My story with "eye drying out"!

[rmalecki]

Here is my story of a lazik "enhancement" on my left eye. August of 2009 had enhancement on left eye. 1 week later my sight in left eye was cloudy. Went back to doctor and he said I have epilitheal cells growing on my eye and they had to be scraped off immediately. I had the flap opened up again and he scraped off the cells and washed them off. He resealed the flap, put a contact lens on as a bandage and said to come back in 1 week. 1 week later the contact lens was removed, he said no further skin cells in place and said things should be OK. 5 months later I had my left eye "dry out". I woke up with eyelid stuck to eye and went to doctor. He said put compresses on and see my regular doctor (on vacation) when he returned. The recuperation from my eye drying out was terrible -- had to go on xanax because I couldn't sleep at night, eye stinging every day, using gel at night and refresh plus drops during the day. At first I was on restasis then after second month he put a punctual plug in. This slowly helped and after 8 months I thought my left eye was improving; however, now my right eye was becoming fuzzy. For past 7 days I have been using "genteal" gel at night and refresh plus drops during the day to keep the clarity in my eyes. I feel the dryness when I get up each night and put in a few refresh drops around 4 in the morning. Use drops during the day about 3 times -- 3 - 4 hours apart. Need feedback on why my right eye would be faltering. It never had the "enhancement" but is drying out. Left eye with plug is working but still needs constant watering/gel at night. Also, anyone experience their eye "dry out"! That was absolutely terrible. Doctor said "you won't let it dry out again". Any feedback on better gel to lubricate eye longer at night?

[Rebecca Petris]

I'm sorry to hear what you're going through. Epithelial ingrowth is not a fun complication to have to deal with.

LASIK, and LASIK enhancements, can obviously cause dryness (even as a very delayed reaction) but based on your story I'd also keep in mind the possibility that it's not only that. Sometimes people have an underlying condition slowly simmering and then something - anything from a surgery to a new medication to environmental change - sets it off bigtime.

You may want to consider more than just gel at night - for example a sleep mask or even the Tranquileyes moisture goggle many people here use at night.

Do you have a more detailed diagnosis from your doctor than "dry eye"? If not I'd press them for more details, and if they won't oblige, maybe consider getting another opinion. Here's an article with some suggestions.

[rmalecki]

my dry eye story

Thank you Rebecca for your information. I am going to see a different specialist next week. I think you are right, there is something other than dry eye going on. My doctor just looked at me when I asked him if I had dry eye, as if he didn't want to label it as "dry eye" but didn't want to go into any more detail.

My enhancement was done 8 years after my original lazik. My doctor said "we didn't have any problems the first time, I don't expect any now". It seemed so routine I felt safe.

Now I find doctors don't recommend enhancements after such a lengthly period. I will take a much higher interest in finding out if something else is wrong with my eyes.

[rmalecki]

sleeping aids

A question to anyone out there -- what do you use to help sleep at night. I have been on xanax for the past 10 months and even with xanax I am only able to sleep around 5 hours.

[Sammy B.]

Rmalecki,

Try something other than the Xanax for sleeping as it is not typically indicated for sleep and doesn't sound like it is helping much anyway. There are a myriad of options.

First though, get rid of the anxiety. The "come down" from Xanax typically causes more anxiety so try something else that is less harsh on your system.

Rose

[rmalecki]

Thanks Sammy. I do have anxiety; however, the eyes are drying out at night so I put drops in around 4:00. I do manage to be relaxed enough to doze back and forth from 4 - 7.

I am retired so these things on my mind are hurting. It has been 10 months since my left eye dried out -- that is the eye I had the enhancement in. I had a plug put in my left eye 8 months ago. Now my right eye is drying out so I use "gen tial" gel at night before bed and use drops about every 2 hours through the day in both eyes.

I feel there is something else other than dry eye going on but he has not said anything except to follow his instructions. He may have to put in a plug in my right eye this week.

I am worried it will all progressively get worse. It appears my eyes are not tearing and I'm not sure why my right eye is acting up since I did not have the enhancement in my right eye.

Any suggestions would be helpful. also, I'll ask my doctor about an alternative to xanax.

[Sammy B.]

RMalecki,

What are your test scores? Schirmers (where they put the little threads or strips in your eyes) or TBUT where they dye your eye and see how quickly your tear film breaks up?

Schirmers indicate low tear PRODUCTION, TBUT indicates low tear QUALITY. So get familiar with each of those scores and you'll have something to gauge your progress with. Some people have both issues, some have just one.

From what I've learned about Xanax, it is really just indicated for those acute, "I'm going to die!" anxiety attacks, not really for everyday usage, but I am not a doctor. Side note - my doctor will not prescribe Xanax in fact, due to its highly addictive qualities. I used Lorezepam when things were tough and that worked great. Xanax always made me feel much worse or anxiety-filled after using it.

Keep in mind that plugs may make the situation worse. I had plugs and hated them. Come to find out, I have a quality problem, not a quantity problem. I produce enough tears, they just break up too quickly. I am looking to do IPL in the near future to help with this.

What you should know is that things will most likely improve, not get worse. Fearing the future is no way to live so quit it if you can. It is going to take time to see improvements though, so try to be as patient as possible.

Rose

[rmalecki]

Thanks for your info Rose. I'm pretty sure my shirmers tests indicated everything was within acceptable ranges. I'll ask my doctor about another alternative to xanax.

Here is a short story of my eye history. Maybe someone can relate and help me:

left eye lazik enhancement
1 week later found epilitheal cells under flap, scraped cells, put contact lens as temporary bandage.
no further cells found after recheck.
5 1/2 months my left eye dried out -- at least that is what I think happened.
used nightime gel, drops in left eye.
Had punctual plug put in after 6 weeks of restasis was not working.
later doctor said use drops in both eyes as right eye was drying.
1 week ago my right eye was drying to the point where I use gel and drops in both eyes each night now.
My doctor wants to hold off on putting a plug in my right eye.
trying to keep my eyes lubricated -- as of today I put in drops about every 2 hours -- only thing that bothers me is my left eye (the one with the enhancement) does not clear up immediately when drops are put in leading me to believe maybe there is an underlying problem with the scraping of the skin cells and my flap not healing properly. All my doctor says is "you eyes want drops".

[Sammy B.]

RMalecki,

My story is similar to yours, although I didn't experience any cell growth. I had a pretty normal LASIK procedure but my eyes dried out around the 6 month mark. I think what we can attribute the 6-month "delayed reaction" to is that the surface of your eye (cornea) is de-nerved after LASIK, and once the healing "stops," you feel the dryness whereas before your cornea was too numb to feel the dryness. Make any sense?

Also, regarding both eyes feeling dry - there is speculation amongst researchers that the eyes are "connected" or at the very least, work in tandem with each other. When one eye feels dry, the other will most likely feel dry as well. I have one eye that feels worse than the other, but I have been told both have low TBUTs.

Anyway, my first suggestion would be to get a second opinion as soon as you can, from someone unrelated to your LASIK doctor's office. I am not sure where you live but you can go to the "Plug a Doctor" section on this board and browse for a recommended dry eye doc in your area. This is a must. The longer you let your LASIK doctor tell you things are looking great and to "use more drops," the longer you delay getting some bonafide help.

My second suggestion would be to take a good look at the amount of artificial tears you are using as there is a such thing as using too many drops. Artificial tears wash away what your eye can produce on its own. Again I am not a doctor but several on this board have ditched artificial tears or reduced their usage of them and gotten better.

My last suggestion would be to ask your new doctor (whenever you go), if punctal plugs are right for your type of dry eye. As I mentioned, there are mainly two different types of dry eye (aqueous-deficient or oil-deficient) and plugs will typically not help oil-deficient dry eye. If your Schirmers scores are good, you probably do not have aqueous-deficient dry eye and must look at other options than plugs.

Rose

[rmalecki]

Thank you Rose for your input. I use the refresh drops about every 2 - 3 hours each day and put drops in before bedrime and about 4 in the morning. My family doctor said to follow the doctor's request but I do think I need another specialist to look at me. I had a second doctor (from his office, one that specialized in dry eyes) and he said I didn't have "dry eye". I'll work on this.