are these ulcers normal for dry eye?

[poppy]

Curious whether anyone else gets ulcers like these or knows what causes them?

My ulcers are linear, very thin, about 5mm long, and occur close to and parallell to the bottom eyelid. They occur on both eyes in the same place. They are on the side of the eye furthest from the nose. My GP has a hand held device that they use to scan the surface of the eye after putting the dye in, the device then shows you a picture on the computer of where the ulcers are. This is how I found out about these ulcers, not from the opthamologist who I doubt would notice them in the one second they glance at my eye.

I also have had corneal ulcers but I understand these are normal for dry eye and also blepharitis (which is what the opthamologist reckons I have).

I am curious about the linear ulcers. Judging by my pain levels, I am probably getting these types of ulcers frequently. Also I can't remember the exact terms used, but from what I've been told by opthamologists and optometrists the surface of at least the bottom part of my eye is completely trashed, which I guess could be explained by these ulcers recurring.

We don't have any decent opthamologists in my city (and you have to wait 3-6 months to get in to see one anyway), so any information would be appreciated.

[Súil Eile]

I've just started getting these, in the same place and about the same size as yours! So I'd also be very interested in hearing about other people's experiences.

[poppy]

I've just started getting these, in the same place and about the same size as yours! So I'd also be very interested in hearing about other people's experiences.

Did your opthamologist recommend any action for these and/or show any form of concern about them?

Last opthamologist I saw I asked him what I should do when I thought I had an ulcer of any kind and he told me dismissively "just keep using the (artificial tear) gel". Full stop, not "and if they don't improve come see me asap" or any mention of seeking help of any kind. Really made me feel like he cares about my vision...

[magoo]

Might this be caused by your lids not being entirely closed while sleeping? Just a guess from the location of the problem.

Here's a link to information about it here at Dry Eye Zone:
http://www.dryeyezone.com/encycloped...phthalmos.html

[poppy]

Might this be caused by your lids not being entirely closed while sleeping? Just a guess from the location of the problem.

I am going to try using the tranquil eyes at night in case this is the problem.
I understand they may help with this.

Feels like these ulcers are still there and getting worse.

[redhector]

ulcers

I agree that they are probably due to exposure while sleeping and toxins from your inflamed eyelids. compresses, lid scrubs and then an antibiotic ointment (Ophthalmic!!) your family doctor can presecribe this. Azasite eye drops at night may also help. Do the anti bointic treatment for a week or two and then just use a bland lubricating gel or ointment at night. You may find you have to repeat the antibiotic treatments once a month for a while to control these ulcerations. if the ulcers themselves are very painful, it might be due to a virus.

[Súil Eile]

I've an appoinment with my ophthamolagist next week, so hopefully he'll have some advice on treating my ulcers.

Poppy, are your's always there? Some days I can't feel mine but I can see they're still there. Other days I can feel them rubbing against my eye.

[willwork4tears]

I completely agree with Magoo.

I would try sleeping with an eye mask, taping eyes shut (you can find eye tape at the dry eye shop) or using the Tranquileyes. Corneal erosions and damage can take a long time to heal, so stick to a therapy that will keep your eyes shut and moist. It could take weeks to months to completely heal.

[poppy]

Poppy, are your's always there? Some days I can't feel mine but I can see they're still there.

Yes, they are always there I think and getting worse. I can't see them, but can tell from the pain that something is definitely not right, and it feels like these ulcers again.

I do feel that sometimes I might be sleeping with my eyes open a little (a few times I've caught myself opening my eyes as I'm about to go to sleep), the only thing that doesn't make sense is my eyes aren't worse in the morning. The discomfort when I wake up isn't any worse than at other times throughout the day. But I'm going to try the tranquil eyes and see if it helps.

Thanks for the suggestions RE antibiotic ointment etc. I do already use the genteal gel several times during the night (and throughout the day). Unfortunately the ******* of an opthamologist I saw last wrote to my doctor and told him "absolutely NOTHING further can be done for me" (even though he has tried exactly NOTHING so far anyway). So I won't be able to get any antibiotic cream etc out of my current doctor, who clearly thinks that NOTHING can possibly help me now. BTW Once I took some oral antibiotics (amoxycillin I think they were, not doxy) for another problem and I thought my eyes were cured! They just went completely back to normal in a matter of a day or two. Unfortunately the problem reoccurred.

[regina]

Hi poppy

I have these also...it seems to be caused by your dry eye...as my doc expla
ined it happens when you have no moisture and your lid adheres to your cornea covering and lifts and tears it when you open your eyes. You know that sticky feeling when you cant open your eyes from sleeping at night? Well I think that is when mine happens.

My doc says in time...they SHOULD go away...well its been years and they are still here...but on my good days they are not so bad. But most of my pain come from these corners. I believe there is a surgury to cut out the excess stretched skin and reattach them...it sounds scarey though!

[spmcc]

RE: Regina

Regina --- It sounds like you are describing conjunctivochalasis (CCh) which is excess conjunctiva and can be corrected by surgery (e.g., AMT or amniotic membrane transplantation).

I don't know if "ulcers" is the same as CCh. But maybe there is just a mix-up in terms?

Poppy --- Did your doctor call them "ulcers" or excess conjunctiva? If it is CCh, then there are a number of people on DEZ who have had a surgery to correct this. You might want to ask them what they did, what the options were, etc.

Good luck.

[poppy]

Poppy --- Did your doctor call them "ulcers" or excess conjunctiva?

They are definitely ulcers.

[Rebecca Petris]

I have these also...it seems to be caused by your dry eye...as my doc expla
ined it happens when you have no moisture and your lid adheres to your cornea covering and lifts and tears it when you open your eyes....

...I believe there is a surgury to cut out the excess stretched skin and reattach them...it sounds scarey though!

Hmmmm

First half of this sounds exactly like erosions (RCE) which many here get whether due to ABMD, incomplete lid closure at night or just plain dry eye.

Second half sure sounds like conjunctivochalasis.

What Poppy describes sure sounds like it's from lagophthalmos and RCE - ulcers can result from chronic RCE that's out of control. But to say nothing can be done is ridiculous! We have had so many reports of appallingly poor dry eye care in Australia... I am really sorry. If you read the blogs from patients here who have RCE, I think you pretty much can't go wrong with the things a lot of people here are doing to prevent erosions - especially Tranquileyes (or another night goggle or mask). Poppy do you have scarring from the ulcers? I'm surprised you don't have more pain from what you're describing.

[spmcc]

RE: ulcers vs CCh

I was confused... because of the "linear" aspect of the ulcers and where they are located (on the sclera (not cornea) toward the bottom lid), I thought it sounded just like CCh.

If they are RCEs, then there are people here who know what to do to help! I found it's especially important to cover the eyes at night. I use drops (lotemax and Dwelle), then Glad Press N Seal (I cut pieces to cover my eyes), then Tranquileyes on top!

I think there are people here to do different things, but it would be best to experiment with the help of a good ophthalmologist. He/she will be able to prescribe the best drops (perhaps steroid drops) to help. I found that steroid drops are the best thing to help reduce pain.

Wishing you the best.

[liz56]

Hi, Poppy.

I have been reluctant to reply, because I did not want to cause any "static" by suggesting RCEs. I suffer from them myself, and I don't want to project on to others.

Your symptoms sound just like the ones I have in my right eye. My left eye had severe RCEs several years ago that had gotten to the point of ulceration but are now under control. However, in my right eye, I felt discomfort once my left eye improved. My corneal specialist described a "wrinkle" in the epithelial basement membrane in that eye. It causes astigmatism and can erode.

As Rebecca suggested may be your case, I have lagophthalamos (wherein the lid does not close fully during sleep), and TranquilEyes goggles have helped improve that for me. The "wrinkle" is not gone, but I do not have erosions in that eye any longer.

Best wishes,
Liz