Don't Leave Me Dry

[Scandinavian Dries]

A beginning

First of all, season's greetings to you all out there, may you get what you wish for this christmas. I bet that comfortable eyes is on the top of most of our lists this year =)

Second of all, a big thank you to Rebecca and everyone else who have been filling this site and LaserMyEye with useful information and just plain support, I've been browsing these two communities for the last 6-9 months, when it got more and more clear to me that what I was experiencing after my laser surgery was certainly not normal, despite what the clinic tried to reassure me.

- Man how I wish that I had come across these pages before having the, at the time, splendid idea of having parts of my eyeballs evaporated by laser =)

But I'm getting ahead of myself, so let me start by telling the background of my case, which - sadly - is not much different than others that I have read here. And in our case, I guess Marx was wrong when he said that history first repeats itself as a tragedy, then as a farce. Regarding laser eye surgery, it just remains a tragedy.

I'm a 27 year old guy, Danish, but living in Norway. I've always used glasses since I was little, and then lenses in my teens and 20's. I'm one one of those persons who always hated my glasses, and with a vengeance. Lenses worked out well for me, but I found them expensive, as well as bothersome, having to always mind keeping solution and containers around and such. So the idea of getting eye surgery had been in my mind for many years, and you always saw these smiling people in the ads, as well as hearing how safe and minor the procedure was, just a few minutes and a small zap, and you'd be off glasses and lenses for the rest of your life, right?.

Well, I pride myself with common sense and a decent amount of intelligence, as well as a higher education, so I didn't just jump out in this without second thought. I browsed the net to look at clinics and as importantly, different methods. Unfortunately, my research must have been incomplete, since I never came across this site of LaserMyEye until after the procedure, but I sure read a lot of articles and a lot of people's opinions. To me, it seemed like LASIK was the great culprit, with flap problems and dry eyes, whereas PRK seemed more safe, albeit with a longer recovery time afterwards.
Well, I thought, that's alright with me, the safer the better. I "only" had about -1.75 and -2.25 prescription anyway, as well as some minor astigmatism, so I thought I was the perfect candidate, with a small prescription, no prior dry eye, and going with the surface treatment instead of LASIK.

Coincidentially, that's what the LASIK clinic called me as well, the perfect candidate, which makes my current situation all the more ironic.
I started noticing my dry eyes about day 5 after the procedure. The first 5 days I had quite the opposite problem, with eyes leaking water like they were competing with the Niagara Falls, as well as an excruciating pain in both eyes that made me unable to sleep more than 2-3 hours a night, without having to wake up, forcing topical anesthetic into my eyes, and hoping for another 2-3 hours of relief. Those 5 days were the most horrible I have ever experienced, to be honest.

[Scandinavian Dries]

What to do but cry

Well, that part over, my eyes started healing, oh so slowly. I had regular follow-ups at the clinic, the first one after 5 days, the second after 3 weeks, and again after 3 months. Dry eye persisted. Nothing too major, but definitely a bother to me. At the time, however, I was more concerned with my quality of vision, since everything suddenly had doubled, and I felt like being on the brink of insanity, repeating over and over in my head, "what if this never gets better!".
Fortunately, it did get better. I had my PRK in feb 2011 (Well, actually I opted for a procedure called ASA - Advanced Surface Ablation - which is basically another form for PRK, that is, a surface treatment of the corneas, with the removal of the epithelium layer), but it took me nearly 9-10 months before my astigmatism and double vision had mostly corrected itself - I still have -0.75 astigmatism in my right eye - not "a couple of months", as the clinic had promised before the procedure. "A couple" usually means two. Not 10.

Visual correction. Well, I'm now 10 months post ASA, and I have -0.75 astigmatism in my right eye. The biggest problem, though, is my -0.5 sphere, which they keep telling me at the clinic is not due to refraction problems per se, but rather due to "my eye muscle having an accomodation spasm" that apparently inhibits it from focusing on long distances. Okay. So why wasn't I told that prior to the surgery? Can't they tell that beforehand? Is it really accomodation spasm, or are they just feeding me that? I must admit that searching the net for accomodation spasm and poor results after visual surgery has yielded preciously little so far, but maybe someone can enlighten me?

The right eye kept being bad. I complained from the start that it seemed a lot worse than the other one, but it wasn't until late september 2011, that I got a re-surgery of the right eye due to some left-over myopia (they never told me how much, just like they generally tell me very little of what they see in all their tests and write in my journal when I'm sitting right next to them - and of course I can't see what they write due to my poor quality of vision).
I'm still "only" a little less than 3 months post ASA re-treatment, but currently I have an astigmatism in that eye at -1.00, which makes reading really bothersome, and I tend to just use my other eye for that.
So, regarding visual quality, I'm now astigmatic on both eyes, more on the right, which is really noticable, and I'm still myopic on the left eye, with no betterment in sight so far (they basically told me that my supposed accomodation spasm might go away later on, but they didn't know when, could take years), and generally, I feel that my vision was much better before the surgery, with contacts/glasses. And this is more than 10 months after the procedure, regardless of their initial promise of "a couple of months of healing and recovery time."

But - that is a minor issue. Right now I'd correct that in an instant with glasses. Lenses isn't an option for me, partially because of dry eyes, partially because - as my independent optician told me - they basically ruined the surface of my corneas, where the contacts should rest, so now they are flopping all over the place, which makes my vision fluctuate from blink to blink, and makes wearing lenses a most uncomfortable experience.

I started mentioning dry eyes to the clinic already at my 3 months check-up. Then at my 9 months. Then at my 12 months. They kept telling me that "it was normal experiencing a little dry eye after such a surgery, but that would disappear again soon. Just give it time." In the meantime, I was going crazy at home. I couldn't see, and my eyes felt sore all the time. Dry and sore, just like others have experienced here, that you feel like you've been up all night, or have a gritty and dry contact in your eye that you just want to rip out. Some mornings I also had the adhering eyelid phenomenon. Thank gods for pages like this one, I thought I was the only person on earth experiencing this, I thought I might be going blind, or that something horrible had happened.

Still, they gave me no feedback at the clinic, they just told me to use regular eye drops when needed, even though I told them that they only gave me temporary relief for like a minute or so. Should I drip something into my eyes every minute, for the rest of my life, then? Well, I was at the clinic again about 2 weeks ago. I had browsed this website a lot, got some good ideas of what to tell them at the clinic, as well as having my independent optometrist's numbers for my current visual "quality".

Again, nothing happened. They just confirmed that I was having accomodation spasm on one eye, and basically, that was just "too bad". The astigmatism on my other eye would smooth out eventually, and quite frankly, I was to expect some astigmatism in my eyes even after surgery, many other people lived with much worse astigmatism than I had now. That's quite literally what they told me - after surgery, that is. Before surgery, they nodded their head and confirmed that of course they'd be able to fix whatever minor astigmatism i had prior to surgery.

Regarding dry eyes, they did no tests, no determination of tear quality, gland functioning or anything else. They just looked at my eyes with their small light and microscope, and concluded that "they couldn't see anything", so basically, I wasn't feeling anything, and must be making this up or something. This was despite my thorough explanation of my symptoms, and the degree that it affected my quality of life. I felt rejected, I felt patronised, and I felt that my reasonable plea for some kind of relief and treatment for my debilitating condition was completely ignored. I told them that if they sent me away now with just another "we'll see you again in three months" comment, I'd seek out another eye doctor for proper diagnosis and treatment. That's when the head doc (the one who'd been performing the surgery on me) was called in to see me. I guess they thought me a "bothersome case" at that point. Well, he didn't do anything but again confirm that they didn't find anything abnormal in my eyes, that the procedure had gone as planned (I wonder if he'd like to switch eyes with me just for one day?), and regarding my dry eyes, well, he was sorry, but he couldn't do anything about that other than tell me to use drops and perhaps some gel at night. Then they gave me another appointment for three months.

Back home, I went directly to my general practitioner to ask for a referral to an eye doc. We talked about pain relief in the mean time, and she suggested that I used a gel called "VitA-Pos", which, and here's when it gets really funny, she used herself due to her botched PRK treatment several years back in time. Oh boy, this just keeps getting better.
Well, here I am then, no diagnosis, no proper treatment, and waiting on a letter from my referral to the public eye doc. I'm currently using this VitA-Pos thing, which is basically grease (paraffin and vaseline) with some added vitamin A. The "gel" is basically solid until it meets the warmth of your eyelid, and obfuscates vision for some minutes afterwards. I've only used it for like 3 days, so it's too early to say anything about results yet. Good days come and good days go. I do get very sticky eyelids and eyelashes though, for what it's worth.

[Scandinavian Dries]

An open ending

I'm sorry, this turned out to be a much, much longer post that I had intended. I guess I'm writing mostly for my own sake, really. It's just nice to know that there are others who have had the same experience as me, or something similar. That I'm not just a freak incidence. I guess what bothers me most (apart from the actual symptoms, soreness and pain, of course), is the fact that I have no idea what caused this. Well, PRK did, of course, but why did I get these symptoms afterwards, when so many didn't. I had a very small prescription, I opted for PRK instead of LASIK, and am in general good health. I have psoriasis, which is the only thing I can think of that might have complicated things, but then again, I've never seen any connection on the net between laser complications and psoriasis. So I, too, was thought a "perfect" candidate, and yet I not only went from the clinic with severely uncomfortable eyes, I also got a "visual correction" that seems more like a different kind of bad, than a real correction. And lenses are no longer an option. Oh, and I have to wait at least 6 months to get some glasses, since my right eye is still recovering. And all this joy only cost me a minor fortune out of my pocket

My independent optometrist has been a good support, has provided me with temporary lenses to use when I feel like actually seeing properly, albeit with the caveat mentioned, as well as glasses in the future. I guess my faith in the laser clinic really dropped when they mentioned last time that "I shouldn't really listen to that guy, as he was only interested in pushing his expensive products on me, as that is what optometrists do." Right.

I'll stop now. I can feel my anger seeping into the text, and anger isn't really getting me anywhere. I guess I'm just baffled that this can still happen, despite all the earlier mistakes, despite the fact that we should know better. And hopefully, someone somewhere might read this and think twice before doing laser surgery, even when they think they're "perfect candidates."

PS: Yes, the title is from the song by Radiohead. Sometimes you either gotta laugh or cry, and since none of us here are very good at crying, it's probably better to laugh =)

[Toril]

Heisann!

Hilsen fra Norge! :-)

I just read your story. Sorry to hear what you've been going through and about the problems you're still having. I have dry eyes due to autoimmune issues so my experience might not be of much help, but if you need tips about various artificial tears sold in Norway, just ask me. I've been trying out so to say everything, and know which ones are supposed to be the best ones.

My eyes got really dry back in 2006 - to a point that I wasn't able to function anymore and was in constant pain all day - and I didn't feel I was taken serisouly by Norwegian eyedoctors. I realized that their knowledge about and interest for dry eyes were limited, so in 2007 I went to see a French dry eye specialist in Paris (Professor Christophe Baudouin) and have been going there once or twice for check-ups ever since. I was offered treatment there that wasn't available in Norway, and on a good day I would say my eyes are 30% better now than back in 2006. Are you concidering seeking help abroad in getting a proper treatment?

Ønsker deg en god jul og et godt nytt år, og lykke til med øynene!

Toril :-)

[Scandinavian Dries]

Hej Toril, and a happy new year to you too!

I'm starting to suspect that my dry eyes have more causes to them than just the laser surgery. Low prescription (around -2.0) as well as PRK treatment instead of LASIK should really not have left me so dry as this. And I already have a pretty aggressive psoriasis, so maybe I have some autoimmune defects as well ..

Anyway, I'd love to hear what kinds of drops/tears that you use, it seems like the selection in the local pharmacies is pretty small.

What kind of treatment did you get in Paris? I'm still waiting on my referral to the public docs.

Also, the Vit-A Pos lube thing seems to have alleviated the dryness some, though it's still a long way from being gone.