Lasik in 2 weeks

[erinlins]

Hey guys,

I'm new to dry eye talk. I found this site when I was debating on whether or not to get lasik. I first began to think about lasik when I had difficulty wearing contact lenses. (I wore them w/o any problem for 10 years) Now however, I have a schirmer of 2-3 and puffy lids. I was told though by three cornea specialists that my eyes do not appear that dry and that I would be a good canidate for lasik. I scheduled an appointment for two weeks. I am starting to have second thoughts. Any opinions? Thank you.

[sazy123]

do a search on dry eye and lasik and make your own decision. You will be shocked at how many people on here have severe dry eye after lasik.

I was told though by three cornea specialists that my eyes do not appear that dry and that I would be a good canidate for lasik.

That doesnt mean anything, apparently my corneas do not look that dry and my eyes look 'normal'. yet i have severe dry eye symptoms. Docs dont no enough about dry eye to tell you it looks 'fine'. lasik is not a good idea if you have dry eye so I would advise seeing a eye doctor to get dry eye under control then reconsider it.

[Rebecca Petris]

On a bulletin board for people with dry eye (a large percentage of whom can thank LASIK for causing it) you are not going to get any encouragement from anyone here to proceed with it.

Now however, I have a schirmer of 2-3 and puffy lids.

With all due respect to the corneal specialists, I flatly disagree. I do not understand how anyone can reconcile a 2-3 Schirmer with "not very dry" (what's dry then? 0 Schirmer and Sjogrens syndrome?). I don't know about your eyelid condition unless you give us more detail, like a tear break-up time.

Has anyone assessed your meibomian glands thoroughly by squeezing them to see what comes out. Has anyone told you why you have a Schirmer of 2-3?

[erinlins]

I have no real reason for such a low schirmer except long term contacts. My glands otherwise have been pressed and seemed to be working fine.

[Eli]

I completely agree with Rebecca. Also, don't forget that your sudden inability to tolerate contacts is why you started down the LASIK path. Dryness is a major cause for people to relinquish their contacts due to the discomfort it causes. It's ironic because intolerance of contacts is also a very popular reason to seek LASIK-but also a possible warning sign of a condition that would contraindict it! So that should definately be a red flag for you.

Also, although many opthalmologists don't think the schirmer tests have much value, a score of 2-3 is quite low. As far as I'm aware, it should be >10mm. Of course, whether your eye was numbed or not before the test was performed can significantly alter the results. The numbing drops will obviously make the eyes less sensitive-and they will tear less. Still, 2 or 3 is not so good.

Perhaps a number more important to know is what's called tear film break-up time, usually abbreviated as TFBUT or just TBUT. Basically, the surface of the eye needs to remain coated with an even, stable tear film between blinks in order to protect it. Eventually, without the blinking that serves to refresh it, the film will thin and eventually "break-up" leaving exposed areas. This can be observed under the slit lamp with flourescein dye. In a healthy adult eye, the time required for this to happen should be around 10 seconds or greater. A low time would indicate something amiss with the tear film, be it a lipid deficiency from meibomitis (ask about your meibomian glands/eyelids), an aqueous deficiency from auto-immune disease, or a mucin abnormality from a chemical burn or other cause. (Not an exhaustive list in any way, shape or form ) This can cause the film to break up between blinks, which can become very uncomfortable. And the more frequent compensatory blinking can sometimes serve to irritate the eye even further. So, a very good thing to know. If your doc feels it is below average, I would consider that another red flag.

Of course, even if all of these tests pointed towards dryness, you may say "My eyes feel fine!" And they might. Opthalmologists frequently see patients who complain (like me!) of tremendous discomfort, while their clinical exam reveals minimal findings. On the other hand, they also see patients who present with significant signs of ocular surface disease and yet the patient is quite comfortable. The point is this: it is very possible to have mild to moderate dry eye disease and not be in any significant discomfort...yet. Like contacts, but much worse, LASIK could be that aggravating factor that tips the scales, causing the disorder to now be constantly symptomatic. Trust me, you will not like it. The pain of severe dry eye can be crippling and life altering. The bottom line is this-signs of dryness, whether felt or not, make you much more succeptible to severe dryness following LASIK. No guarantees or course, but there you go. I would at least wait until you have a better understanding of the health of your eyes before proceeding, if at all. Lastly, dont forget...you probably look much better in glasses than you think you do!
Good luck,
Eli

[Hangus]

Don't do it! I wish I had my glasses back! Remember lasik in haste and repent in leisure!
Seriously it is really not worth the risk of suffering dry eye believe me.

[Natalie06]

erinlins

Please hold off on Lasik until you have seen a corneal specialist who does NOT perform Lasik. You are raising every red flag in this post and in your post under newbie for potentially permanent or severe dry eye.

Contact lens intolerance
Meibomaion Gland Disfunction
Veiny eyes/Swollen eyelids (that could be ocular rosacea or another form of blepharitis)
Eyelashes that fall out

You have tried restasis and not seen relief? Imagine then what could/will happen when your corneal nerves that stimulate tear production are severed during Lasik. What will you do then?

Please get a diagnosis and treatment before you even consider Lasik. You are describing many of the symptoms I told my Lasik surgeon about and who also assuremed me I was an "excellent" candidate. And today I am spending over $100.00 a month on eye care PLUS frequent visits to the eye md. Never mind that I am constantly miserable.

Lasik will be there 6 months from now. Treat your eyes first.

By the way, are you taking any type of hormones? Birth Control Pills? They can be an underlying cause of DES and can affect your glands.

Natalie

[dianat]

You've gotten great advice here, erinilns.

Please consider their advice. You do have dry eye and it was caused by extended contact lens wear. It was great advice to find a corneal specialist that does not perform LASIK. His/her opinion may be very different from what you are hearing.

For the record, my eyes have been a painful struggle every single day since LASIK. I did not, nor had I ever been diagnosed with dry eye. I certainly did not have a low schirmers score like yours. You really could be in trouble with LASIK. Even if you get your current eye situation under control, you will likely always be predisposed to dry eye. LASIK is a horrible idea for you.

Here's my story below. It's really the best way for me to communicate my feelings about this surgery.

http://www.dryeyezone.com/talk/showthread.php?t=53

[erinlins]

Thank you

thank you for all your advice! I think im going to post pone my lasik.

[Guest]

Great News

Postpone, good start, if I were you I would forget about it all together.

Stick with glasses, I wish I had.

Warm regards

Ian

[Kate29]

There are no things in my life that I regret, but there are two things I wouldn't do again if I had the choice, and Epi-Lasek is one. And that's even the "gentler" version, meaning less risky as far as dry eyes are concerned (or so they say).

I'm happy with the result as far as my vision is concerned, very happy actually, but that's NOTHING compared to dry eyes. I had the treatment about five months ago and - although people assured me that I'm still early in the healing process - it's a very disturbing thought. I only want to get out of that without any damage and I certainly wouldn't want anyone to go through this roller coaster, so please re-consider.

Here's just a short list of what you MIGHT face:

- corneal abrasions (it's as painful as it sounds)
- eyelids sticking to the eyeball at night, either resulting in the above or in red, tearing eyes
- pain when you rub your eyes
- burning
- itchy feeling as if you are wearing dirty contact lenses (you can't take them out!)
- pretty high costs for tear drops, gels

At the end, it's your decision, as it was mine, and I don't blame anyone but myself, but if I were you, I wouldn't do it. Glasses aren't all that bad when you read what people here are suffering from!

Kate.