any RN's here

[untkicker29]

I have always had an interest in medicine and wanted to be a doctor for the longest time. I was taking some science pre-requisites along with my business classes when I developed dry eye, and decided to just concentrate on Finance because I knew I wouldnt be able to survive 50+ hour work weeks as a physician.

Now having worked in business for a little bit, it just isnt for me.

Is there anyone here that is a RN? Any advice on nursing as a career? How do you cope with dry eyes while working 12 hour shifts? Hospitals are just like any other huge building that has A/C or heat blowing constantly, and I wondered how unbearable the hospital setting is on the eyes.

[kitty]

I have been an RN for 24 years. I have not worked in a hospital for some time, long before the onset of DES. It is a wonderful career. There are more places to work than just hospitals, like schools, ambulatory surgery centers, nursing homes and assisted living facilities, private industry as an occupational health nurse, for insurance companies and as a nurse consultant. Medical equipment suppliers also hire nurses to do patient education and sales. There is also home health and hospice nursing. The office type jobs and home health will give you greater environmental control/comfort.

[DrG]

I have always had an interest in medicine and wanted to be a doctor for the longest time. I was taking some science pre-requisites along with my business classes when I developed dry eye, and decided to just concentrate on Finance because I knew I wouldnt be able to survive 50+ hour work weeks as a physician.

You should do rounds with me sometime. Today, you would have seen a couple of glaucoma cases, a hyperopic LASIK patient with 3 enhancements, as well as a patient with type I diabetes, glaucoma AND graft vs. host disease who was referred to me by his oncologist at Medical City Dallas for dry eye treatment.

[untkicker29]

DrG,
That sounds like that would give me some insight into the profession. I would really like to do that sometime.

[dianat]

Hey, maybe you could give Dr. G some kicking lessons in exchange!

[brd888]

eh?

Hey, maybe you could give Dr. G some kicking lessons in exchange!

What are you implying Diana?

DrG your post is interesting and moot to my point that I think more Optometrists should be proficient in dry eye problems. Ophthalmologists obviously have sight threatening diseases to consider which is why dry eye folk get such a raw deal from them.

-oh look its my 100th post today!!-

[DrG]

DrG your post is interesting and moot to my point that I think more Optometrists should be proficient in dry eye problems. Ophthalmologists obviously have sight threatening diseases to consider which is why dry eye folk get such a raw deal from them.

Interestingly, the patients I have the greatest success with are those with the more severe forms of dry eye, such as graft vs. host disease, where the surface of the cornea is significantly compromised. You might say that they do have sight-threatening issues. In those cases, the bandage contact lens provides almost instant relief. They feel as though they have tears in their eyes again. With these patients, neither plugs nor Restasis help at all. The use of the bandage lens appears to be so novel, that they think I am some kind of miracle worker. Some thinking outside of the box does have its place.

Another thing that may set me apart a little bit is the many years I have been intimately involved with the refractive surgery patients and trying to come up with refractive solutions for them.

Maybe it's human nature, but some people like to gravitate away from difficult cases, whereas others seemed challenged by them. Not everybody has a problem-solving mentality.

[Rebecca Petris]

Some thinking outside of the box does have its place.

Or outside the bottle, as the case may be

[DrG]

Or it may be the "wow" effect of a dramatic improvement as compared to small incremental improvements over a long period of time.

I doubt whether one ever gets completely outside of the bottle with a dry eye patient. Even with bandage lenses, rewetting drops are necessary, just not as frequent.

[DrG]

Hey, maybe you could give Dr. G some kicking lessons in exchange!

I did kickboxing for several years. I've got the kicking thing mastered. It's the age. I've simply mellowed.

[dryeyes2]

bandage contact lenses question

Hi Dr. G,

The bandage contact lenses you are referring to, are they the Boston Scleral or some other type of contact lens? Do they correct vision too?

I wore hard contacts and then RGP for many years. I had to stop wearing them almost 3 years ago because of my eyes were getting dry. They have worsened over the past 4-5 months. I am on Restasis. I tried plugs, but they didn't work. I would love to wear contacts again, but I figured that that would never be possible again. My rx is so high that I can't get wraparound sunglasses made. Is there hope for those who have dry eyes that they could wear contacts again?

Thank you.
dryeyes2

[DrG]

I use bandage lenses in the presence of corneal surface damage to facilitate healing. So far, the silicone-hydrogel lenses have worked very well for a host of conditions, mainly involving corneal filaments and erosions. A scleral lens would also work, but the fitting of those is so much more expensive and involved that I avoid going there if at all possible. I generally use a Focus Night and Day in a close to plano prescription so that the patient is able to wear their regular spectacles over the lens for optical correction.

[dianat]

Since it seems like there's some confusion...

Untkicker29 is an expert football kicker and was very successful at the college level. He played in a Bowl game...last year was it?

I wasn't implying that Dr. G likes to kick his patients in the teeth or anything. Of course, maybe he does like to do that; I've never been in his chair...)

I was merely suggesting an exchange of services, nothing more. Dr. G, do you have some sort of reputation or something?!

[dryeyes2]

soft lenses

Dr. G, thanks for your reply. I am curious. I had tried soft contacts in the mid 1980s and found that I couldn't tolerate them because they made my eyes dry. RGP were very comfortable. What I am wondering is could a patient who could not tolerate soft contacts a long time ago, benefit or be able to tolerate the new soft contacts now, even if they are just for a bandage purposes?

Could they be made into an rx and still be used as a bandage?

Thanks again!
dryeyes2

[DrG]

You might want to try again. The Focus Night and Day is available in a wide range of prescriptions. Interesting that you were able to tolerate RGP lenses, though.