Another young, confused dry eye sufferer....

[gormz]

So ive been lurking on these forums for far too long and havent posted anything yet. Ive gained quite a bit of knowledge through them and i feel like i should share my story for the many others going through the same thing. So here is my story and if you have any questions or comments feel free to post or pm me.

So ill start my story from what I think was the beginning. I started wearing contacts around the 8th grade and wore them "successfully" until i was 23. I never really had any dry eye issues and I should also say that i was always pretty diligent in cleaning them/storing them in clean solution. I probably slept in them a total of 5 times during that whole stretch and that was only for an hour nap or so. I also wouldn't consider myself an overwearer of contacts. I would wear them to school and would take them out when i got home. I would often not wear them on the weekends unless i was going out.

So at age 23 i suffered from a corneal ulcer in my left eye. It was my own stupidity on the day that i got it because i felt that there was something under my contact but was running late for work so i didn't bother taking it out and flushing it. When i took it out later that day i had that foreign body sensation and in a few hours my eye was bloodshot. I woke up the next morning with extreme light sensitivity that caused really bad headaches. I went to urgent care and luckily the corneal ulcer was out of my field of vision and healed nicely in a couple weeks with tobradex/vigamox. I basically quit wearing contacts after this to let my ulcer heal since I realized how i could have permanently damaged my vision if the ulcer was just a little higher up on my cornea.

So fast forward about a year. My life was on track. I had just recently found out i got into a physician assistant program at an ivy league school. My buddies and I wanted to do a backpack trip through europe before we all went our separate ways. I decided I wanted to get back into contacts for the trip so i went to the optometrist and he fitted me with a new pair. However when i started wearing them it seemed different. I would get a tired, uncomfortable feeling in my eyes with them in and no matter what different brand he tried, it seemed like they all felt this way. I also noticed that there was some veins in my eyes that i didn't have before so i raised these concerns with him but he brushed it off and said "maybe its dry eye". He then tried me in a different pair of contacts. So at that point i quit contacts for good because I thought there was something more to this. So i went to the ophthalmologist i saw when i got my ulcer and he diagnosed me with dry eye. He gave me suggestions to use artificial tears and also put me on the steroid FML.

So I left for the European backpack trip and was taking the FML drops 3x a day for 2 weeks. I was also using artificial tears a couple times a day and refresh pm at night. To be honest, I think this is when my eyes really took a turn for the worse. Before the fml and artificial tears i didn't even notice that my eyes were dry but while i was taking them it seemed like they got drier and also more veins started to grow in my eyes. I ended up going to two ophthalmologists while in europe who basically said i have dry eye and gave me more drops. One said the fml probably made my eyes worse.

So a month later im back and my eyes are at their absolute worse. My trip was basically ruined because i thought about my eyes all day 24/7. I was in a depressed mood and my anxiety levels were through the roof because my eyes had a tired, dry feeling all day. I went to several ophthalmologists before i finally found one that was atleast willing to help answer my questions and explain the reasoning behind doing stuff. We went through a kind of trial and error period over the summer. I used restasis, doxy, fish oil, warm compresses, plugs, and stopped using the refresh pm because of what i read on the site. I definitely wasn't using as many drops by the end of the summer and my eyes only occasionally had the tired, dry feeling.

So here i am today....5 months since finding out i had dry eye. I moved out to the east coast for school and left all my family/gf/support system behind. I thought i was ready for school/air conditioning, but i definitely wasn't. Orientation last week in a/c for 8-9 hours killed my eyes and i had to keep them closed most of the time despite putting an eye drop in every hour. I had been avoiding a/c all summer and babying my eyes so they would hopefully heal enough but apparently that didn't work. My mood has gone from good to kind of depressed over the past week. I have seriously considered dropping out of school these past few days and i don't know if i can manage the long hours of studying and the a/c. It gets me so frustrated to think that all my hard work over my life could go down the drain because of my stupid eyes being too dry.

So that is my (long) story. I still dont know the reason behind my dry eye despite seeing 7 different ophthalmologists. I felt the need to get that off my chest and was hoping for some words of advice/encouragement to help me get through this rough patch. I would also appreciate it if anyone would be willing to talk to me either through pm or on the phone just for those times when im feeling really low and need someone who understands how severe dry eye affects your life. Thanks for reading!

[snurre86]

Hello Gormz
Im sorry to hear your story, but were exactly in the same boat.. tomorrow i have the first day of my last year at university and then the eyes become worse than ever.. Im also really depressed about the situation.. But haven't the ophthalmologists gave you any kind of diagnose, like MGD or something? I try to think like this i have a lot of people in my surrounding that i share great moments with, and if i keep struggling and try to do the best of life it will come one day when the dry eyes can be cured and thats my story of whats drives me during this moment

//Snurre

[gormz]

Thanks for responding snurre. Ive gotten a range of diagnoses/reasons for my dry eye from all the different doctors ive seen. One said it was caused by contacts, one said i just had sensitive eyes, one thought i had blepharitis, one said the steroid drop i used caused it, and one said i had aqueous deficiency caused by some autoimmune problem. I tend to agree with the last one since autoimmune diseases somewhat run in my family although ive been tested for lupus, RA, thyroid issues, etc and haven't tested positive for any of them. Im also guessing if you have aqueous deficiency it can lead to blepharitis since there isn't adequate tears to wash away the bacteria that get into your eye.

I try to stay positive like you do but its just hard at times. Everyone around me has no idea how much dry eyes affects me. My gf/family just think its not that serious and i should just use some drops and get over it. I often think how its not fair that i can have eye problems at such a young age even though ive taken care of myself so well over the years. I always exercised, ate super healthy, and followed contact lens cleaning/wearing regimen. It also boggles my mind how the body can heal/overcome so many things such as having only one kidney, having only a lobe of a liver, heal a broken bone, etc but yet can't heal your eyes if theyre dry.

I digress though. I should count my blessings since i dont have serious pain associated with my dry eyes and my vision is still good enough where i can read/watch tv if i take breaks. I also, like you, believe ill be healed one day. Either through my body's natural healing process or some scientific breakthrough that will cure all of dry eye zone. Its just hard waiting for that moment when im so used to going to the doctor and being fine a week or two later.

[robster]

Have you had a Schimers test and a TBUT test? The Schimers test will tell you if you are producing enough tears and the TBUT(tear break up time) test will tell you how quickly your tears are evaporating. If your Schimers score is low then you have aqueous deficiency dry eye and if your TBUT score is low then you have evaporative dry eye (the most common type of dry eye). If you haven't had these tests done then I suggest you have them done as soon as you can. if you have had these tests done what were your scores on the respective tests?

[gormz]

I've had a schirmers test done 3 different times, all anesthetized. The first one i had done i think i got a 15 and a 13. I really felt the paper in my eyes though so im guessing a lot of that was reflex tears. Another time i got it done i had 0's in both eyes. I dont think she did it correctly though because if i had 0's in both eyes im pretty sure i wouldn't be able to see anything and would be in a lot more pain. The last time i got it done i had some wetting of the paper but she just told me it was low.

As far as TBUT goes, i dont think they've ever told me what my score was. I know theyve put fluorescein stain in my eye on numerous occasions and there is definitely some dry spots after looking at my eye through the slit lamp. I should ask for an actual number next time. The dr really doesn't think i have blepharitis/mgd though and when i do warm compresses i do get blurry vision from the oil being secreted. I only occasionally notice that one of my glands is blocked but it usually is unblocked after a day or two.

I think my dry eye is the aqueous deficient form, which probably leads to some blepharitis just due to lack of tears. They have said that my tear meniscus isn't as robust as it should be. Any suggestions as far as artificial tears that are best for this type? All the dr's ive went to basically just say to try them all until you find the one you like. You would think they could recommend a certain one that would help more for the aqueous deficient dry eye vs dry eye due to evaporation

[spmcc]

Hi gormz,

You have quite a history with this and have obviously done your homework! I'm sorry that you're suffering.

Here are a few of my suggestions:

1) to help yourself immediately, I would *run* to the store to get some moisture chamber glasses. These are essential to reduce pain quickly for both aqueous deficiency (AD) and/or MGD. They are also essential for environments with a/c, forced air heat, moving air, etc. Once you reduce your pain/discomfort, you'll feel calmer and will be able to work better at school AND at improving your eyes.

Check out Rebecca's guide to moisture chambers: http://www.dryeyezone.com/talk/showt...sture+chambers

Also you can read other threads (for e.g., http://www.dryeyezone.com/talk/showt...sture+chambers).

2) I've never worn contacts so I don't know much about this type of dry eye (IF your problem is caused by contacts). However, people have posted about things like GPC (Giant Papilliary Conjunctivitis) caused by contact lenses (and other things). I understand it can be missed by doctors. So, altho you've already seen a bunch of doctors, I still think it would be good for you to see more (!!) to try to get a real diagnosis. Rebecca wrote a helpful article on how to get a better diagnosis. It can be accessed from the DEZ home page (http://www.dryeyezone.com/ - just scroll down almost halfway).

Rebecca also has a list of questions to ask a doctor at every appointment. They're comprehensive and, I think, will help get to the heart of the problem. Here they are:

1) How is my tear quantity?
2) Do you see any dry spots?
3) Can you check for staining?
4) Can you press on my meibomian (oil) glands? Are they releasing oil? Is the oil clear and flowing freely? If not, what does it look like?
5) Do you see any signs of allergies?
6) Do you see any lid closure problems? (I added in this one)

3) Finally, the universities that I've attended have had good on-campus doctors, so if you have access to this, I would make sure to be in touch with them. Perhaps get some blood tests for thyroid, autoimmune and other potential systemic problems just to rule them out. Make sure you're being assessed and followed *regularly*. They might be great help to you (e.g., refer you to others) esp at a time when you might consider leaving school because of your eyes.

Wishing you all the best,
Sheila

[gormz]

Hey Sheila.

Thanks for all your suggestions and for reading my story! I do have a pair of liberty motorcycle sunglasses that i wear out all the time and, while not perfect, they do seem to make going outside in the wind/elements more tolerable. I also have a pair of chem goggles that i wear at home sometimes. I guess i should try to wear them more often even if my eyes aren't feeling that bad. Im still a bit apprehensive about wearing moisture chamber goggles at school though. I was hoping i could get by with just doing drops so i dont look extremely out of place although judging from last week im not sure. I did have some punctal plugs reinserted last week friday so maybe that will help next week in class.

I will ask the ophthalmologist next time about GPC. From my understanding though it usually resolves once the contact lens user has quit wearing contacts for a few weeks. I also had a dose of steroids right when i got diagnosed with dry eyes which would have helped the GPC resolve if i had/have it. You never know though...it could just be a recalcitrant case of GPC.

Great suggestion about the doctors. As far as other blood tests go. I have been tested for lupus, RA, and thyroid issues. None of them came back with anything out of the ordinary. Im almost positive i dont have sjogrens because i dont have salivary insufficiency and im still able to produce reflex tears. I was also allergy tested by a dermatologist with the basic allergens...the only thing im allergic to is dust mites. I have also asked a dr about lagophthalmos and she didn't think i had it.

Any idea if dust mites can cause dry eye? The dermatologist i asked said it most likely wouldnt cause any ocular discomfort. Also any other systemic causes that could possible cause dry eyes that i should get checked for?

Thanks again for your help

[spmcc]

Hi again gormz,

I PMd you (look at the top right of your screen for "Notifications").

Cheers,
Sheila

[daphane]

I understand totally I was in school and still am finishing up. I could not read books, could not focuse that long, eyes would hurt. I just listened in lecture and also taped it and listened over and over again-always asking many questions so I would not have to look things up. My daughter was a big help because she would read to me. OMG and the nclex and things like that on computer was crazy thank GOD I passed it after only 85 questions I was going nuts because of air. I did find out if you just talk to people (instructors and so on) they will help you. Mine instructor let me wear my sunglasses in class (at that time thats all I had) and always had to find right seat so I could not feel the air from vents, classmates were very nice even though I had to help them with studies and they would help me with my eyes. They would tape lecture for me if I was to bad with eyes. It was hard so I wish you the best of luck, just keep trying if it is something you really want to do. I also would save my eyes for the things that I needed to do. I dont watch tv and only on computer for this site and school when necessary. Maybe you can find someone that will help you in the really hard times. I learned that you have to give a lot sometimes to receive a little but it worked for me and hopefully you can find something

[gormz]

Thanks for sharing Daphane. It is something i really want to do. I talked to my advisor (who is also the director of the program) about this and he was very helpful. Im going to look into taping the lecture and i might start wearing my motorcycle glasses in class. Im still nervous about wearing those but i know it would help me with the a/c. Im also debating taking a medical leave of absence for a year to see if my eyes will get better in that time. I guess i just have to feel out my options first and see what one is the most pragmatic.

[sazy123]

I try to stay positive like you do but its just hard at times. Everyone around me has no idea how much dry eyes affects me. My gf/family just think its not that serious and i should just use some drops and get over it. I often think how its not fair that i can have eye problems at such a young age even though ive taken care of myself so well over the years. I always exercised, ate super healthy, and followed contact lens cleaning/wearing regimen. It also boggles my mind how the body can heal/overcome so many things such as having only one kidney, having only a lobe of a liver, heal a broken bone, etc but yet can't heal your eyes if theyre dry.

I digress though. I should count my blessings since i dont have serious pain associated with my dry eyes and my vision is still good enough where i can read/watch tv if i take breaks. I also, like you, believe ill be healed one day. Either through my body's natural healing process or some scientific breakthrough that will cure all of dry eye zone. Its just hard waiting for that moment when im so used to going to the doctor and being fine a week or two later.

Yep exactly!! it boggles the mind! it does.

I was super healthy before dry eye, I had no other issues, i ate decent, im not overweight, i used to do alot of exercise when i was younger. All i did wrong was wear contacts and go on anti depressents, and dam SEVERE DRY EYE that doesnt get better. Dry eye just has a mind of its own.

[sazy123]

If an allergy is bad enough- it could deffo cause dry eye. I would try to eliminate dust mites from your room and see what happens. Air purifyer, dust mite covers etc. You never know.

Dry eye is strange, you never have a problem with allergies then something happens such as your ulcer and all of a sudden we are looking for allergies else where that didnt bother us before. Thats what i have a hard time understanding. when Doc say it looks like allergies.

[Katewest]

Hi gormz,
I am a school counselor and love my job but am ready to quit because of the ac making my eyes so much worse. On the bright side though you are catching this early. It took me years for doctors to rule out allergies. And the east coast has humidity! Sometimes I think we obsess about them too. Like mine are never as bad when I'm home or busy on the weekend. However as soon as I go in the office I'm so self conscience of my eyes. From my experience I would say keep going to different ophthalmologists until you find relief. Right now I just finished my first IPL treatment in las Vegas.

[heyjude0701]

Gormz, I sympathize with your DES problems, and I hope that you can find relief, and also that you have a lot of patience until you find what helps you most. Other people have responded to you with excellent suggestions, and you have done much research too; there is only one suggestion I can add. Make sure the lenses in the motorcycle glasses or other sunglasses you are wearing are polarized. I went through two pairs of motorcycle glasses that only helped a little before I discovered that polarized lenses are much, much more helpful. I've been wearing 7eye Panoptx polarized moisture chamber sunglasses indoors and outdoors for the past couple of months and that has helped me to cope. One other suggestion, if you do reading on the computer, the f.lux program is extremely helpful in taking away the glare on the computer screen; it makes the colors on the screen much gentler on your eyes, yet preserves enough contrast so you can see clearly.

[gormz]

Hi gormz,
I am a school counselor and love my job but am ready to quit because of the ac making my eyes so much worse. On the bright side though you are catching this early. It took me years for doctors to rule out allergies. And the east coast has humidity! Sometimes I think we obsess about them too. Like mine are never as bad when I'm home or busy on the weekend. However as soon as I go in the office I'm so self conscience of my eyes. From my experience I would say keep going to different ophthalmologists until you find relief. Right now I just finished my first IPL treatment in las Vegas.

Yeah the east coast definitely has some nice humidity. I also agree with you on the obsessing about it part. I am not that bad at home but outside of it my eyes seem instantly worse. I think my next step is trying a new diet. It is something that i think most people overlook but it is key to a healthy functioning immune system. I would guess that the inflammation from my dry eye is somehow related to that.