Dry Eyes, Sinus Pressure, Migraines after Laser Eye Surgery

[rampage76]

I'm glad I found this forum since dealing with this problem alone has been quite miserable.

I had laser eye surgery (wavefront - zyoptix) almost a year ago. I've had dry eyes since immediately after the surgery; the doctor put me on restasis and I used it for about 7 months without improvement. After the 7 months, I just tried to ignore my dry eyes because I had other problems that I didn't think were related.

About the time of my surgery, I was having lots of sinus problems. I had congestion, a stuffy nose, and the worst symptom was the headaches (pressure behind the eyes). All the symptoms fit sinusitis and I went to a regular doctor and was treated with antibiotics. After my forth visit to the doctor, I didn't think it could be a sinus infection and figured that it might be environmental. I live near the beach and was certain that the house had mold - I figured that my sinus problems were a result of the mold. I tried using an sinus irrigator, the nasal sprays, and steroidal (flonase) without improvement. I also went to an ENT who told me that I had migraines and gave me migraine medicine (which didn't help and made me feel terrible).

I recently moved to a new place that definitely does not have mold and was hoping that this would help me condition. Unfortunately, as I type this message, I feel a mild headache, pressure behind me eyes, and my eyes are dry.

I've been suffering from these migraines/sinus headaches for about a year now and after moving, I can eliminate mold as the underlying cause. I started to research whether my laser eye surgery could cause migraines and I read a multitude of articles that explains how laser eye surgery causes dry eyes (I knew that) and how the dry eyes can cause both headaches and sinus problems. It would certainly be a good explanation for my symptoms...

Can anyone offer any insight? I would greatly appreciate feedback if someone has experienced anything similar.

[dave]

I also have bad headaches behind my eyes from what I thought were sinus problems with just after I developed dry eyes about 4 months ago. I had a CT scan of my sinuses done and they found no infections or blockages but treated me with antibiotics anyway. So far no relief and I now believe it is allergy related as my eyes are always inflamed. Mold can do this as I live in a warm climate but A/C keeps down this issue so I'm looking at other sources such as dust mites or other allergens. Good luck and I'll let you know how my search goes.

[rampage76]

Hi Dave,

Thanks for responding - I was starting to think that I was the only one who read this thread. My ENT doc wanted me to see a neurologist who would then order CT scans. I didn't have faith in my ENT doc's opinion because he seemed incompetent and completely convinced that I had migraines. I did get some personal referrals to a couple neurologists by someone I trust but I have not set up appointments yet. I was hoping that moving into a newer house would help (mold differential).

[Scout]

Your story sounds very similar to my story after LASIK, including the flare of allergies and inflammation with periodic migraine-like headaches.

The first thing I want to do is reassure you that it does get better. It took me longer to find the answers because my surgery was in 1999 and at that time, complications were not at all understood.

What I did learn over time (after many wrong turns along the way) is that a compromised tear film and ocular inflammation due to laser surgery can worsen your body's allergic response and increase irritant allergies on the ocular surface, eyelids and even sinuses.

So you may be having the same allergies, but more severely and you may also now be very sensitive to irritant allergies due to the dry eye and ocular surface inflammation.

I found that in my case, the doctor prescribed prescription allergy eye drops, which helped the allergies, but because the preservative in the drops is an irritant, it was in turn, increasing the irritant inflammation.

Systemic allergies are the body's response to allergens, with histamine release, etc. (Like hay fever, with itchy and burning eyes).

Contact or irritant allergies are an immediate inflammatory reaction at the site of the contact. (Like poison ivy).

Both types of allergies can occur in the same person and potentiate each other, making the reactions more severe. Dry eye complicates the whole thing and may make you that much more sensitive to irritants in your environment.

Finding and removing the irritants has been the answer for me. It took a long time and frankly, surprised me. Lotions, shampoos, soaps, hair sprays, etc. all were changed--prroducts that I had no idea were triggers to ocular surface inflammation and had not been a problem before LASIK.

I have had 3 really good years (after 5 bad years).

I hope this helps.

[rampage76]

Scout,

Thanks for replying and yes, it is quite helpful. I actually am following the same path as you did after your surgery; eliminating environmental irritants. Unfortunately, I haven't eliminated enough yet.

Do you think that your condition might have improved due to the elapsed time alone? It is disheartening to think that I might suffer for another 3-4 years.

Regardless, you are absolutely correct that the Lasik surgery has aggravated any sinus problems that I had before. You mentioned that the drops your doctor prescribed you didn't help; did you ever find drops that did help? I feel like the preservative-free drops get your eye wet for a minute and then they feel more dry than before.

[Scout]

Do you think that your condition might have improved due to the elapsed time alone? It is disheartening to think that I might suffer for another 3-4 years.

I can't say for sure, but I am pretty convinced that my eyes would have improved much quicker had I not taken so many wrong turns along the way.

You mentioned that the drops your doctor prescribed you didn't help; did you ever find drops that did help? I feel like the preservative-free drops get your eye wet for a minute and then they feel more dry than before.

The drops I was talking about were prescription allergy eye drops (Zaditor, specifically). They actually did help with the allergies, but eventually made my eyes worse because I was using them daily and over a long period of time. The preservative in them (BAK) is an irritant, so the irritant allergies were gradually getting worse but the allergen allergies were improved.

Because my ocular surface was so inflamed and sensitive, there were very few wetting drops that didn't cause more inflammation after initial relief. One of the drops that used to be available here (but is no longer produced), NutraTear, was the only wetting drop I found that didn't produce that rebound inflammation.

Most members here with that extreme sensitivity have to go through lots of different wetting drops to find one that triggers the least amount of rebound. There are lots of threads in the archives that discuss this. It seems there can be a different answer for each person.

Cold, wet compresses help me more than wetting drops at this stage. The cold compresses help reduce inflammation and can even stimulate tears.

My journey was a long one and you have already figured out in one year what took me probably 4-5 years!

Keep reading this wonderful site and you will find lots of helpful ideas.

Scout

[Margaret]

all of the above for me as well

Hey there,

Yes, my sinus seems to be bothering me now that I have had Lasik, 9 months ago. I also have migraines that are now enhanced thanks to the dry eye. I have a feeling it all has to do with the nerves, although some of the sinus issue might be because you don't have as many nutritive tears going down through your eye ducts into your sinus cavity that I'm sure also protects your sinus from offending allergens, etc. I don't like to use many drops, even though my eyes could use some, because of the sensitivity that I have to seemingly everything, but when my sinuses becomes extra dry i use a little olive oil and eye drops and put them up my nose!

Scout, can you tell us a little bit more about your journey? What wrong roads do you think you took? What do your bad years look like and your good years look like? What do you do if you have a bad day, regimine wise, etc.

Thanks!
Margaret

[Stressed Steve]

Hi rampage76 & Margaret

I have chronic sinus & post-nasal drip problems following my Lasik in 2011. I'm interested in knowing how you two are doing as your stories seem similar to mine own? Did you find anything to ease the symptoms?

Thanks
Steve