Post Lasik victim --> Drye eye/eye strain

[olb]

Hi guys, I'm new here!

here's the deal. I had conventional Lasik end of 2009 (initial prescription: 2x -6.00, after Lasik: left: S: -0.50 C -0.75 and right S: +1 C -0.75 ) and a retreatment after 2.5 months on the right eye due to ghosting (final result: S -0.5 C -1.00). Ghosting has changed but not decreased. Most of the time I can deal with the current prescription although the right eye has decreasing acuity during the day.

The major problem for me is dry eye (both eyes), at least I think so. During the past year I have been to several eye docs, with always the same result: not severe dry eye, but somewhat dry though.

I have been using eye drops ever since: no easing of pain most of the time.
I have been taking fish oil: no improvement.
Now this week I had inferior punctal plug: no result.

I am a professional computer use 8h/day, and that's where the problem is. Ofcourse the problem tends to intensify during working hours with continuing pain/fatigue during the evening. Eye strain, very tired eyes, burning hot pain most of the afternoon/evening. Also car driving puts the eyes on fire.

I also believe the cause for the eye strain is the ghosting and astigmatism in both eyes, and the eyes not working well together.

Anyone can comment on this situation where none of the treatments (eye drops, omega3, punctal plugs) work?
Has anyone experienced no improvement from inferior punctal plugs?
Should I have patience to allow the punctal plugs to take effect?
Sometimes I think the eye strain is due only to my imagination/fear of dry eye during working hours.
I really need to have some improvement in the burning pain during working hours, cause it's taking effect on daily behavior/mood.

Thanks!

[Sammy B.]

Olb,

Be patient with the plugs, worst case scenario they don't work and you have them removed.

Plugs did not work for me, and they are not for everyone. I also gave up on drops as they didn't seem to be doing anything but creating a dependence issue for me.

What kind of dry eye do you have? Low tear production or bad tear quality? I have the latter. There are things you can do for either type, try to be patient.

You do wear glasses for computing, right?

Rose

[olb]

well, i have been to a few docs and the response is always: you have some dry eye. They don't seem to bother with investigating whether it concerns low tear production or bad tear quality.

what i do notice that there sometimes are small bubbles on the cornea, like small air bubbles. does not seem normal but what the h#ll is it??

interesting topic that you bring up: reading glasses for computer work. What prescription could they have then since i'm only slightly myopic, not hyperopic? I would love a glasses solution that would ease the eye strain!!

[Margaret]

You definitely need to see a better dry eye expert that can tell you what they think regarding tear quality vs. quantity. I think it helps you know what you need to work on, improves your mood because you have a goal and less wondering what the hell is going on, and it narrows down your treatment plans.

[Sammy B.]

Agree with Margaret - find someone who is willing to help. Where do you live? You can use the "Plug a Doc" forum on this site to find a caring dry eye doc. Even mild signs of dry eye can cause discomfort.

The sudsy or bubbly appearance of your tears leads me to believe MGD is at play. Or are the bubbles really on the cornea itself? Not just in the tear film "lakes" that line your lower lids?

I am not an expert at reading prescriptions but when you find a good doc that you trust, ask them outright if you need a prescription for your computing. Even a good pair of "computer vision" lenses that do not contain and Rx can help reduce strain. I was experiencing daily headaches and I thought it was all due to dry eye, when in fact I needed some readers for the computer. I didn't buy any at Walmart, I got a specific pair tailored for my Rx/astigmatism and voila, the headaches went away. Is it embarrassing to be back in glasses after LASIK? Sure, but it beats the hell out of the daily eye strain.

Rose

[olb]

I live in Belgium, so probably will not find any doc recommandations. But if someone is reading and can help, please feel free! Docs in the Netherlands are OK too.

I notice the bubbles on the cornea itself mostly I guess, but it's difficult to judge that...

[olb]

Hi all,

an update: i had lower punctum plugs beginning of December. Unfortunately without result Still tired and painful eyes during especially car driving and computer work.

So today went back to the eye doc. He checked my eyes and now pushed on the lower eyelids. He said this time he could see, more than last time, irritated inner eyelids. When he pushed the eyelids, he saw oil coming out. So diagnosis this time was: MGD.
He prescribed an ointment with fusidic acid to treat the irritated glands, together with eye lid compresses/scrubs for eyelid cleaning.
I find it strange that suddenly now he saw this, and not the previous time. My complaints are present now 1.5 years, but at least 10 eyedocs never diagnosed me with MGD.

But I'm starting this treatment tomorrow and hopefully this time it will work. i'm just worried that the ointment contains benzalkoniumchloride.