Back to Square One, 5 years post-LASIK

[Johno_87]

Hi hosanna, any update on your progress? Thinking of asking about Lipiflow at my next doctor's appointment.

Sorry for my ignorance, but can someone explain to me how Lasik can cause dry eye? What has it got to do with the glands?

Farmgirl nailed it as far as the nerves go...when they make the flap, the cut some nerves pretty deep. This disrupts the signal to your brain saying, hey I'm dry, send tears.

As as far as your meibomium glands...if you have MGD then the oil layer of your tear film is already altered in a negative way. You may be asymptomatic before lasik, never even felt dry eyes before lasik, but you had MGD. Then you damage the nerves in the cornea...so now you have an aqueous deficiency and even more atrophy of the meibomium gland. So the MGD you had that didn't bother you before, now rears its ugly head when you damage the cornea through lasik. I believe this is why my corneal abrasion was so bad, I had MGD, no one diagnosed it when I had the abrasion, so it didn't heal well because my tear film wasn't stable...then boom tipped me into the moderate to severe dry eye category.

That said, once the nerves heal, assuming they heal...and you get the MGD under control, you can get your life back for the most part I believe.

[farmgirl]

LASIK causes some nerves in the cornea to be cut, which reduces corneal sensitivity to some degree. In response, you eye may not sense the need for lubrication, causing your body to produce fewer tears, leading to dry eye syndrome. Dry eyes after LASIK can cause both discomfort and less than optimal visual outcomes. Usually the nerves regenerate and the symptoms go away, sadly sometimes they never do regenerate which can be devastating.

[jack1988]

Sorry for my ignorance, but can someone explain to me how Lasik can cause dry eye? What has it got to do with the glands?

[hosanna13]

yup, i am going to get scleral lenses to deal with the work environment.

[MGD1701]

Hi hosanna
Thanks for sharing.
So in the drafty, dry environment, we can only apply drops, wear wrapped around glasses, other alternatives??

[hosanna13]

Update: So I found out what was causing me to have painful, irritated eyes daily. It was a topical acne cream I had been using called Finacea. It was immediately obvious to me because it took about a month after I started using Finacea for my eyes to become affected, but within 2 days of stopping Finacea, I was back to baseline. Now I still continue to take fish oil/flaxseed oil and express my glands, but Maquibright made no difference after 2 months on it. It's still painful for me to be in drafty, dry environments, but I am relatively 'normal' at home.

[hosanna13]

3 weeks after Lipiflow update: Knock on wood, but my eyes feel better and better daily. I am continuing with daily fish oil, flaxseed oil and plenty of water. I also started taking LifeExtensions Maquibright supplement. There was actually a Japanese clinical study that showed significant improvement in tear production after 1 month, so I'm willing to try it. Costs about $13 on Amazon for a month supply.

[hosanna13]

I bought this one on ebay for around $50, 3x4mm paddle size. They work well for expression and I do it every other night. I think it helps to keep the glands unplugged. Sorry, fish oil and flaxseed just have omega 3 and 6. http://www.ebay.com/itm/like/182635570625

[MGD1701]

Hi hosanna
Thanks for sharing great news! You are lucky to find relief so fast!!

Expression: What kind of the actual medical tool you use, particular brand name? how long and often you do it?
If there is a similiar one at YouTube, what could be great. Thanks!

Omega 9: what would that help?

[deep_dry_eye]

In the last week, I have been taking 1g fish oil three times daily, 0.5 tbs flaxseed oil, green tea with lemon. All the studies say that it takes months for omega3/6/9 to help MGD, so I doubt the oil supplements are doing anything yet. Since lipiflow, I see more oil coming out of my glands with expression after hot compress (I use the actual medical tool, not Q tips). I hope to get lipiflow as a maintenance therapy at least every 3 months since it's covered at my hospital for free.

wow! which country/hospital are you from/goto?

[hosanna13]

I forgot, I also took a Z-pak, or 5 day course of azithromycin. 1st day is 500 mg, days 2-5 are 250 mg. I started it 2 day before lipiflow.

[hosanna13]

In the last week, I have been taking 1g fish oil three times daily, 0.5 tbs flaxseed oil, green tea with lemon. All the studies say that it takes months for omega3/6/9 to help MGD, so I doubt the oil supplements are doing anything yet. Since lipiflow, I see more oil coming out of my glands with expression after hot compress (I use the actual medical tool, not Q tips). I hope to get lipiflow as a maintenance therapy at least every 3 months since it's covered at my hospital for free.

[Hokucat]

Thanks for the update, hosanna. So Lipiflow and Azasite are the only treatments/changes you have made in the last few weeks? Did you take any other meds or make any diet changes?

I hope you continue to feel even better!

[hosanna13]

1 week update after Lipiflow:
Finger crossed, but my eyes feel much better now. Almost back to "normal" on some days. Of course I still can't sit in front of a fan, but my eyes are not as painfully dry. I tried Azasite on eyelid margins for a few nights after Lipiflow, but couldn't tolerate the dryness and pain the day after. My eyes feel better without Azasite.