some ideas on plausible mechanisms. I mean - it's not hard to understand why you would get dry eye immediately after Lasik, when the nerves are severed, but... I started thinking about whether I had quite dry eyes all these years but only recently got symptomatic because inflammation reached a treshold.
Recently, my main interest has been in reading about small antiinflammatory lipid mediators, like neuroprotectins and resolvins, which are synthesized from omega 3 fatty acids like EPA and DHA. There are some animal studies on dry eye models which sound promising, and I'm thinking about ordering this compounds myself to create my own eye drops, since they don't seem to hit the market anytime soon.
http://www.ncbi.nlm.nih.gov/pubmed/19797230
http://www.ncbi.nlm.nih.gov/pubmed/22257864
And for you Sjögren's sufferers out there - if you have Sjögrens, can you still cry normally, or is that function compromised as well? I have no trouble crying.
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