Blinking pain misery - please help

[Guest]

Thank you for sharing your story! I am sure you will be able to get of Xanax because although it is a physical/psychological issue, dependency is still something you can eventually control. I don't think you can go cold turkey so be careful.

I was on Ativan for a few months to control panic attacks thanks to my dry eye and tinnitus. I think these drugs are invaluable when you are losing your mind and becoming suicidal. Antidepressants really messed me up (tried them for two weeks in a row, plus a few trials here and there). I found benzos better because I only used them when I needed them.

I can't agree more on the last ideas...about benzodiazepines being better than the antidepressants . They have their drawback of course, for me it's the horrible rebound I get when I don't take my xanax. I cry, I panic, I pace around feeling horrible because I'm physically dependent at this point. However, had I not had them, I may very well not be writing this right now. It was what I personally needed. You're also correct, you have to taper xanax slowly to avoid a seizure.

I know I can quit taking xanax, it's like anything if you taper, as you go down you NEVER go back up. It's not fun but it can be done with diligence. The reason I seemed unsure, is because I think I may genuinely need it, or maybe something weaker like klonipin or Ativan to just stabilize my anxiety. I'd prefer that over lamictal lol.

[MGD1701]

Hi Hopeful_hiker

Just found this. Perhaps it helps?
Filamentary Keratitis

Slit lamp examination
reveals filaments (‘mucoepithelioid” strands) adherent to the corneal surface. The filaments can vary from 0.5mm to 10mm in length. A gray colored subepithelial opacity can sometimes be seen at the base of the filament. Blinking causes painful traction on the filaments and may detach them, leaving behind an epithelial defect. Filaments stain best with rose Bengal, but can be seen with fluorescein as well. The location of the filaments can help determine the underlying cause. Filaments due to dry eye syndromes tend to be found in the interpalpebral space, those due to ptosis superiorly, and those due to surgery at the site of the wound or surgical trauma


Pathophysiology
It is hypothesized that the initial step in the development of filamentary keratitis is damage to basal epithelial cells, epithelial basement membrane, or Bowman’s layer leading to focal detachments of the epithelial basement membrane. Blinking causes these areas of detachment to become elevated leading to irritation, inflammation, and increased mucus production. The sites of epithelial damage provide the scaffold for filaments to develop. A postmortem analysis of a cornea in a patient with this condition revealed inflammatory cells and fibroblasts just beneath the basal epithelium.

General Pathology
In filamentary keratitis, there is often an increase in the tear film mucus to aqueous ratio. This is commonly due to a decrease in aqueous tear production, but may also be due to increased production or accumulation of the mucinous component. This alteration in tear film makeup sets the stage for formation of mucoid filaments. Small defects in the corneal epithelium provide an anchoring surface for the filaments. Mucin attaches to the epithelial defect and loose epithelial strands are incorporated into the mucin strand attached to the surface. Filaments may be small sessile adhesions or longer strings that cause irritation and discomfort.

Risk Factors


Any alteration of the tear film or corneal surface can increase the risk for filamentary keratitis.

Common risk factors include:

• Aqueous tear deficiency as in keratoconjunctivitis sicca
• Corneal exposure (e.g. seventh nerve palsy)
• Occlusion abnormalities such as blepharoptosis
• Ocular surgery (e.g. keratoplasty)
• Systemic diseases with effects on the ocular surface (e.g. Sjogren’s syndrome)
• Extended use of anticholinergic medications
• Other ocular surface abnormalities.

full text http://eyewiki.aao.org/Filamentary_Keratitis -------------------------------
this is more update (with a case), as of April 20, 2018
Treating inflammation tackles filamentary keratitis


http://www.optometrytimes.com/dry-ey...tary-keratitis

[hopeful_hiker]

MGD1701, thank you for taking the time to post this! I don’t have this issue but it is good to raise awareness about this complication.

A bit of an update:
I was in a lot of distress and went to the optometrist. My tear meniscus height was low that day - 0.15mm. A week before that it was 0.45mm. Crazy how it fluctuates!

I got lower punctual plugs and they took the edge off the pain. I also got a second opinion that day. The second optometrist said that my signs a better than my symptoms. I suspect I may have corneal neuropathy, perhaps, a mild case.

Also, I think that my eyelid anatomy contributes to my pain. Doctors always have issues flipping my upper eyelid due to its tightness. I imagine that a tight eyelid combined with a moderate dry make the symptoms worse especially on my aqueous deficient days.

I researched all all of the posts mentioning blinking on this website (around 30 pages). I found 3-4 posts that related to blinking pain and some of them came from LASIK patients. The majority of posts focus on blinking exercises or mention blinking as a temporary solution to discomfort. In other words, people blink a lot because they feel dryness or irritattation and blinking makes them feel better. My case is somewhat unique, unfortunately.

[hopeful_hiker]

Updated the main post.

[MGD1701]

Thanks for the update.

[Guest]

Thank you for sharing your story! I am sure you will be able to get of Xanax because although it is a physical/psychological issue, dependency is still something you can eventually control. I don't think you can go cold turkey so be careful.

I was on Ativan for a few months to control panic attacks thanks to my dry eye and tinnitus. I think these drugs are invaluable when you are losing your mind and becoming suicidal. Antidepressants really messed me up (tried them for two weeks in a row, plus a few trials here and there). I found benzos better because I only used them when I needed them.

I was just reading through your thread again and wanted to update my progress on my mental state.

Started feeling better so i so I pulled the xanax 30% and oh my god...tinnitus out of control, bp was 190/100, felt like I was going to die. Stabilized at that dose 3mg then started dropping .25mg a week which is actually considered fast but I did it. I went from 3mg to 1.75 in a month so I exceeded my goal. So now I'm here this month doing 10% drops, my last one was rough...it's only going to get harder.

I agree with you, I chose xanax because antidepressants really mess me up. However, I had no clue how addictive xanax was. This is like heroin withdrawal. I will NOT give up...but I have a long road ahead. I though my eyes were an issue...this is equally as hard, just different. I just want my life and personality back.

Hope youre doing well!

[farmgirl]

I just read about Xanax addiction OMG who prescribes this stuff. Hang in there and detox slowly so that you don't get rebound symptoms that make you go back to the drug. Don't be in too big a hurry that could backfire on you. My son is being weened off of prescription opioids which have really screwed up his life and the first thing the doc did was to move him over to Suboxone which is difficult to abuse. When he was stable on that for 2-3 months he started the taper at 20% every month, you shouldn't make the jumps too big and should give yourself time to adjust to the lowered dose.....just saying

[Guest]

I just read about Xanax addiction OMG who prescribes this stuff. Hang in there and detox slowly so that you don't get rebound symptoms that make you go back to the drug. Don't be in too big a hurry that could backfire on you. My son is being weened off of prescription opioids which have really screwed up his life and the first thing the doc did was to move him over to Suboxone which is difficult to abuse. When he was stable on that for 2-3 months he started the taper at 20% every month, you shouldn't make the jumps too big and should give yourself time to adjust to the lowered dose.....just saying

Oh trust me I learned from my first drop I did a 33% drop from 4.5mg to 3 and wow...I can't even explain the pain involved with that. But I stabilized there and started 10% cuts a week. I'm now at 1.625mg a day. I'm holding here because I'm going to visit a friend in Vegas.once I'm back though I'm cutting again and starting to get down more. You're right the key is going slow. You can literally cause brain damage or die if you go too fast.

Let me also say I was suicidal, I was very much ready to die when my eyes were were at their worst. So I don't know if it was the right decision, but at least I'm alive to deal with it. I'm sorry about your son. I took vicodin for my eyes for 5 months and came off in 14 days no problem. I was taking on some days my vicodin dose 60mg and a 40mg oxy the pain was so bad. I was lucky that opiates were easy for me to walk away from. Not the case for everyone. Hope he's doing well.

[farmgirl]

Apparently Oxy is easy compared to hydrocodine and fentanol, don't EVER go there his life has been HELL.

[MGD1701]

Hi hopful_hiker
Just found this vidro, Dr Toyos mentioned about blinking pain, something new which I have never heard of.
Seems Keratograph® 5M can detect such issue. His wife even mentioned a new drug to tackle this.
Do you think that CCH is your issue? Hope it helps.

''Listen as Dr. Rolando and Melissa Toyos describe how they utilize the Keratograph® 5M daily for dry eye diagnosis and management. Filmed at ESCRS 2018 in Vienna.'' Nov. 13 2018
https://www.youtube.com/watch?v=oBvHsivmPvE

[hopeful_hiker]

''Listen as Dr. Rolando and Melissa Toyos describe how they utilize the Keratograph® 5M daily for dry eye diagnosis and management. Filmed at ESCRS 2018 in Vienna.'' Nov. 13 2018
https://www.youtube.com/watch?v=oBvHsivmPvE

Thank you! I don’t have CCH or at least not to the extent they are talking about. I think it is something to do with the lid wiper maybe.

[Guest]

Thank you! I don’t have CCH or at least not to the extent they are talking about. I think it is something to do with the lid wiper maybe.

I know the cause of my blinking pain was the papilae and concretions that formed due to the FES. As the eyelid becomes less inflamed and those papilae slowly heal, my ability to fully blink has come back. I don’t feel all that pressure and paralyzarion in the eyelids. So it could be the lid wiper, it could be s lot of things. I hope you find the cause soon.

[MGD1701]

Dr Toyos' video

Sorry, hopeful_hiker,
I am still curoius so watch the video again, Dr Toyos actually meant conjuncativa issue NOT CCH (from 2:30)
Most people think it is LWE though.Curious to know the trigger too, please let us know if you find out the answer.

https://www.youtube.com/watch?v=oBvHsivmPvE

[Meibum Ian]

hopeful_hiker

Hi, Do you see any similarity with the blinking pain I describe in http://forum.dryeyezone.com/forum/dr...meibum-probing ?

[hopeful_hiker]

Meibum Ian hmmm, hard to tell. In my case it is like the upper lid edge (where I imagine lid wiper is located) hurts my eye but only when blinking. Closed eye is ok. But when I blink during flare ups my eyelid does not glide, it kind of drags and touches my eye too much. It is a searing sensation.