Background: LASIK in 2013, immediately had severe DE. My haunch is that I've always had subclinical MGD that became apparent after I became aqueous deficient post-LASIK. After trying almost every drop known to mankind (Restasis, serum tears, etc) and scleral lenses (by Dr. G, which I couldn't tolerate due to sensation and cloudy debris after few hours of wear), I've somehow managed to get by and slowly improve to the point where I can just get by on a good day with little pain. For the past 4 years, I have been able to survive with bilateral lower punctal plugs and no drops. By God's grace, I was able to successfully graduate from medical school even though there were many days where I thought I would have to drop out and be on disability.
1.5 months ago, my eyes became dryer and more inflamed. My flare ups would usually only last a few days and there was usually an obvious culprit, e.g. new face wash, makeup, etc. This time, there was no obvious cause, but I did start a new job (started medical residency, working 40-60 hours/wk, increased stress, decreased sleep, drafty hospitals). I've never had a flare up last this long. I'm in constant pain (burning, soreness) and my eyes are red. I feel like all the improvement I made over the past 5 years has been erased
Of course, the emotional suffering and depression directly caused by DES is making everything worse. Before LASIK, I was a very positive/compassionate person who was very ambitious and hardworking. Now, I'm the exact opposite. I hate being a physician where I have to put on a caring face 24/7 for patients when I am distracted with 10/10 pain myself and just wanna cry. I sleep 12+ hours a day when I can to forget about everything, and I'm anxious for the future. I feel terribly sorry toward my husband and family who have to deal with this version of myself. I hate that I did this to myself by getting an elective surgery. Yes, I probably should be on a SSRI, but unfortunately, 'mental illness' is a big no-no in my line of work and could jeopardize my job.
Today, I saw the optometrist who ruled out corneal abrasion, keratitis, or infection as cause for my flare up. She found that my TBUT was nonexistent, and I had maybe 1 working oil gland in each eye. She said my predominant problem was MGD, and that lipiflow would be helpful. Thankfully, my insurance covers it, but there's a 2+ month waitlist. I am still going to try it because it's free, but I know that many here have not found it helpful. She also said that I should get refitted for scleral lenses since that's about my only option right now for regaining some semblance of normalcy. I am not a good candidate for Xiidra because my type of DE is not inflammatory/autoimmune.
In the mean time, I am going to start Manuka honey on my lid margins (stings like a ***** and causes redness, but worth continuing for now) twice daily, accupuncture, fish oil 3g/daily, eliminate all inflammatory food from diet including gluten, and use lacriserts to get through the work day.
Like it is for many here, this forum is about my only outlet. I wanted to chronicle and share my experiences, and hopefully we can all gain a little something to get through these trials.
1.5 months ago, my eyes became dryer and more inflamed. My flare ups would usually only last a few days and there was usually an obvious culprit, e.g. new face wash, makeup, etc. This time, there was no obvious cause, but I did start a new job (started medical residency, working 40-60 hours/wk, increased stress, decreased sleep, drafty hospitals). I've never had a flare up last this long. I'm in constant pain (burning, soreness) and my eyes are red. I feel like all the improvement I made over the past 5 years has been erased
Of course, the emotional suffering and depression directly caused by DES is making everything worse. Before LASIK, I was a very positive/compassionate person who was very ambitious and hardworking. Now, I'm the exact opposite. I hate being a physician where I have to put on a caring face 24/7 for patients when I am distracted with 10/10 pain myself and just wanna cry. I sleep 12+ hours a day when I can to forget about everything, and I'm anxious for the future. I feel terribly sorry toward my husband and family who have to deal with this version of myself. I hate that I did this to myself by getting an elective surgery. Yes, I probably should be on a SSRI, but unfortunately, 'mental illness' is a big no-no in my line of work and could jeopardize my job.
Today, I saw the optometrist who ruled out corneal abrasion, keratitis, or infection as cause for my flare up. She found that my TBUT was nonexistent, and I had maybe 1 working oil gland in each eye. She said my predominant problem was MGD, and that lipiflow would be helpful. Thankfully, my insurance covers it, but there's a 2+ month waitlist. I am still going to try it because it's free, but I know that many here have not found it helpful. She also said that I should get refitted for scleral lenses since that's about my only option right now for regaining some semblance of normalcy. I am not a good candidate for Xiidra because my type of DE is not inflammatory/autoimmune.
In the mean time, I am going to start Manuka honey on my lid margins (stings like a ***** and causes redness, but worth continuing for now) twice daily, accupuncture, fish oil 3g/daily, eliminate all inflammatory food from diet including gluten, and use lacriserts to get through the work day.
Like it is for many here, this forum is about my only outlet. I wanted to chronicle and share my experiences, and hopefully we can all gain a little something to get through these trials.
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