Sudden Irritation from soothing drops

[Eli]

Hi all,
Well, I was wondering if anyone has had this problem...We have all experienced the relatively limited relief that one gets from artificial tears. However, I think its also fair to say that for most on this site that they represent the cornerstone of daily dry eye management. I know personally that I couldn't get through the day without some kind of artificial tears. Now, here's my developing problem. Since becoming constantly symptomatic with DES around the holiday season (Merry Christmas indeed!) I have found TheraTears and Systane to be soothing (well, as much as can be expected anyway). The other day however, while traveling to see Dr. Latkany in NYC, I somehow managed to go without dropping for 4 or 5 hours. (Every 1-2hours would be typical) Strangely, my eyes felt pretty good. When I finally used Systane again however, I got an intense, hot burning in my left eye which began to reflex tear like crazy. It was bad enough to force me to keep my eyes shut for a minute or so. Oddly the right one felt fine and after several minutes the burning subsided. Since then (about a week ago) this has happened several times with both Systane and TheraTears, although the burning hasn't been as intense. I speculate that this is from some kind of increased sensitivity due to dryness that gets worse as the interval between using artificial tears increases. Has anyone experienced this?

[kitty]

I have noticed the same thing. If I go too long without putting drops in, when the drops do go in there is a lot of stinging and reflex tearing.

[Rebecca Petris]

My (layman's...) guess would be that it's from a little bit of SPK developing from the epithelium being allowed to dry out too much. Dumping polymer on a compromised surface will often make it smart. Dwelle does that to me in the morning if I haven't taken good overnight care of my eyes. Sometimes I just flood my eyes anyway and ignore it. Other times I follow a little tip someone once posted here (thanks again, whoever that was!) of doing a Unisol rinse about 15 minutes before putting my drops in. I try not to overdo that but periodically it seems to be just the right thing.

[Eli]

Hmm

Thanks guys,
Rebecca-Let's see how my DES I.Q. is progressing. SPK=superficial punctate keratitis? Yet another acronym that I really wish I didn't know. (Unless I got that one wrong, in which case I don't have to worry!) Anyway, thanks for the suggestions-that would make sense as to why my eyes stung.

Eli

[Rebecca Petris]

You're well on your way to DES Mensa membership, Eli.

Sorry to be glib with the acronyms - bad habit . I actually don't really know the technical ins and outs of SPK diagnosis but to me, SPK means dry spots. When there's nothing at all between those poor little damaged epi cells and a foreign chemical substance - even if the substance is therapeutic - it can hurt like heck.

[Eli]

I think you're right about the polymers being irritating to a somewhat dessicated epithelium. Chilled Unisol (of course no polymers) consistently feels very good when I use it after Dr. Latkany's eye spa technique. Although I wish I hadn't, wearing contacts for just a year has made me a lot less squeamish around my eyes than I know I would be otherwise. I think that has been helpful when doing MG expressions/lid hygiene.

[Cindy]

SPK waxes and wanes depending on how dry your eyes are on a given day and how much your lids stick to your eyes in the morning (or after a nap...). Teensy bits of your epithelium can stick to your lids and be ripped off when you open your eyes. The microscopic holes left on your epi will make drops sting sometimes. It can also make you photophobic (make you want to slam your lids shut in response to light).

SPK can be diagnosed by flourescein staining. Or, in my experience, from how much drops that didn't sting yesterday, sting today.

When my drops, usually NutraTear or Dakrina, sting...it's a signal to pamper my eyes: moisten my lids in the morning before opening my eyes, use a warm compress, rest my eyes. I've kept a glass of water next to my bed for years in the event I need to dip my fingers in it to moisten my eyes to open them. I am prone to erosions so I am hyper-vigilant. Easing my eyes open in the morning with drops or water helps.

[Eli]

Interesting...

Thanks Cindy,
I can certainly relate to having good days vs. bad days. Or, even having a really bad morning turn into a really good afternoon. Eyes it would seem, have a mind of their own. One good thing from all of this-at least our eyes haven't yet lost the ability to heal themselves-although perhaps not as efficiently as they once did.