New Dry Eye Sufferer - Feedback Appreciated

[Brant]

I'm a 36 year old male who has been dealing with this condition for about 3-4 months now. Onset was likely gradual but felt extremely sudden...they worked fine one day, and were a disaster the next. I initially chalked it up to eyestrain or possible allergies, and when it didn't go away on its own I had my first appointment with an Opthamologist. I saw him twice over two weeks, and both times he said the surface of the eye showed no discernible signs of dryness or inflammation, but that I didn't produce the reflex tears he would have anticipated in reaction to the dye. He said he was confused by the severity of my symptoms based on what he was seeing, gave me some samples for various eye drops, and sent me on my way with an apology.

SYMPTOMS

I actually don't get very much "dryness". Only on rare occasions do my eyes actually feel bone dry. Most frequently, they feel "sketchy" or agitated. Sensitive. Easily exhausted. They rapidly get tired or sore, even from doing nothing, and occasionally I'll get deep throbbing aches (most commonly behind the right eye). When this happens, I'm frequently mildly to moderately photosensitive. There is no discharge. The eyes, particularly the left, have shown increased redness and the veins have become more prominently red, but only sporadically, and it seldom matches up with symptoms of distress (dryness or pain). I can still cry (emotional tears) and I still get light reflex tearing from yawning/rubbing (I know rubbing is a no-no) or environmental conditions. Crying occasionally leaves the eye feeling a bit worn out, and once it stung quite a bit. Cutting an onion stung significantly and produced no tearing whatsoever.

There doesn't appear to be any rhyme or reason as to what aggravates or promotes agitation in the eyes. Some days a few minutes on the computer will do it, other days I can go hours without any appreciable change in how they're feeling. Some days television is almost unwatchable, other days not. Lying down and listening to headphones with my eyes closed can often make them feel worse than just having them open and looking at things. Recently I was on vacation for several days relaxing and resting my eyes, no computer, no television, just stress free rest, and they were worse than when I was constantly doing things with them. It's desperately confusing.

The eyes feel at their best first thing in the morning after a long sleep, when I'm exercising (about 30 minutes in), when I'm in the shower, and (I have no explanation for this) when I'm eating. Getting hungry or thirsty can appear to have a negative effect on the eyes, but that's impressionistic. It gets a little tedious feeling like I constantly need water nearby so I can sip at something.

POSSIBLE CAUSES

I haven't taken very good care of myself over the last decade or so. Very little exercise and terrible nutrition. Recent blood work ruled out diabetes or even pre-diabetes, though, and ruled out auto-immune conditions (I know Sjogren's can hide, but it seems unlikely as I don't have dry mouth). My HDL cholesterol is apparently quite low and I was commanded to start taking fish oil, which I'd already been doing for over a month, so it might very well have been disastrously low prior to the manifestation of DES. As such I'm currently focusing on nutritional supplementation, dietary changes, and hormonal factors, as my doctors and opthamologists have thus far been relatively clueless as to possible underlying factors and seem content to recommend I go buy some drops.

Other possible medical contributors...a few years ago I had some mysterious liver issues that couldn't be diagnosed by a specialist. Since then I've had occasional liver "attacks" (likely a complaint from my body about my lousy eating habits). I've also been a habitual ibuprofen user for years due to chronic pain in my arms and shoulders from repetitive stress.

It's also notable that in my work and hobbies I spend extensive time on the computer. I play games as a hobby, love films, and love to read (reading has been nigh-impossible since this has started, I've had to swith to books on tape). At work I'm a proofreader/editor, and a lot of peering closely at things is necessary.

THINGS I'VE TRIED

• Compresses, hot and cold. Neither seem to accomplish much of anything other than to get my eyelid wet. They feel nice enough while they're going on, but have a negligible effect on symptoms.
  
• Goggles. Thus far I've only employed swim goggles due to cost and convenience, but they do seem to help a bit (again, it's impressionistic, and possibly imaginary). They fog up almost instantly, though, and aren't terribly comfortable. So they've been alright, but no panacea.
  
• Omega-3 supplementation. I'm taking 4000-5000mg a day (as high as 6000mg at points), and have gradually shifted towards a pure, glyceride based brand (Carlson's, atm). These should help my other, more generalized health issues as well, so I'm happy with them. My circulation has improved mildly since I started taking them a couple of months ago.
  
• Astaxanthin. 8mg a day, down from 12 (stuff is expensive). Any anti-inflammatory is welcome, especially since I've gone off ibuprofen entirely since this started in case it contributed.
  
• I've been taking Glucosamine for a couple of years anyway, so I've continued with that. I've also been supplementing with Vitamin D, Evening Primrose Oil, Cod Liver Oil (stopped), Milk Thistle, and most recently Maca Root (so disgusting) and another hormone balancer.
  
• I've been exercising regularly, which helps (while I'm doing it), and has dropped about 10-15 lbs so far off my delightful little pot belly.
  
• I've been undertaking gradual dietary changes. Significant influx of vegetables, decrease in starches and fatty meats. I've also taken steps to cut out sugar entirely, not that I was ever much of a sugar nut to begin with. Long term goal is to make a transition to a whole foods diet, and near term goal is to undertake a detox.
  
• I've had a humidifier running night and day in my room for about two weeks. If it's making a difference, it's an imperceptible one. It does make a racket, though, so I'm thinking of just unplugging it and retiring it.
  
• I've started wearing sunglasses outside after getting nagged for years about the importance of it. It's amazing how quickly you grow dependent on them. I feel twice as photosensitive now as I was before I started wearing them. They do help though.
  
• Drops. I've tried multiple brands of drops, including GenTeal, Refresh, Bion, Systane, Theratears, Similisan, and a few one-shots from samples. Without exception, they have been almost if not entirely worthless. They DO relieve the dryness on those occasions when it occurs, with the caveat that the eye often feels twice as dry 20 minutes later. On rare occasions, often on first using a new brand, I'll get good results and feel like I've made a breakthrough. Often this is gone by the second application. As a result, I've gone almost entirely off the drops. On really bad days I still use them from time to time, almost always with the result that they exacerbate the symptoms, causing me to curse them anew. Since 90% of articles seem to view artificial tears as the "first line of defense" against dry eyes, this is absolutely maddening for me.

WHERE I'M AT

I seem to be in a holding pattern. My eyes have not gotten substantially worse. Some days they feel like they might be getting better. Other days they're awful. I tried putting aside all my hobbies and just resting/working on getting them better for a period of time, but that was making me miserable and I wasn't seeing any real gains from it, so I've resumed to what extent I can. Sitting quietly in the dark with my eyes shut gives me zero relief anyway, the symptoms I experience continue unabated. Slight dryness, gumminess or "tackiness" when I blink, a tightness or pulling sensation when I move the eyes, generalized soreness/tiredness, all that gets worse as the day goes on. From reading some accounts, this seems like "mild" or "early stage" dry eye to me, as I'm not fantasizing about blinding myself yet to make the pain stop, but there are some inconsistencies.

First, the pain and sensitivity seems OTT for "mild" dry eye. It's WAY more disruptive than the "mild inconvenience" it's billed as. It's had an extremely negative effect on my quality of life, and it's decimated my performance at work. I've heard that in early stage Dry Eye the cornea is still very sensitive, which could explain this, but I'm reluctant to pray the disease advances so I can numb the eyes.

Second, I have trouble finding dry eye accounts that match up with mine so I can follow their protocol in terms of how they cope. I don't have Blepharitis. I don't have discharge. They're seldom DRY, even, just constantly agitated. I don't have allergies. I didn't have LASIK performed. I don't (think I) have Sjogren's. I don't wear contacts. Drops do absolutely nothing for me but mess my eyes up, so I don't have a "drop regimen" I adhere to. Resting and shutting my eyes doesn't "bring relief", they just continue to feel crappy while shut and I often end the rest feeling worse than when I began it.

I would be delighted if anyone has any insight or advice for me. I'm currently waiting on yet another Opthamologist appointment. I haven't (truly) had my vision checked...the Opthamologist gave me a quick test and pronounced my vision excellent, and I don't know if vision related problems can contribute to dry eye (or to what extent) anyway. I'm considering investigating homeopathic/naturopathic solutions, but there's a cost associated with that and I've already run up quite the bill that I have limited means to pay.

So, again, any insight or advice is welcome. Things I could or should try, things I should continue doing or expect to wait a long time to see results from, things I'm doing wrong and should stop immediately. Anything.

[jadavispcfl]

Hey,

First, I would suggest getting the book, "Reversing Dry Eye Syndrome" by Dr. Steven ******. There is so much more information in that book than I could ever tell you in this posting. Second, I don't know where you live, but from my experience, some doctors are really not up to speed with dry eye. I suffered for 3 years before I sought out Dr. ****** in Tampa, FL. I can never thank him enough for helping me. Third, if you are taking lubricants often, I recommend getting "preservative-free" drops. Some have resealable tops on them, so I reused mine within a 24 hour period. The preservative in the bottles affected my eyes. The thicker ones work a LOT better. I liked Thereatears (Thick-type). I ended having surgery, and no longer need them very much (yeah!). Fourth, the goggles I like are called ONYIX www.eyeeco.com. They really help me. Fifth, your doctor should be doing specific testing. Dr. ******'s book outlines the tests that should be done. After I read his book, I realized that none of the doctors I tried in three years time had ever done any testing except the yellow dye test. Hope this helps.

[spmcc]

There is also a book by Latkany (The Dry Eye Remedy) that is good beginner reading.

[Rebecca Petris]

Wow. Very interesting story.

If you have a chance I'd love to talk to you and see if that way anything further comes out that might give a clue. 877-693-7939. I'm in the Seattle area.

...when it didn't go away on its own I had my first appointment with an Opthamologist. I saw him twice over two weeks, and both times he said the surface of the eye showed no discernible signs of dryness or inflammation, but that I didn't produce the reflex tears he would have anticipated in reaction to the dye. He said he was confused by the severity of my symptoms based on what he was seeing, gave me some samples for various eye drops, and sent me on my way with an apology.

Is this ALL the diagnostic workup you've had in this period?

Reading your story, I find myself wondering if there is a subtle vision component to this of some kind that could be investigated. As you've concluded yourself, this is not a typical dry eye pattern (although of course that's a wide spectrum). But then, the reflex tear issue sounds interesting too.

[Brant]

Wow. Very interesting story.

If you have a chance I'd love to talk to you and see if that way anything further comes out that might give a clue. 877-693-7939. I'm in the Seattle area.

Is this ALL the diagnostic workup you've had in this period?

Reading your story, I find myself wondering if there is a subtle vision component to this of some kind that could be investigated. As you've concluded yourself, this is not a typical dry eye pattern (although of course that's a wide spectrum). But then, the reflex tear issue sounds interesting too.

Thanks for the reply Rebecca, I'd love to chat. I tried to drop you a line this evening but it appears your business hours are done for the day. I'll PM you with my home number, which you're welcome to call collect.

The diagnostic work...yes, that's all I've had done to date (aside from bloodwork via my GP). I have another appointment pending with another opthamologist, which is apparently months away (waiting list). The Opthamologist I did see took the "sometimes these things just happen" and "maybe it'll go away on its own" approach. It sounds a tad blase in print, but I didn't get the sense he was being unprofessional or lazy, he just seemed to feel there wasn't much he could do for me based on what he was seeing, which is apparently not uncommon for early dry eye.

[Trac]

I orderd "Reversing Dry Eye Syndrome" by Dr. Steven ****** a couple of days ago, I am looking forward to reading it. If I can see well enough to read it. Thanks for the tip.