has BAK ruined my eyes for life?

[Ciaran]

i have had problems with my eyes for the last few years and now can no longer use ANY eyedrops, even preservative free. i've tried every eye drop including homeopathic and they all make my eyes much worse.

i recently went to a new eye doctor to get my eyes looked at, as they're having a huge impact on my life and i didnt like my old eye doctor. basically he didnt know what was wrong with my eyes because i'm producing a normal amount of tears and my oil glands are healthy and secreting nice clear oil and overall have healthy eyes and perfect vision.

the only thing i can put it down to is my use of things like Visine and Clear Eyes that i was using quite a lot for years without realizing how bad they are.

now my eyes are both red and painful 24/7

is this something i may be able to reverse over time, or are my eyes likely damaged for life?

[Rojzen]

dig deeper, and never assume anything is permanent

For someone who has been through loads of diagnostics, I'm still quite stupid about all the tests that can be done to pin down ocular surface problems, but I can say with certainty that despite your tear production being normal, and the lipid secretion looking clear and adequate, there may nonetheless be irregularities in your corneal tissue, and/or in your tear film, that account for your pain and redness. . .

For example, regardless of how the lipid looks when secreted, what is your tear break-up time? If the lipid is in any way imperfect/off-balance, this can cause your tears to evaporate so rapidly that your eyes burn most of the time. . .Rapid tear evaporation and burning sensation have been linked. . .

On the other hand, any blips in your corneal topography, or in the thickness, or ability of the corneal tissue to adhere to basement membrane, could account for eye surface pain. . .

All that said, whether BAK contributed to any problem you may have now may ultimately be difficult to pin down, but there's no reason to assume that the harm BAK may have done is permanent or un-treatable. . .

The way you phrased your question is incredibly helpful, Ciaran. . .It prompted me, for one, to realize that at some point, if a really specific and accurate diagnosis is not available, many of us simply proceed to test remedies on ourselves, within understood safety margins. . .

You say that all eye drops make you feel worse. . .but have you tried the Dwelle/Dakrina product line, and stuck with it for a while?

Alternatively, have you tried the regimens described here at the Zone for stimulation and cleansing of your meibomians?

Can you, moreover, go to an even more specialized/motivated eye care provider, to press for more testing?

[Ciaran]

thanks for the quick reply

I dont believe i was tested for the tear break up time, i think i had a 'shumer' test where they put strips of something in my eye lids and measured how much they absorbed in 5 minutes. i am a little suspect of this, because although it came back normal wouldnt the irritation of having them in your closed eyes cause watery reflect tears which dont provide much/any lubrication?

the new eye doctor supposedly specializes in dry eye... i think there is only one other specialist i can see in my city.

I cannot source any Dwelle/Dakrina drops in my country unfortunately and i am skeptical that any eye drop could help.

i most recently tried (again) Theratears and Bion Tears and both made my eyes feel like i had something in my eye, or like a small dry patch of eye that was catching on my lid. Occasionally drops will be OK for 2 days, but the 3rd day is very painful and i have to stop.

i think my reaction to normal drops is caused by the BAK products i was using, anything containing BAK now brings INCREDIBLE eye pain, to the point of nausea and feeling like i am going to vomit from the pain. now normal drops that were fine a year or so ago bring this same sensation but to a lesser extent.

one thing that has improved, i remember several years ago my eyes were visibly dull with no shine. they are now shiny and glossy, so some things have improved just unfortunately not enough

i've tried warm compresses, cold compresses, lid scrubs (which i now cant use because they cause eye irritation...), steroids in pill form, doxycillan, allergy pills, padding my eyes in cotton wool and covering my eyes in bandages like a mummy in case i was sleeping with my eyes open... tried a naturopath for a natural solution... i think i've pretty much done everything i can do

[Lucy]

Theratears in the single application vial contains no preservatives. It's as pure as you can get. There are others, but TT is perhaps the best known.

Are you saying after using TheraTears for 3 days makes your eyes worse?

Lucy

[Eli]

Ciaran,
Unfortunately, many people aren't aware of the dangers of using vasoconstrictors, i.e. "get the red out drops." Also, you are correct. When the paper strips are placed in your eyes druing the schirmer test, it does casue irritation, which in turn causes tearing. This is called reflex tearing, it's purpose being to try and rid the eye of whatever is irritating it. Oddly, reflex tearing is not what the schirmer test is supposed to be measuring, so sometimes it's done after numbing drops are instilled in the eye. Still, many doctors, including Dr. Latkany who posts on this site feel it is a waste of time.
What I am wondering is this. Why were you using Visine so much in the first place? In other words why were your eyes always red? Did you have allergies? Do you have rosacea, bad acne, psoriasis or another skin disorder?
As Rojzen pointed out, a tear break up time would be nice to know. It should (ideally) be 10+ seconds. Also, ask you doctor if you have a sufficient tear meniscus, and whether or not you have any corneal/conjunctival staining that would indicate a problem. I have had moments where even TheraTears would hurt on instillation, usually when I had been lax about using them, or very first thing in the morning when my eyes are very dry. Perhaps you don't even have dry eye, just an allergy or something. Let me know what you find out.

[Ciaran]

Lucy, I have no problems with Theratears or any other eyedrop when first putting them in, but after several applications they make my eyes very sore and redder.

Eli, I started using Visine type products because i was getting sore, red eyes at work. went to the chemist and looked at eye drops and Clear Eyes, Visine etc say "for relief of sore, red eyes". I put the drops in, redness goes, soreness goes - i had no idea these drops were bad and what they were really doing and continued to use them for years until the start of this year when the pain i started getting from their use was so intense it felt like my eyeballs were going to implode.

I do not have any allergies, also my eyes are never itchy. i am going to get allergy tested anyway, but i do not believe this is a likely cause due to my eyes being sore and red 24 hours, 7 days a week.

i guess i will try and find another eye specialist, otherwise i may poke my eyes out and get a guide dog

[Guest]

i guess i will try and find another eye specialist, otherwise i may poke my eyes out and get a guide dog

Just be careful that the dog breed you chose is not susceptible to dry eyes.

At least if you were living in the UK you could take the dog to the vet and get cyclosporine (Restasis) for it. Unfortunately, as the owner of the same dog, you can't access cyclosporine for yourself - the world has gone mad!!!

Ian

[Rojzen]

fluourescein clearance test

So true about the illogic of those Schirmer tests done without anesthetic. . .And yet I'm told that using anesthetic also confounds results (why, I'm not sure, if the objective of the testing is itself poorly understood). . .

I'm reminded of a test that used to be standard at Bascom Palmer, designed to be a truer test of actual tear production. . .It was the flourescein clearance test. . .It takes a half hour, and no anesthesia is used. . .It is the rate at which tears drain down the nasolacrimal duct that is used to determine production. . .and there is an aspect of the test, involving nostril stimulation, that helps distinguish reflex tears from passive tear production. . .

That said, I'm FOREVER being told that one's tear production volume is rarely the measure of the severity of one's problem. . .We have people on this site with scores of 0 on some version of the Schirmer who actually cloud up their moisture chamber glasses. . .and then there's me and others like me, who produce some tears, but who have TBUTs at or near 0, and whose eyes are drippy and painful all the time, without mechanical protection. . .

Anyway. . .More testing could be in order. . .but a more empirical, symptom-based approach might be great, too, after any surface abnormalities that require treatment are either treated or ruled out. . .

I have also been amazed at how long cyclosporine was available for dogs before Restasis came on the market. . .but at the same time, I've often wondered just how effective the veterinary cyclosporine gel is. . .First, I think it's petrolatum-based, which is quite stupid, I think. .. and second, experience tells me that dogs are probably not generally diagnosed carefully before being put on cyclosporine. . .Many probably have ocular surface problems unrelated either to lacrimal or meibomian gland dysfunction, and that worries me, for them. . .Nonetheless, there are some truly fine and dedicated veterinary ophthalmologists out there who may do well in this area. . .