My PRK induced DE journey

[mydryeyez2014]

I just got through reading Ian's (prattstar) post-LASEK experience and it gives me some renewed optimism and hope. I am 10 months post-PRK and going through the same mental anguish that he experienced at this phase of his recovery: depression, anxiety, and obsessing over the DE. I made my decision to have laser eye surgery after years of uncomfortable contact lens wear and eventual contact lens intolerance. The purpose of the PRK surgery, like most people, was to free myself of my glasses so I could live a more active lifestyle (hiking, camping, exercising, martial arts, etc.) without the burden of glasses. Had I known that I would end-up substituting the inconvenience of glasses for constant eye drops and irritation, I would have never gone through with it.

I want to start this thread to chronicle my journey towards managing my DE and hopefully provide some helpful information to anyone else who is going through this mess. I already posted the background information in my introductory post (http://www.dryeyezone.com/talk/showt...047-Struggling) so I will pick up from there. I will post results of my doctor visits and any significant changes (good or bad) to the thread. Unlike Ian, I don't expect a full recovery since I already had been diagnosed with MGD prior to surgery (thanks doc for recommending me for surgery anyway) but I never had the symptoms of DE prior to surgery. Without recapping too much, my current DE symptoms are as follows: occasional sticking eye lids in the morning, burning eyes during the day (much worse at night), and intermittent pain in the right eye. I also have a PVD that gives me an opaque string in my vision under certain light conditions, which was likely caused by my excessive eye rubbing due to the DE.

I have a scheduled appointment with my primary optometrist in December for my 1 year post-PRK check-up, but I am planning on seeing another ophthalmologist before then based on positive reviews I read on DEZ. My last appointment was this past Thursday at a highly regarded dry eye clinic in MD. The doctor there was very dismissive of my concerns. I brought a list of questions with me to the appointment and before I could get through all of them, she said to me, "This is your last question". I'm hoping that I will have better luck with another doctor.

Thanks to everyone on this board who risks drying out their eyes even further by reading these posts to provide positive feedback and words of encouragement. As anyone on this board knows, this whole ordeal has flipped my world upside down.

[zoso967]

I may be able to answer some questions for you

I just got through reading Ian's (prattstar) post-LASEK experience and it gives me some renewed optimism and hope. I am 10 months post-PRK and going through the same mental anguish that he experienced at this phase of his recovery: depression, anxiety, and obsessing over the DE. I made my decision to have laser eye surgery after years of uncomfortable contact lens wear and eventual contact lens intolerance. The purpose of the PRK surgery, like most people, was to free myself of my glasses so I could live a more active lifestyle (hiking, camping, exercising, martial arts, etc.) without the burden of glasses. Had I known that I would end-up substituting the inconvenience of glasses for constant eye drops and irritation, I would have never gone through with it.

I want to start this thread to chronicle my journey towards managing my DE and hopefully provide some helpful information to anyone else who is going through this mess. I already posted the background information in my introductory post (http://www.dryeyezone.com/talk/showt...047-Struggling) so I will pick up from there. I will post results of my doctor visits and any significant changes (good or bad) to the thread. Unlike Ian, I don't expect a full recovery since I already had been diagnosed with MGD prior to surgery (thanks doc for recommending me for surgery anyway) but I never had the symptoms of DE prior to surgery. Without recapping too much, my current DE symptoms are as follows: occasional sticking eye lids in the morning, burning eyes during the day (much worse at night), and intermittent pain in the right eye. I also have a PVD that gives me an opaque string in my vision under certain light conditions, which was likely caused by my excessive eye rubbing due to the DE.

I have a scheduled appointment with my primary optometrist in December for my 1 year post-PRK check-up, but I am planning on seeing another ophthalmologist before then based on positive reviews I read on DEZ. My last appointment was this past Thursday at a highly regarded dry eye clinic in MD. The doctor there was very dismissive of my concerns. I brought a list of questions with me to the appointment and before I could get through all of them, she said to me, "This is your last question". I'm hoping that I will have better luck with another doctor.

Thanks to everyone on this board who risks drying out their eyes even further by reading these posts to provide positive feedback and words of encouragement. As anyone on this board knows, this whole ordeal has flipped my world upside down.

Hi, I am 9 years post lasik and while our surgeries were somewhat different the manifestation of our dry eyes seems to be the same. Maybe I can help you avoid some of the mistakes I've made and help you better understand what's happening with your eyes. Feel free to ask me all the questions you have.

[mydryeyez2014]

Hi, I am 9 years post lasik and while our surgeries were somewhat different the manifestation of our dry eyes seems to be the same. Maybe I can help you avoid some of the mistakes I've made and help you better understand what's happening with your eyes. Feel free to ask me all the questions you have.

Thank you for the offer to help, I sent you an email so we can discuss.

[mydryeyez2014]

Had a visit with a local ophthalmologist on Friday to discuss my DE and the floater in my vision. The doc confirmed that I have MGD. Encouragingly, he said that he is able to see a "good number" of the glands still producing oil, though not a lot of secretion out of them. I told him about the Accutane usage as a teenager and he was aware of the possible link between it and MGD. He recommended the usual MGD treatment of warm compress, lid massage, and omega-3. He also encouraged me to continue with the Restasis and told me it can take up to 6 months to see the full effects. He also told me to avoid drops with preservatives as he could see evidence of irritation underneath my lids.

As for the floater in my vision, the doc didn't see any retinal tears but recommended I come back in a week for a follow-up. It has been a month since I first noticed it, so I should be nearing the all-clear point. He said that it should become less noticeable as time goes on. I've been told that can be a result of the floater itself getting partially broken down and absorbed by the vitreous fluid, falling outside of the field of view, or the brain learning to ignore it.

My DE has improved significantly since my flare up several weeks ago. I attribute this mostly to the lower plugs that I had put in. The day after getting the plugs I noticed a big improvement. I have also decided to go back to my old routine of daily omega-3, warm compress, gel at night, drops as-needed, and getting back on Restasis. I've noticed that my near vision using the computer has become a lot crisper since I started this. I'm still hoping that one day I can ease-up on the amount of effort I have to put into treating my DE but for now my eyes feel better than have during the entire 10 month ordeal. The true test will be in couple of months when the cool dry air returns and humidity levels drop.

Next scheduled update will be in December for my 1 year post-PRK check-up.

[mydryeyez2014]

Had my one year post-PRK anniversary appointment last week and wanted to quickly post an update for anyone who has read my earlier posts and is curious how things are progressing. I'm trying not to obsess over my dry eyes and just go back to living the way things were before the surgery. While reading and posting occasional updates on DEZ is therapeutic for me, checking DEZ daily and reading articles about dry eye treatments seems to only add to my anxiety levels. With that in mind, I probably won't post anything additional to this thread unless there is a significant change in my condition.

Since having the punctal plugs put-in and starting back on the Restasis my eyes have felt the closest to the way they were pre-surgery since starting this whole ordeal. I still have some issues with dry eyes, especially later in the day after staring at a computer screen for 8 hours, but I am able to go most days without needing re-wetting drops. I have also not had any morning eye sticking experiences in a few months. My current treatment regimen is as follows:

-Restasis drops morning and night
-1000mg fish oil daily
-Warm compress at night
-Refresh Optive Advanced drops at night before bed

I'm not sure how much of the improvement is a result of the above and how much, if any, is a result of residual healing after the surgery but either way I'm doing better. I read The Dry Eye Remedy and the author said it can take years for the nerves to fully heal following surgery, so there still might be room for improvement. Regardless, I'm thankful that I am no longer suffering so miserably.

For anyone reading this that is in the same dark place I was at a few months back just realize that things can and will get better over time. It also helps to keep things in perspective and realize that dry eye, floaters, or whatever ails you is not worth getting anxious and depressed over. Letting this condition get you down like that is taking away precious moments of your life and we never get those back, so there's no use in obsessing over it. Come up with a treatment regimen that works the best for you and move on with life. Best of luck to all DE suffers out there and may you all find peace and happiness in the new year!