Hello, it's me.

[David Matthews]

Hi, everyone. My name is David Matthews from Little Rock.

My story began about two and a half years ago when I underwent PRK surgery. The surgery went fine although I went through what I have researched as a very painful and long recovery.

Ever since, I have suffered debilitating severe dry eye at night only.

My typical night’s sleep involves using GenTeal Severe eye gel in the tube before I go to sleep. The “oil” based ointments never worked very well for me. Much to my chagrin and dismay, they stopped making the gel last year—something about production problems. I was overjoyed to find it restocked in the stores about three months ago. I bought about 20 tubes just in case. I think the clerk thought I was nuts!

Back to my nights: I, as about everyone else, wake up about three to four times during the night. Only when I wake up, if I don’t’ follow my “procedure,” I will experience searing pain for at least 30 minutes. I have “trained” my unconscious mind to not open my eyes from sleep until I apply drops (I have found Soothe to work well) in the closed corners of my eyes and “milk” the liquid under my eyes with eyelid pulsing. Sometimes, of course, during REM sleep or awakening from a particularly vivid dreams, the “ripping” occurs. When I move or open my eyes the lids somehow stick to my corneas and rip the top layer of my already overly-sensitive eyes. I must endure the pain and go back to sleep. Thankfully, most times, the pain is gone when I awake. But other times, the pain lasts for at least two days or so in a particularly severe event.

Thank God I don’t experience any symptoms during the day as I have read—I might have to shoot my self in the head.

My doctor has prescribed Restasis and inserted temporary lower punctal plugs which I have been on for five days. It says wait a month or two. I have high hopes this will work.

This has been a complete nightmare for me. If I had it to do all over again I would absolutely NOT choose to have PRK.

I must retain hope or I will loose all sanity.

By the way, Merry Christmas everyone. It is the season for hope.

Regards,

David

[20/20_Hindsight]

HI David and welcome!

I am sorry to hear of your night time troubles. Sounds like recurrent corneal erosions. I suffer them also, after Lasik surgery over 5 years ago. They are miserable and that is all I can say. I've been told they can do micropuncture or PTK to the surface to aid in this problem. I won't do it though due to an autoimmune disorder, which could cause more healing problems than I already have. I can sympathize with you as unfortunately I know just how painful these episodes are.

[jcorbett]

The drops sold on this website...Dwelle, in particular....are quite good. I know several people have posted about how after using these drops for a while, the erosions have gone away.
Hang in there with the restasis. It can take a long time to work. Are you keeping your eyes super-lubricated during the day, even though they don't feel dry? Or perhaps installing drops several times in the evening before going to bed. I find that although my eyes are OK in the evening, if I put drops in several times in the evening before bed, it helps the night time dryness.
Let us know how your plugs do. Can you tell a difference during the day with the plugs?

[jcorbett]

One other thing... have you tried warm compreses before bed? To get the oil in your eyes flowing. This also helped me when my eyes were at their worst.

[shells]

Hi David,

I'm so sorry to hear of your troubles. I also use the GenTeal Gel at night and do the warm compresses before bed as jcorbett mentioned. I wanted to mention one thing about nighttime. Do you know if you keep your eyes slightly open when you sleep? I think that some people on these boards tape their eyes closed before bed in order to keep the moisture in. I've also read of people sleeping with moisture chamber googles. My dry eye problems are mostly during the day, but just to keep my eyes extra protected at night, I wear a sleep mask over them. It seems to help now that it is the winter and the heat is on. Anyway, I guess you may have already tried all these things, but just incase, I thought I would mention it. I am also on Restasis and started about 6 weeks ago. I haven't seen any results yet, but am still hopeful. I hope that it works for you as well.

Michelle

[DrG]

It does sound like David suffers from recurrent corneal erosion. Ironically, surface ablation is considered a treatment for recurrent corneal erosion that is secondary to EBMD, or epithelial basement membrane dystrophy. Nevertheless, at least one study indicates that painful overnight eye incidents are more frequent following both PRK and LASIK. Other treatments include diamond keratectomy, or stromal puncture with a needle, but only if the erosion is NOT located in the visual axis.

Palliative preventive treatments include ointments at night. One ointment, Muro 128 is specifically for RCE. It is 5% sodium chloride in a light petrolatum ointment. I have prescribed it on numerous occasions over many years with good results. Ceiling fans are to be avoided at night.

DrG

[Delilah]

Question for Dr. G

Dr. G hello its Delilah from Idaho and I was wondering if the Muro-128 ointment would help with these strings and severe dry eye I have been suffereing with for 3 years now? Well next year will make it 3 years, I've tried the Muro drops but they burn like hell and I also wanted to know what RCE is? Im still on the Restasis but I still have dry eye and these strings coming out of my eyes. Is there any hope for me at all? What do you think is causing these stringy mucus things to be coming out from my eyes day and night? Then when I wake up in the morning I have to hurry to the bathroom and rinse my eyes out and put saline drops in because they are so dry the eye lid feels as if its stuck to my eye ball. Well I'll quit for now, hope you had a good Christmas and Happy New year as well. Ciao Delilah

[DrG]

Delilah,

I might cautiously try the Refresh PM at night, and not the Muro 128. The salt content can be a bit irritating. RCE is the abbreviation for recurrent corneal erosion. Regarding mucus strings per se, about the only treatment for that is topical acetylcysteine, or Mucomyst.

Perhaps the Refresh PM will enable you to open your eyes less painfully in the morning, while the topical acetylcysteine will act to thin the mucus.

DrG
www.leukoma.com

[calli66]

Reply to Delilah

I know you have tried everything for the mucous strings. I had them really bad when I tried Restasis for 2 months--and they continued afterward, too. I have been using Soothe eyedrops for about 3 weeks--the ones with the micro-oils---and suddenly now, I hardly have any mucous strings. I don't know if it's the Soothe, or the TheraTear Vitamin supplements, or the massive quantities of Genteal Gel I'm using at night, or the hot compresses, but maybe it's the Soothe drops. I use them once in the morning after I wake up and wash my face, and then again several times in the evening after I take my contacts out. They burn a little bit (a few seconds).

C66

[DrG]

The idea is to emulsify, or thin the mucus. Perhaps the lipid in the Soothe has a polar molecule to help emulsify the mucus. Worth a shot, I guess, since its over-the-counter. But most ophthalmic texts, even the old ones, mention acetylcysteine topically as a treatment for the mucus filaments of filamentary keratitis.

[Delilah]

Thank-you Dr. G and Calli

I will try all of it, once again thank-you for your advice. Also a question to Calli, did the mucus strings in your eyes just start out of the blue like mine did and did they even get in the way as you were driving? I am so sick of them and sick of suffering from this disorder and this dry eye makes you want to die!!! But again thank-you Delilah

[Missy]

Can dry eye cause RCE or are they usually caused by an injury? I worry b/c my eyes get dry at night and I don't want to get an erosion.

Missy

[Lucy]

Can dry eye cause RCE or are they usually caused by an injury? I worry b/c my eyes get dry at night and I don't want to get an erosion.

Missy, dry eye is a major cause of RCE (recurring corneal erosion). It can also be caused by an accident. Once I accidentally jabbed my eye with my fingernail while inserting drops. That caused an erosion.

An erosion is usually not any big deal. They are painful, or at the very least irritating. It's a feeling of havind sand in your eye. You may have had erosions and not even known it. Of course, one has to use their intuition and seek medical help if it's something serious.

[calli66]

For D--mucous strings

From the way you describe yours--I don't think mine are as bad. I had them off and on for years when I wore Acuvue contacts. I was alway dragging mucous globs out of the corners of my eyes, but at that time I just accepted it because my eyes weren't so dry. It was this summer when I tried Restasis that the strings got really bad. Yes, they sometime slide over my cornea and just hang out there impeding vision and irritating like heck.

C

[Delilah]

Calli

Thank-you for replying so fast, man these stupid strings are horrible aren't they? I read what Dr. G said about filamentary keratitis and looked it up on the net and was so relieved when I finally found the exact definition to what I have, not too mention along with the MGD and the Lattice Degeneration and the severe dry eye. So are your eyes doing good now? Sounds like they are, Im gonna try to find a compound pharmacy to make me some of those drops and try everything you said too. Once again thank-you and Happy New Year Delilah