I'm new. Dry eye started 3 months after lasik!!!!

[wantsim]

Hello all!

I have been following the bulletin board for the past few months and wanted to drop a note to say hi. Before I begin I should say thank you to Rebecca and all the dry eye veterans, such as Lucy, for facilitatin and fostering a great community for reaching out.

I am a healthcare provider, a nurse practitioner working in family medicine. I had many friends, colleagues, and patients who had LASIK. Everybody I talked to had such a "wonderful outcome!" and was so happy with their results. I decided to go for it. After all, technology has advanced a great deal and everyone was happy with their results. It was even 20/20 vision guaranteed or your money back. Can't beat that with a stick!

In March 2009 I had regular LASIK eye surgery on both eyes. I was told that regular lasik would provide the same outcome as custom lasik and that I did not need it. Immediately afterwards and up until now (6 months later) there are still night vision disturbances. Haloes, starbursts, glare. These HOA's actually seem to be getting worse! :-(

I had no dry eye symptoms up until 3 months. The first 3 months I had absolutely no dry eye symptoms...at all No night time symptoms, no burning, nothing! One day after the 3 month follow up appt, my eyes felt dry, burning, and irritated. I started using generic artificial tears and that alleviated it.

The dry eye symptoms gradually worsened. I developed the usual symptoms of burning, pain, fluctuating vision.

I do not know why I developed DES after 3 months post-lasik. The eye docs have no idea. They say that lasik can severe the sensory nerves in your cornea that stimulate tear gland activity as well as meibomian gland secretion. The lasik flap created is usually one that leaves a nasal hinge because apparently the corneal nerve bundles enter the cornea at the 9 o'clock and 3 o'clock position.
If the nerves in the cornea were severed then that would create immediate DES is what I have researched, but if that was the case my symptoms did not begin until 3 months post-lasik. I'm puzzled. It's a head scratcher.

Here's what lasik did for me:
1. Loss of contrast sensitivity; difficulty fine tuning focus
2. Double vision in left eye
3. GASH (glare, arcs, starburst, halo)
4. FLOATERS which have increased in number 1 month post-lasik
5. Dry burning painful eyes

Here's what I have been doing over the past 3 months:
1. Rice baggy warm compress 3 - 4 times/week
2. Permnent plugs x 4 punctum; both upper and lower
3. Lotemax drops four times a day for 3 weeks.
4. Doxycycline 100mg twice a day for 1 month
5. Eyelid scrubs with warm water.
6. Flax seed oil daily. I grind the seeds up direct and mix it with some yogurt.
7. Refresh Endura
8. Optive eye drops
9. Refresh celluvisc, Refresh plus, Acular, Muro, Azasite
10. Genteal Gel at bedtime
11. Lacriserts
12. Erythromycin ophthalmic ointment
13. Restatis. started 2 days ago. woo hoo!

I have good days and bad days. I am finding that the more inflammed my eyes are, the drier they become. Lotemax has helped somewhat. Not one thing has stood out as being the most helpful, however.

My current regimen is:
1. Restatis twice a day. (just started 2 days ago though so too early to tell if helpful or not)
2. Drops when needed. I use a combination of Refresh plus, Refresh endura, Optive. I mix up the eye drops rather than just stick with one.
3. Genteal gel at bedtime.

Anyhow, I have a lot more to say but I figure writing too much can be a bad thing!

I just wanted to say hi to everyone and look forward to more posts. Thank you for the opportunity to reach out to others that understand. !

[Lucy]

Hi wantsim-
Sorry for your situation. It's not uncommon for problems to start some time after Lasik with the pain and dry eye. I've heard any where from immediately to a few years later. Of course, the drs never want to admit the dry eye may be from Lasik or PRK. There is also no way to prove it after a lengthy time.

It looks like you have a decent handle on the situation to hopefully bring you to having healthier eyes. It does take time. Sometime lots of time. Maybe you can think in weeks or months instead of daily. All of a sudden you'll notice you've had a good day. You think so, at least. Then a couple of weeks later, you'll notice you had two good days in a row. Then the burning and pain again. And on and on. It will get better. It is also overwhelming to know that Lasik caused this crap. I only hope folks who are contemplating Lasik or PRK run across some of our posts and maybe have second thoughts.

When your eyes are really sore and burning and you are able, try some ice wrapped in a ziplock bag (covered with a cloth) over your eyes for 15 min while you lie down. I know you can't do this while working, but you can at home and it can at least give you a short vacation from the "eyes of fire." Stay with us here. Lucy

[Sammy B.]

Wantsim,

I feel there may be room for improvement in your situation. You are only 6 months out, correct?

The way post-LASIK dry eye was explained to me by an opthalmologist (who had PRK himself, and had performed LASIK on his wife and two adult children!) is that when the flap is made, the nerves are severed (as you said). At that moment, the nerves on the flap are basically deadened or numbed, so much in fact that you probably could have placed a contact lens over the eye and not even have FELT it there.

It takes a while for those nerves to heal. Perhaps around the 3 month mark these nerves began the regeneration process for you and that is why you suddenly felt something? Or, the dry eye could have been lurking and only at three months did a bonafide dry spot appear on your cornea (which you would feel)?? There are a few different concepts behind a "delayed-reaction situation" like ours I believe.

I, too, did pretty well after LASIK, until about May of this year (LASIK was in January of 2008). I was majorly stressed out and the horrors of LASIK hit me like a ton of bricks (almost like a bout with post-traumatic stress disorder). Once I dealt with the mental aspect of it, and was able to focus on alleviating the symptoms, things began to improve. I'm not 100% but I've been using Dwelle since September 9th and it seems to really help. I am considering a trial of lower punctal plugs if Dwelle doesn't entirely do the trick. I also have been doing my warm compresses religiously and taking omegas, vitamins, and glucosamine/chondroitin for a while. I bought a pair of WileyX Air Rage sunglasses with the removable gasket and have been wearing them in my car (which has a measly 20% humidity level when the AC is on!!). I wore those puppies around EPCOT last weekend too and they really seemed to help during the day, so in turn my nights were a lot easier.

Stick with your current course - I truly think there is some improvement ahead for you.

And remember not to freak out, as we cannot go back in time at this point. We've found ourselves here for various reasons and the only option is to MOVE FORWARD. You will find a regimen that works for you.

- Rose

[izzy3usa2002]

Hi wantsim,

I am so sorry to hear you have so much discomfort. It does look like you have lots of things that will help you. I read Lucy's post and agree the ice works wonders. Whenever I would have a bad attack of the pain it sure did take it away. So thanks again Lucy!

Have you tried the tranquil eyes goggles for sleeping at night?

I wish you good luck and hang in there!

Vicky

[Rebecca Petris]

In March 2009 I had regular LASIK eye surgery on both eyes. I was told that regular lasik would provide the same outcome as custom lasik and that I did not need it. Immediately afterwards and up until now (6 months later) there are still night vision disturbances. Haloes, starbursts, glare. These HOA's actually seem to be getting worse! :-(

Hi there and welcome.

When there is optical 'trash' like this, don't be surprised if it 'moves around' a lot in the first several months. This does NOT necessarily mean that it's not getting worse or won't get better. There are reasons for the instability and unfortunately a lot of us just have to tough it out till that icky period passes. Always bear in mind that the residual visual stuff can continue improving for months and YEARS after surgery... I've seen that happen over and over and over in the forums. It's not the norm but it happens.

I had no dry eye symptoms up until 3 months. The first 3 months I had absolutely no dry eye symptoms...at all No night time symptoms, no burning, nothing! One day after the 3 month follow up appt, my eyes felt dry, burning, and irritated.

Not surprising to me. Back in the old days with the lasik-related discussion forums I was part of this was frequently reported. Happened that way with me in fact, dry eye kicked in about 3 months. Nothing at all before that. Lasts longer for some than others. Rose gave a good explanation of the cause.

I'm kind of interested in that 'one day after the 3 month follow up' though. Sometimes people have reactions to drops that are used during the appointment. Not that it would cause anything, but it could cause enough irritation to be noticeable and that in conjunction with the 3 month dry eye sensation kick-in scenario would make you very uncomfortable.

Hang in there, and keep at it diligently, and try some of the things that work for other people here... the worst of it hopefully will be soon over.

[Sammy B.]

Clarify Current Regimen?

Wantsim,

I agree with Rebecca in that it seems strange that the day after one of your post-op appointment you began having issues. That's kind of a brow-raiser. The drops they use during the exams can irritate the cornea and thus cause an already dry eye to take more time to heal - that could be all you are experiencing.

By the way, can you clarify your current regimen for us? It seems that you had tried a LOT of things in a short period of time and that your current regimen is quite simple. Are you not doing any steriods, etc., at this point? Only the Restasis?

Perhaps it would be best if you could give the Restasis a real college try first, before circling back to other things. I think what I am trying to say is that if you try 1 thing VERY SLOWLY and are diligent, you'll know whether or not it's doing you any good. In my experience, trying several things at 1 time didn't necessarily give me the tools to know what was working and when. However, I know this makes for a slow process when all we want is IMMEDIATE RELIEF!

- Rose

[ALK-O'd]

"It was even 20/20 vision guaranteed or your money back."

It's nice of them to offer a refund if they destroy your eyesight. Sigh...

Sorry. I couldn't resist that one. Hang in there. Things will get better.