Dry eye worse at work (psychological cause?)

[olb]

I have had lasik end of 2009 and suffering from burning pain ever since. I have been to numerous opthamologists to have my eyes checked. They never see anything more than mild dry eye etc. I now have lower punctal plugs, fucidine acid ointment, eyelid cleansing, omega 3 and of course every OTC drop available. All without result.

What I notice is that in the weekends the drye eye/eye pain almost reduces to tolerable/very tolerable most of the day. The problem is at work while looking at a screen 8h/day and maybe the dry air. I am at a 3rd job and thus at a 3rd location. With all 3 I have the same problems. But also when I am not continuously looking at a screen at work I have burning pain.

Ofcourse with an office job you have frequent occasions you are able to worry and think about your eyes. I am puzzled by the fact that on working days I have eye pain sometimes even before I arrive at work, while I don't have that during weekends. I have also started a habit of yawning at work (yawning induces tears). Is it a surprise I don't like to go to work because on working days I always have burning eye pain? It's a vicious circle: work = eye pain, worrying = tiring, feeling tired causes heavy eyes etc......

Could dry eye pain come from a self fulfilling prophecy during working days ("you'll see, i'll have eye pain today"), thinking/worrying about it beforehand etc? I don't mean that my dry eye is only due to psychological reasons, but I fear that my discomfort is caused by it. Every eye doc only sees mild dry eye, but only on working days it's causing major discomfort.
Has anyone been able to find a way/therapy to stop this routine of compulsive thinking about your eyes? Has anyone experienced the same issues as me? I'm getting quite hopeless and depressed.

I have also read on this forum about neuropathic eye pain. It might be just that? Who has experience with eye pain improvement from medication (SSRI, Prozac,...)? Almost all antidepressants have dry eye as side effect, which one does not have that?

[Rebecca Petris]

Could dry eye pain come from a self fulfilling prophecy during working days ("you'll see, i'll have eye pain today"), thinking/worrying about it beforehand etc? I don't mean that my dry eye is only due to psychological reasons, but I fear that my discomfort is caused by it.

I doubt it.

I mean, the stress of worrying that your eyes will feel bad will exacerbate it, sure. But your problem ain't in your head. There are heaps of studies about the evils of 'office air'. Even in someone with fairly mild clinical symptoms you can have really bad effects from air at the office. And with LASIK, frankly, all bets are off: the pain course is simply unpredictable.

Who are these ophthalmologists you've seen... corneal specialists? any of them real dry eye experts? Entirely possible someone's missing something. But mild clinical symptoms can produce major pain too. Score yourself on an OSDI questionnaire during work one day, and take that to your dr. appointment. - And in the meantime for some relief, some moisture chamber glasses could be in order....

[olb]

Thanks Rebecca!

But I don't know that the opthalmologists are DE or cornea experts? I only know they are outstanding eye docs, but for the rest I don't know.

My flaps are (unintendedly) only 80 micron (done with keratome). Might that be an indication for more nerve damage or exactly the opposite?

[Rebecca Petris]

My flaps are (unintendedly) only 80 micron (done with keratome). Might that be an indication for more nerve damage or exactly the opposite?

I don't know. A confocal microscope might yield some useful info though.

[GinaJ]

Well I have nerve pain in my legs so am on meds like neurontin but not sure how much it helps with the eyes or the legs actually but for some it helps a lot. Some meds like Cymbalta for ex can also help with depression and pain. As for the mental side of this I feel that mentally when I am stressed or similar it makes it harder for me to cope mentally with my pain and condition so it seems that much worse. That is part of why I went back to the psych so I could work on mentally coping better. For my eyes I never had lasik and was dx with dry and bleph but the amount of pain was not adding up and why it may be a neurological condition that is similar in my legs. So I do hope that when I find a better treatment for my legs it will aid in my eyes as well. Hope you feel better

[Scout]

I spent weeks and even months trying to figure out what in my office/work setting was causing such a severe reaction for me. My weekends were so much better than my work days so I had assumed it was something in my office.

Ironically, it wasn't anything in my office at all. It turned out to be the very expensive, wonderfully scented body lotion that I saved for work days only! The cheap stuff that I used on weekends was fine.

Now I use the cheap stuff everyday.

Sometimes the solutions are not at all what we expect.