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Just a quick write up of my visit to my local NHS hopital yesterday, for my reference and anyone else who is interested.
Waited 1 hr 10 mins (which sucked) then had Schirmers which I'd previously suggested (I know it's variable and invasive but I wanted to test with anesthetic to determine any AD). First 3 mins (not 5) without anethetic and then with. Results:
No Anesthetic:
R 3
L 5
With anesthetic it's was suprisingly a little more, which both I and Ophth agreed was due to stinging/initial reflex response. However this was the first time AD has definitively been observed and measured (only other Schirmers was 10 in both eyes - i.e. borderline)
Saw Ophth and I suggested lower plugs. Previously had not seemed a good idea due to Ophth's feeling my irritated inner lids were due to allergy. I asked why he felt that and he said he could see folical signs of allergy response and something similar to "anoidals" (that's not right - note to self find out what he actually said).
However, I've not responded to steriod drops or Panatol so he didn't seem to feel plugs were out the question. They can be easily removed in A&E and I observed even if it makes me worse that's diagnosically useful. Follow up appointment in 2 months - if 2 plugs aren't doing anything then plug my uppers too.
Plugs were size 7, and silicone. Did ask to see brand name and was shown but can't remember (xxxxx plugs was name format).
When inserted made a kind of pop or click. Can't see plugs exactly, but puncta look a little bigger and have fluid which I guess is a sign they are blocked.
Nurse who administered Schirmers said Ms K*rr was corneal specialist whereas Mr M was plastic surgeon. Mentioned to Mr M if still getting no joy might be worth me seeing Ms K*rr.
Mr M also recommended I seek Restasis using Internet as he was aware from his time in USA that was commonly used. I mentioned Azasite, and he looked it up (funny when I saw google return a dryeyezone link in the results) and he said he didn't see how it would help DES. Of course he can't perscribe it so in fairness he's not familiar with it.
He also recommened I try Optive when I reported I felt Celluvisc just irritated - I'll look into this.
Also going to have Thyroid function checked. This will be a bit of an ordeal for me as it involves a blood test which I've managed to avoid for the last third of a century (i.e. my age). Ah well - might be worth wearing rubber clothes and a crash helmet for when I pass out (likely before I even get to the actual blood taking). Asked for cholesterol test too since I need it and might as well if going through the test anyway.
Will see how the plugs go - right now they seem OK and I can't really feel them much. The jury is out as to whether they are helping or not.
Waited 1 hr 10 mins (which sucked) then had Schirmers which I'd previously suggested (I know it's variable and invasive but I wanted to test with anesthetic to determine any AD). First 3 mins (not 5) without anethetic and then with. Results:
No Anesthetic:
R 3
L 5
With anesthetic it's was suprisingly a little more, which both I and Ophth agreed was due to stinging/initial reflex response. However this was the first time AD has definitively been observed and measured (only other Schirmers was 10 in both eyes - i.e. borderline)
Saw Ophth and I suggested lower plugs. Previously had not seemed a good idea due to Ophth's feeling my irritated inner lids were due to allergy. I asked why he felt that and he said he could see folical signs of allergy response and something similar to "anoidals" (that's not right - note to self find out what he actually said).
However, I've not responded to steriod drops or Panatol so he didn't seem to feel plugs were out the question. They can be easily removed in A&E and I observed even if it makes me worse that's diagnosically useful. Follow up appointment in 2 months - if 2 plugs aren't doing anything then plug my uppers too.
Plugs were size 7, and silicone. Did ask to see brand name and was shown but can't remember (xxxxx plugs was name format).
When inserted made a kind of pop or click. Can't see plugs exactly, but puncta look a little bigger and have fluid which I guess is a sign they are blocked.
Nurse who administered Schirmers said Ms K*rr was corneal specialist whereas Mr M was plastic surgeon. Mentioned to Mr M if still getting no joy might be worth me seeing Ms K*rr.
Mr M also recommended I seek Restasis using Internet as he was aware from his time in USA that was commonly used. I mentioned Azasite, and he looked it up (funny when I saw google return a dryeyezone link in the results) and he said he didn't see how it would help DES. Of course he can't perscribe it so in fairness he's not familiar with it.
He also recommened I try Optive when I reported I felt Celluvisc just irritated - I'll look into this.
Also going to have Thyroid function checked. This will be a bit of an ordeal for me as it involves a blood test which I've managed to avoid for the last third of a century (i.e. my age). Ah well - might be worth wearing rubber clothes and a crash helmet for when I pass out (likely before I even get to the actual blood taking). Asked for cholesterol test too since I need it and might as well if going through the test anyway.
Will see how the plugs go - right now they seem OK and I can't really feel them much. The jury is out as to whether they are helping or not.