PreMenopause & Dry Eye?

[sonnie]

Hi Everyone,
This has been a very helpful site to me but I do still have some questions. I am a 43 year old female who has been wearing contacts since I was 16 years old. My last eye appointment was in October '06 and went very well. Nothing different, not even my perscription (-3.00, -3.00). In March my eyes took a turn. Apparently I have developed Dry Eye. It's not severe, to me, but my doctor seems very concerned. He asked me if I had made any changes to my daily routine (ie: diet, make-up, soaps, etc) and if so, STOP. I went home and literally cleaned house looking for anything that I may have changed or bought new. I found nothing "new". My doctor keeps pushing different drops on me and keeps saying, "Try these". I was scheduled for lasik and had to cancel because my eyes have not healed enough. I am not good at wearing glasses and in fact on days that I have sinus trouble the glasses put even more pressure on my nose and make the pain worse.
Here are my questions:
1) I am pre-menopausal. I believe there is something to that but my doctor does not seem to agree.
2) I have read so much about fish oils, both responsive and unresponsive, that I am not sure if it would be worth trying or not.
3) If I can't have Lasik then I desperately want to go back to contacts but do not know if it would be potentially harmful to my eyes.
4) Bottom line is that I really want Lasik but I am very concerned that if my eyes are dry now, even if they heal even somewhat, will I do more harm than good if I proceed with Lasik and be sorry and even in pain.

Any feedback would be great!!! Thank you.

Sonja

[calli66]

Depending on what contacts you're wearing now, perhaps a change to a more dry-eye-friendly type would work for you.

I have worn contacts for 25 years, off and on, but when my eyes went over the edge to very dry, I couldn't wear my old Acuvue's any more. I was in my mid-forties.

Your prescription is low enough so that you wouldn't have a problem getting a stylish pair of glasses frames, hi-end well-designed lenses (not polycarbonate). You really should have an alternative to contacts while you're working on the dry eye problem, and while you're trying out some new contacts.

I am positive you can find some frames that don't put pressure on your sinuses--there are some remarkably lightweight materials now, and very creative designs. But you'll have to go the optical stores that specialize in quality frames--not the chain stores. And the glasses might end up costing $500 or more.

I wouldn't recommend Lasik (I haven't had it done, but there are many on this board who are dealing with severe dry eye symptoms because of it--I'll let them respond to that).

C66

[dianat]

Hi, Sonja!

You are lucky to be here. I'm sorry for your dry eyes, but I'm glad you found us. Here's my $0.02 worth.

1) You have every reason to believe hormonal changes could be causing increased dryness in your eyes. Extended use of contacts may be a culprit as well.

2) Regarding any remedy: everything is worth trying. Fish oils can benefit you in many ways in addition to helping with dry eye syndrome. Why not try it?

3) Post a message to Dr. Gemoules about contact lens use. I'm certain he will be very positive about your potential for getting back into contacts. You can post to him under "special forums" on the main page of Dry Eye Talk.

4) You absolutely cannot have LASIK done. You are highly at risk for severe dryness post-LASIK. The condition is horrific and life-altering. Do not even consider it. Many of us post-LASIK dry eye sufferers didn't have dry eye symptoms prior to our surgery. If you are already compromised, it's a really, really bad idea no matter what the LASIK clinic tells you!

Diana

[Eileen]

Hi Sonja,
I am 43 and have dry eye syndrome secondary to menopause. Menopause or perimenopausal hormone levels put women at risk for developing dry eye. In fact, we probably make up one of the largest groups of people with dry eye.
If your eye doctor does not know this I would be seriously considering a new doctor.

As for lasik, you should forget completely about it. It would do serious harm to your already dry eyes. You would end up wearing ten pair of glasses instead of one.

Try punctal plugs or restasis so that you can wear contacts again. The fish oils may help and they also also help with cardiovascular health as well.

Eileen

[kitty]

Hi Sonja. My DES hit hard about the time I figured out I was in peri-menopause, about age 44. I had worn contacts for many years and had always had a minor problem with dryness, but nothing I could not manage. For many years I wore extended wear lenses. Then late fall of 2005 DES hit me like a ton of bricks. I figured the cause was multi-factoral, but the hormonal changes I think put me over the age. I have not worn contacts for more than a few hours at time since I was diagnosed in January 2006. I'm lucky if I can handle them for 4 hours, and that is with having two plugs in one eye and one in the other. I tried fish oil for a while but I saw no difference in my DES. I wish you the best.

[Natalie06]

Sonja

Please, do not have Lasik if there is any question of dry eye. And don't let anyone tell you that hormones/dry eye are NOT contra-indications for Lasik. There is a wealth of medical literature establishing the link between peri/menopause and dry eye, including responsible Lasik sites and Laser manufacturers.

I am now 10 months post Lasik with severe dry eye. My Lasik surgeon completely disregarded my medical history of chemically induced menopause and dry eye symptoms, assuring me that I was an excellent candidate. I would go back to my pre-lasik annoying, bothersome DES symptoms in a heartbeat than deal with the severe dry eye I have now.

Diana, Kitty, Callie and Eileen are all right. Look for ways to regain your ability to wear contact lenses or find the best, lightest weight glasses you can. For what it is costing me to cope with dry eye, I could buy 2 pair of really expensive glasses per year and many, many months worth of contact lenses.

Natalie
Lasik 7/14/06

[jannz]

Hi Sonja,

My dry eyes are worse around my period I'm presuming because of the estrogen drop -- so yes there is a hormone connection. I can't believe your doctor didn't bring this up himself and have you rule out any hormone issues.

Have you had your thyroid tested? Also, there is Sjogren's to consider given your age -- although Sjogren's can happen at any age, I think the group most affected are middle aged women.

I agree with the other posters -- DO NOT HAVE LASIK. I can't believe what living with the regret would feel like.

Best wishes...
Jann

BTW: I take 6grams of fish oil daily -- which is just one of the supplements that I take. I feel a definite benefit to my dry eyes -- I still have dry eyes, but they don't feel as dry and I rarely have to use eye drops except around my cycle.

[Rebecca Petris]

Regarding LASIK: What they said. They're all absolutely right.

You are in an unusual situation for a dry eye patient:

It's not severe, to me, but my doctor seems very concerned.

With dry eye, it is far more common to hear EXACTLY the reverse of what you describe: The patient has severe symptoms and the doctor often seems unconcerned based on what he sees under the slit lamp. This makes me concerned about the potential allure of laser surgery for you combined with your vulnerability to have a very bad dry eye outcome from surgery. Many people here had mild symptoms at most before surgery and yet ended up with severe dry eye. If you have clinical signs severe enough to be causing your doctor concern, you are definitely at higher risk than the rest of us were.

[rubyslippers]

My doctor said this is definitely part of my underlying issue with dry eye. I can no longer wear gas permeables, nor can I tolerate soft contacts. I got Synergeyes and have 20/20 vision and wonderful bifocals. I can wear them 16 hours a day with no discomfort. They are hard contacts held slightly off the eyes by a narrow soft contact skirt. They are heaven even on my bad dry eye days.