Lasek screening-troubling discovery

[Jen72]

I am very troubled and confused.
(I had Lasek 6 mos. ago)
I found out today in my office visit- that according to my Dr. and tech they did not feel the need for objective dry eye testing ie. schirmers, tbut during my screening. They state that they can observe the tear film to ascertain this info. In my case they did not note dry eye, it seemed within normal limits. I just feel that I could've been saved from this nightmare of DES I am in now if these basic tests were done.

IS this the case, is cornea observation enough?
What pre-screening tests did you have?
What could I have done differently?

Thanks

[bernmee]

I did not have Schirmers or TBUT test prior to Lasik. I only found out about those tests through this site, and was very upset as I felt if I had these tests things would be different. But now I don't believe this is the case. I believe there are people out there who produced great test results but still had a bad Lasik result.

I was asked if I had "dry eye" and said no, as I had no idea what dry eye was. If I was quick enough I would have thought further about this, as the technican, when getting me ready for my tests, told me my eyes were dry and put some drops in them. I also have rosacea, ocular rosacea and MGD, but only found out about this after surgery. I only had one eye done so my new "dry eye" Dr. can tell me that I have MGD in both eyes.

My Lasik surgeon, who is also a corneal specialist with a qualification from Stanford didn't perform these tests even after I developed dry eye. When I asked about the tests he told me he didn't need to perform them as he already knew my problem was that I don't produce enough tears, which as it turns out is not true. Having said that though I believe that some Dr.'s don't use these tests as they are not reliable, so there are probably many more here who didn't have these tests performed prior to surgery.

I don"t think there was much else we could do. I, like so many others, trusted that we would receive the best of care. I thought by paying top dollar I could avoid a bad Lasik job, but this is not the case.

I don't go to my Lasik surgeon any more as it is to depressing. It try not to think about what I have done, or what was done to me as it is not going to help me heal. I am trying just to move forward on the road to recover, and just give it more time.

I'm sorry you are feeling like this so close to Christmas...I hope the new year offers you some good news, and lots and lots of healthy tears

Bernadette

[Jen72]

Thank you Bernadette for your reply. Your situation sounds very similar to mine. I guess at some point I just have to accept it and not blame myself- now of course I blame the Dr. but as you said the tests are not always definitve. So , you only had one eye done correct? do you wear a contact in the other eye? is your good eye dry too? When was you Lasik done? I am 6 mos out and hoping time will change it. Jen

[dianat]

I don't think there exists effective screening to ensure every refractive surgery patient a healthy outcome. I don't respect the schirmers test very much, so don't feel particularly bothered that I was not given one. I do know my doc looked at my TBUT as I remember asking him what he was doing. While I concur with your concern, Jen, it's the entire industry who is at fault here, not just the doctor...

[bernmee]

Hi,

My lasik was performed 8 months ago this week on only one eye. My eye sight was only bad in one eye having had two operations in my left eye about ten years ago for a bad detached retina. My right eye is fine and I have no problems in that eye regarding dryness. I am so thankful for this.

You can look at my profile page to see what my treatment plan, though I finished Doxy and Acasite about three weeks ago. The first 6 months were the worst, but I really believe this is because it takes time for the whole treatment regime to really start showing results, though this is persuming you have a good Dr. helping you.

Three weeks ago I went to my eye Dr. and I was told my eye was looking so much better than when I first went to see him, about 4 months ago. I told him it often didn't feel that way. The next day my eye burned as bad as it did at the start of this nightmare, and I wondered how and when it was going to get better. The next morning I woke up and the pain was gone, and since then it has been doing really good. It has played up a couple of times but the next morning it seems to have returned to a comfortable place. There is a calmness to my eye that I have not felt since Lasik. I now believe for the first time that there is light at the end of the tunnel, where before my pain was so out of control I couldn't see or imagine how it would ever get better.

I'm not yet ready to post myself as success story but I am very hopeful that I soon will be doing just that.

There is a documentary I watched some time ago when a good friend of mine had cancer that I found myself going back to once I realized how limited my treatment options were. It is called "crazy sexy cancer" and it is about a young woman, Kris Carr who was told she had an incurable form of cancer. She decided to take control of her situation and become more healthy in an effort to improve her life.

She has appeared on many TV shows in the last year. I have found her documentary, book and website to be very helpful. Now I am not comparing our situation to cancer or saying that living a healthy lifestyle will cure us, but there is something about her message that I find really appealing, and inspiring, plus she is just so funny! If you are interested her book is in the library and her DVD can be got through Blockbuster.

And I agree with Dianat, it is the industry that is at fault. We were not to blame for trusting in this procedure, and we were not at fault for not being told the full risks involved.

Please feel free to PM me if you wish.

I hope you are having a good day.

Bernadette

[Lucy]

I don't respect the schirmers test very much, so don't feel particularly bothered that I was not given one.

While my friend, Diana, isn't bothered that she wasn't given a Schirmer's test, I am livid that my doctor didn't test me for dry eyes prior to my Lasik 9 years ago. As Diana says, it's the industry at fault. I also believe the doctors are at fault. For example, if my doctor does not test me for dry eye prior to lasik, there is no record or indication of any problem. In other words, no test, no problem. Green light, another good candidate.

On the other hand, IF, just IF, Schirmer's tests were given, or more attention paid (really paid attention) to the possibility of dry eye, this patient might have been pulled off the assembly line of Lasik. If the Schirmers test is given, the doc has to make notes of the outcome on your records. If you have a Schirmer's test of 3 mm, and he does lasik, someone might question his ehthics later? Maybe I'm making this too simple.

Nine years after my Lasik, I have Schirmer's of zero iin both eyes in a controlled test. It's pretty hard to argue with that. Now, if I had an influx of reactive tears when being given a Schirmer's test, I may have a higher mm of tears, I realize that. That would be a false positive. I really would be zero on the test after the influx of tears disapated. (I want to add that Sjogrens is now in my vpcabulary and is also contributing to the dry eye. I was dx two years ago, seven years after Lasik started this eye problem. There is no way of knowing how long I had Sjogrens before diagnosis. Sort of like a Schirmer's test.

I know the Schirmer's has gotten a bad reputation and no one likes it, it's unreliable, etc. etc. but I also think it's a way for a doctor to worm his way out of even bothering to let us know there is such a thing as a test for dry eyes. I'd never heard of a Schirmer's test until after Lasik and dry eye sets in. I'm someone who was a high myope and had to visit my ophthalmologist frequently.

Lucy

[bernmee]

For example, if my doctor does not test me for dry eye prior to lasik, there is no record or indication of any problem. In other words, no test, no problem. Green light, another good candidate.

On the other hand, IF, just IF, Schirmer's tests were given, or more attention paid (really paid attention) to the possibility of dry eye, this patient might have been pulled off the assembly line of Lasik.

Lucy you have made a really good point. If I am not mistaken the FDA website recommends the Schirmers test pre-Lasik, but they do not require that the test is performed.

I just went on a rant there about my surgeon, who I believe should be ashamed of his post op care, if he knew so little about post op dry eyes, how could he have diagnosed dry eyes pre op, but I deleted it as my blood temperature soared. DEEP BREATH.......

Yes this is an industry that needs to be tightened up. And while I can't change what happened to me I am doing my best to eduate others about the full risks involved in this surgery.

Bernadette

[Jen72]

Yes, I agree Lucy and Bernadette. I think that dr.s should proceed with extreme caution when a person has warning signs ie. contact intolerance, complaints of tired eyes etc. I had those yet they did not do any tests, the tech said the dr. can tell by observation. Which I now beleive is wrong. I can feel your frustation Brenadette, I can relate thats for sure. I was such a novice at my Lasek screening I really trusted their judgement. I had a friend turned down for Lasik due to dry eyes, so I assumed there was a objective test that all Dr.s used- and that I had passed.
Lucy- Have you had any improvement- do you think that your nerves have regenerated, or has the Sjogrens masked any change?
Bernadette- I am glad that you are feeling better 8 mos. post op, patience right. I could not seem to find your treatment plan?
Thanks for the support- Jen

[dianat]

Don't misunderstand me. If I felt the schirmers test were a worthy and easily performed test, I'd be all for it. It's just that there's a whole lot of room for error and false reading. It's subjective and not very sophisticated...certainly not the test I want performed routinely to rule out potentially disastrous refractive surgery results.

Again, the industry needs to create more effective screening procedures.

[lboogie]

Well, I had my lasik done at very well regarded university hospital eye institute. And I ended up with bad dry eyes, starbursts and floaters.

I had a Shirmers but the kind with no anestheic, I was overflowing with tears! Aside from that they just asked me about dry eyes, I said only on long days of wearing my contacts....but I figured everyone was like that. Had she really pushed me, maybe I would have realized I was at a greater risk......but I just didn't even know it could be such a problem.

I'm convinced that nonone can know who will have a problem -- eyes are just too different and unique in healing. I learned the hard way....and now just pray and hope for more healing....

We'll get better yet -- hang in there......I have my close-out appt. tomorrow at my lasik place -- then I'm sending my "letter" of disappointment to the office and to the head honchos of the university.

[bernmee]

Jen,

You can find my treatment plan either in my "public profile" section or in a Nov. 10th posting in "daily routine".

To give you a quick recap of the last 8 months.

First three months were spent in agony from dry eye and erosions. The only help I was gettin was from this site and valium. Than I found a very good dry eye Dr. who started treating me.

Month 4, started taking Doxy and I no longer was in agony, just good old fashioned pain.

Month 5 started Azacite, warm compressed and scrubs, but still in pain.

Month 7, at my December 1st apt. I was told that there was no longer any dry spots on my cornea. Was told to stop takin Doxy and Azacite. I couldn't understand why I was still in pain but was told that I needed to be patient and the recovery path was long and slow.

I experinced terrible agony the day after this appointment but since than I have experienced no major pain. I would say half the time I have a perfect eye that needs no drops and I have irritation the rest of the time. To go from pain to feeling only irritation half the time is a huge step. I am hopeful, for the first time, that it is only a matter of time before this is behind me. If I was told a month ago I would feel like this I would not have believed it.

Bernadette