Newly stricken with dry eye!

[Dunnie]

Hi,

My name is John, I'm 28, I was diagnosed with "dry eyes" in October. In the months before October, I had been experiencing some redness and discomfort, but nothing I considered serious enough to check out. Then suddenly, one night I lost a decent chunk of my vision and went to an ophthalmologist. She diagnosed me with "dry eyes" and told me my vision would come back to normal, which it did over the course of a few weeks.

At first I didn't know what was going on with my vision (I lost a decent chunk very quickly), and was ecstatic to learn that I only had "dry eyes". From everything the ophthalmologist said, which wasn't much, I was just grateful that it wasn't something worse. Anyway, I'm starting to learn this might not be going away any time soon.

My first RX was: Pataday once a day, preservative-free eye drops every hour, Refresh PM at night. I ran out of Pataday, and stopped taking it last week (I finished all my refills).

The drops I'm taking are: Busch & Lomb Soothe, Refresh Celluvisc, and Blink tears (preservative-free).

I take Refresh PM at night. Then I flush it out with Soothe drops in the morning, because I don't know a better way.

I was having pain from blinking, but the Blink tears stopped that.

Now, I have dryness all day -- I'm not making any tears. The eyedrops help with that and the pain/discomfort is bearable enough. My eyes do get very sore at night. Also, my eyelids feel shut, I can't open them wide. I sometimes get light sensitivity.

This week, my vision declined again, but not as bad as the first time.

Also, my eyes now look a little "dead" - kinda grey, and slightly bloodshot.

This stuff doesn't bother me as much as not knowing what lies ahead. Since I started researching this, I worry more.

I've only had this for a few months now and I'm hoping to learn to treat this as best I can.

[03CobraDryEye]

You need to have a talk with your dr about going on Restasis and even considering punctual plugs. That seems to be a conservative approach at this point.

[Rebecca Petris]

Welcome! Sorry to hear what you're going through. Sudden loss of vision like that is unusual with dry eye. Are you seeing a corneal specialist?

[Dunnie]

When I say sudden loss of vision, I don't mean temporary blindness, just a substantial decline. Then I got it back, and now (2 months later), my eyesight is slightly down again.

I don't think she is a corneal specialist. Is that who I should be seeing?

[Rebecca Petris]

I understand. Usually if there's that sudden a vision change with dry eye it's because of an erosion or something.

The doctor doesn't have to be a corneal specialist, it's just that those are the ones with the most training in this area.

[Dunnie]

Oh,

well here is where it gets to be a long story. My vision went down during the night (from 9 pm to 7 am). This was on a Sunday morning. The only place I could go besides an emergency room was an optometrist (to tell me if I needed immediate medical attention or not). Then two days later, I was able to see an ophthalmologist.

The optometrist told me I had an eye infection and corneal erosion. Also in the paperwork, he marked something off saying "Corneal, SPK". He prescribed me Vigamox and told me to take regular eye drops hourly.

The ophthalmologist disagreed with what the optometrist told me, took me off the Vigamox,and told me I had "dry eye". Then she gave me the RX I described in my first post.

I don't know what "corneal spk" is, but the optometrist definitely told me I have corneal erosion, which the ophthalmologist didn't really address.

My dry eye symptoms have gotten worse in the last two weeks, and my vision declined again at some point in the last week. I don't know what to do because I know almost nothing about dry eye syndrome at this point.

[Rebecca Petris]

OK thanks for the detail, this is making sense.

SPK is basically dry spots on the cornea. To be expected when you're going through the kind of episode you just had. For some people with severe dry eye they have SPK on an ongoing basis.

Do you know whether you've had additional episodes of erosions? Usually those are accompanied by quite a lot of pain so you know it (in addition to the vision change). Did the doctor suggest any reason for the erosions other than "dry eye"? Did you have any eye injury like a scrape or anything within the last, say, 18 months? - Dry eye alone can certainly lead to erosions but you might also want to read up here about ABMD (check the encyclopedia) and the next time you see the doctor, ask them if they think you might have this. That's different from dry eye but quite a few people here have both. It matters as regards what treatment is going to help the most. A corneal specialist will be the most experienced with diagnosing these things... though not all of them (some people here went to several specialists before getting an accurate diagnosis). Not to scare you, just saying because sometimes it can take a lot of homework and probing to get detailed information from the doctor.

[Dunnie]

I started having problems (comfort issues) with my contacts around January of this year. Before that, I had never had problems with my eyes. No scrapes, nothing that I know of.

When I had the decline in vision, there wasn't really any pain involved. The dry eye seemed to start after that. The ophthalmologist said that my vision loss was related to my dry eye.

Thanks for all the advice. I don't really know what I'm doing at this point, and I worry about what might be next. I need to learn as much as I can about this.

[Dunnie]

I don't know why she gave me Pataday.

After the episode, I didn't wear contacts for about 5 weeks. Then I was prescribed a pair for my brother's wedding, which was a month ago. Then I wore them a few times a week, for no more than an hour or two each occasion.

I haven't worn them in about two weeks. My dry eye has gotten worse in the last week, with the slight vision decline, so it can't be from the contacts. I've basically given up on them.

As far as lubricants go, I'm using Refresh PM, and having a lot of trouble washing it out in the morning. This morning it took me four vials of eye drops to flush it out of my eye. I could really use some tips on that.

[Rebecca Petris]

Mast cell stabilizers e.g. Pataday are not always used only for allergies. I'm using it periodically for chronic GPC in one eye.

Re: How to wash Refresh PM out: At the risk of contradicting your doctor's advice I'm going to suggest the idea of simply not using it. If you're getting very dry at night try a physical barrier (sleep mask or goggle) and something non greasy like Genteal Gel. Check out the Night Eye Protection section of the forum, and also the night protection section in the encyclopedia, for tips on night protection.

[LasikLady]

Genteal Gel

Rebecca is so right about not using ointments at night and switching to gels. The couple times I tried ointments very early on in my dry eye life they caused my symptoms to way worsen. I switched to genteal gel and found that it is sooo much better and does not need to be washed out in the morning. I still use it though my eyes are not that dry anymore. I get up in the morning and take a warm wash cloth and gently wipe my lashes if there is any residue and it comes right off. That's it, no using drops or anything to get it out and it makes my eyes feel very refreshed and not one bit greasy. Can you tell I'm a big fan!!

[Dunnie]

I have an appointment with a corneal specialist on Monday.

Do you mean Genteal Gel or Genteal PM ointment?

http://www.genteal.com/info/products....jsp?WT.svl=LM
http://www.genteal.com/info/products....jsp?WT.svl=LM

[Rebecca Petris]

Genteal Gel. The first of your links.

[Dunnie]

Oh. It says in the ingredients that it has a preservative (sodium perborate)?