Announcement

Collapse
No announcement yet.

New; trying to decide whether to manage dry eye with contacts or glasses...HELP!?!

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • New; trying to decide whether to manage dry eye with contacts or glasses...HELP!?!

    So I’m new and this is my story. My apologies for the length of this, but thanks in advance for reading. I would appreciate any help or advice if you can give it:

    I am 34 years old, and suffer from what I've been told is about medium myopia (-5.50 contact prescription) and mild astigmatism. I was an exclusive contact lens wearer for about 20 years before problems with severe dry eye led to me switching back to glasses early last year. I really wore contacts all the time; there were periods in that span where I did not own a functional pair of eyeglasses. I believe now that my dry eye is the result of this contact lens use, maybe more appropriately termed as abuse for probably at least 12-15 of those 20 years. When I first started wearing contacts as a teenager, promotion of “extended wear” was a big thing, and I would sleep in my contacts for days, even weeks at a time before changing them. This continued through high school, college, and into my mid 20’s, into the early years of my marriage. (Yeah, I know. I just didn’t care). It’s hard for me to believe now as I look back, but I never really saw this as a big deal. If my eyes were sticky, I would just turn up a few drops from the multi-purpose solution in the morning and I was good to go. It was never painful; I remember consciously thinking that I did not have any of the same problems as other contact wearers I knew; I even wondered how I was so lucky. As I grew to be a bit more responsible in my old age, I read an article by chance and got scared about corneal neovascularization and finally cut this out and started sleeping without them every night maybe 5 or 6 years ago. But I was still wearing them during the day for maybe 15 hours or more, still with no issues. Fast forward to maybe 3 years ago, I started noticing these weird little pains in my head right above my eyes that would come and go. Sometimes it was dull, sometimes more like a shooting pain. I had no clue what was going on and wondered after some time if I might even have a brain tumor. The short of that story is that one optometrist, two ophthalmologists, and one MRI later, I was diagnosed with severe dry eye. It took a while to diagnose, because it did not present like typical dry eye and those sensations were not what I was telling the doctors. But that is clearly what it was after the last guy finally thought to do a Schirmer’s test on me. In one eye I had virtually no tear production at all over however many minutes the strips were left in. The other eye at least produced something, but it was still severely deficient.

    This was, of course - perplexing to me at first because I never associated the pain I was having in my head as a “dry eye” type of pain. I did know from previous experience that it seemed my eyes were always very dry and painful whenever I didn’t have my contacts in, which I tried not to let happen very often. (I didn’t originally put much thought into this, if you couldn’t tell). So early last year to deal with the head pains I was having, I went back to wearing glasses full-time for the first time since I was in junior high school - figuring it would alleviate the dry eye or whatever you might call those other symptoms finally. Instead of this happening though, my dry eye over the past 2 years has become worse. Uh, much, much worse, and without my contacts in on a daily basis it has steadily and finally morphed into the classic, dry-as-a-bone scratchy painful dry eye symptoms.

    So – for this forum - my dilemma now has become over the argument for glasses vs. contacts. I know now that my contacts likely feel somewhat better because they are acting sort of like a band-aid or shield, covering the eyes up and protecting them from some of the more typical symptoms, but at the same time I know they are perpetuating the dry eye problem by so many hours of wear. I am now at a point where I really don’t know what to do. Part of me wants to say screw it, chuck the glasses and go back to wearing contacts at least during the day since it feels so much better. But I also don’t want to make my long-term dry eye problems worse than they already are. It scares me to think the damage that may already be done to my eyes just in the past 15 years or so. And I plan on needing my eyes for some time to come…

    When wearing glasses, I get into what seems to be the repetitive problem of eye drops, then more drops, more drops, and then by the end of the day I wind up in a place where my eyes are drier than ever, more painful than ever, and I have almost a low-grade headache due to all of it. There are times I’ve had to pop ibuprofen or something at the end of the day just to deal with that. I am beginning to suspect that I have problems with the oil / lipid layer of my tear film (Meibomian Gland Syndrome / Disease?) in addition to regular tear production, since I seem to get into that repetitive problem where most OTC drops just dry up quicker and quicker from the time I put them in. Sometimes they don’t last for even 10 minutes before I’m tipping the bottle again. I did try Restasis at the urging of the middle opthalmalogist I saw for about 6 months last year, but with no luck. My eyes burned twice a day when applying the drops, and then I would still wake up at 2 am or so most nights with them screaming in red, dry pain. I don’t have to tell anyone reading this forum here probably how annoying to downright painfully depressing this all can be. There are days when I can manage ok, and there are days where by 5 pm I realize I’m in a horrible mood and have been very unproductive all day long just because of my eyes. That’s no way to live life. I’m also starting to think it is affecting my relationship at times with my wife and our 2 small daughters.

    Help please? I am so sick of this. All things considered, I would rather stick with my glasses from here on out because I’m worried anymore that wearing my contacts for more than just a few hours at a time may damage my eyes further in the long run. I’m a runner and I do generally wear my contacts for an hour or so several times a week when I’m out pounding the pavement; I don’t see a problem with this, but I really don’t want to go back to them full-time. Glasses so far however have proven to be a real challenge, since my eyes always want to dry-up like raisins in the sun under them. And if I’m being honest, I have spent a small fortune over the last two years on trying all kinds of different eye drops and products. Just today I got some more Systane Balance to see if the oil in that might make it last longer on my eyes. But so far after two applications about 4 hours apart, my eyes have a low-grade burning sensation and feel heavy and tired. Not as dry as they ever have I will admit, but they still felt pretty rotten due to the other issues.

    Seriously, is anyone else going through this with glasses after having worn contacts for many years? I really expected that my dry eye would be helped out by not wearing contacts after only a couple of weeks or so. But that has been about the farthest thing from the truth so far.

    Thanks for any help,
    John in NC

    PS:

    • Yes, I do also stare at a computer screen for probably 10 hours a day. I work in IT and there is not much way around this.

    • I also was prescribed Accutane acne medicine as a teenager. Shaking my head in this forum at more than a few posts lamenting how that drug ruined other people’s eyes. I don’t recall how long I used this for, but I know a lot of people feel that Accutane continued to work negatively on their eyes long after it did positively on their acne…

    • I also take more than 1000 mg of Omega 3 per day in the form of fish oil pills on the advice of all of the eye professionals I have seen over the past two years. This has done wonders for my cholesterol, but not sure I can say the same for my eyes.
    -John
    Winston-Salem, NC

  • #2
    Hi John and welcome.

    Familiar story. And when it's gone on that long, it's hard to give up the 'shield' aspect of contacts, but it shouldn't be a dilemma at all at this point because at the severity of dryness you're describing, you can only harm yourself further by using lenses more. (It's almost like the problem of vasoconstrictors: people with chronically red eyes from the stuff go off it, find their eyes are still red and then think, what the heck, I might as well still use them... but do you really want to make yourself worse??). Sounds like you have a pretty good understanding of that anyway.

    What I would be doing is...

    (a) getting some better palliative and protective tools for your eyes so you can feel better and cut down on further harm... and considering your profession, moisture chamber glasses are going to be pretty much unavoidable if you don't want to be miserable by the end of the day of work.

    while at the same time

    (b) pursuing better diagnosis and treatment of your problem. I don't see anything in your post about any treatment whatsoever except Restasis, and I don't see anything about any more detailed diagnosis than "dry eye". Have a look through some of my articles like:
    How to get a better diagnosis, How to get better care from your doctor and so on. If you don't have severe meibomian gland disease, punctal plugs might help significantly with making you more comfortable. If you do have MGD, you need to be on some kind of treatment for it. Since you're using a computer constantly, read up here on all the tips and tricks we use to keep our eyes better hydrated while at the computer and how to reduce the exposed area of the eyes.

    p.s. How long did you try Restasis? I'm not a bit fan of it but it does help some people quite a bit so if you're going to try it at all, I'd urge you to give it a fair try - that could include buffering the sting effect by applying some saline or artificial tears a few minutes before you put it in. Also this business of waking up at night should be addressable with the right combination of lubricants and protective gear to keep your eyes covered and perhaps hold the lids still to help prevent erosions.
    Rebecca Petris
    The Dry Eye Foundation
    dryeyefoundation.org
    800-484-0244

    Comment


    • #3
      Thanks Rebecca,

      To be honest I'm feeling kind of embarassed here. I was so ignorant for so long about my contacts and am just really beginning to realize how bad it was. I guess at least I'm not blind yet...

      I tried Restasis for somewhere between 5-6 months. Do you think I should have another go at it? I guess it couldn't hurt. I'm at a point now where I'm willing to do more than I was probably even 6 months ago.

      Um, moisture chamber glasses? Yeah I'm going to have to do some more research here. Would that be for only at night? Getting to the end of the work day without being in pain is kind of the challenge right now. Part of the problem is that in addition to the dry eye, I'm pretty sure I have instances of regular eye strain and just tired eyes as well due to the constant computer use (sitting here now at 9 pm est in front of my home laptop now, how smart is that?) Sometimes my head gives up and just tells me that my eyes hurt, not distinguishing between dry or tired or stressed and I feel like giving up.

      I have not really researched plugs or anything like that but maybe it's time there too. I have a start. I'm going back to my regular optometrist here in 2 weeks, the same guy who referred me to the others originally back a few years ago. This time the goal on my end will be to get more of a real diagnosis other than just "dry eye." Is it MGD? Is it all of the above? The guy I saw last (who diagnosed it finally with the Schirmer’s) was an experienced surgeon who deals with all kinds of cataracts, macular degeneration,etc. I was the youngest person in his waiting room the one time I went by at least 3 decades. If I can get back in with him I'm willing to bet he could figure it out...

      I'm tired but not giving up. Thanks again to you and this forum. I'm "starting" and I'm determined...
      -John
      Winston-Salem, NC

      Comment


      • #4
        For me it was pretty obvious:

        6 month lenses = 120 bucks
        glasses = 150 bucks

        So if I buy glasses which last at least 2 years I have more money for other stuff ...

        I can't wear contacts anyway so I don't really care about them anymore ...

        As long as you don't feel like your eyes are full of gasoline when you try to remove your contacts you can keep using them, for me however the pain and burning was too intense.

        Comment


        • #5
          I hear you. Contacts for me generally feel fine, though when my eyes get tired with them at the end of the day they start to feel very tight (like my eyes want to pop out) and that is when I get some of the weird head pain I mentioned in my original post. After I take the contacts out after 15 hours or so is when the problems really start - I know I will be dealing with big time dry eye problems for at least the next 24 hours.
          -John
          Winston-Salem, NC

          Comment


          • #6
            I just replied to your newer post, but wanted to agree with Rebecca about starting better protective care for your dry eyes, especially at night. You've already tried going full time with glasses---so it's clear that you need more than just quitting your contacts.

            Even though your eyes feel fine in contacts, they are just more protected, and as you said, the "real" pain starts after you take them out. Not a good sign. As far as Restasis goes---you would probably do better with it AFTER you get the dryness under control. If you use it on raw, dry eyes, it's going to really burn, and it'll be a struggle to use. I tried Restasis for long periods, 3 or 4 times---but, I was wearing my contacts during that time, and I think that's the reason it never worked for me.

            You also might find relief from eye strain and associated head pain, in getting a reduced strength glasses prescription to use when you work at the computer. With your degree of myopia, you could easily get a pair of 7eye prescription moisture chamber glasses to wear at work.

            Calli
            Just wanted to add that at 10 hours a day at work, you're eyes are "accommodating" (holding a close focus) all day, which is super tiring. Reduced strength glasses allow you to view the near focus without having to accommodate.
            Last edited by calli66; 01-Oct-2011, 09:45. Reason: added a comment

            Comment


            • #7
              Originally posted by jchcollins View Post
              To be honest I'm feeling kind of embarassed here.
              If it makes you feel any better, I abused soft contacts for years in my teens/twenties. (Never slept in them, but I probably would have if I could have.)

              I tried Restasis for somewhere between 5-6 months. Do you think I should have another go at it?
              Usually if it's going to help, you know by that amount of time. I've known exceptions, but whether it's worth another try, I don't know. I'd perhaps try some other things first.

              Um, moisture chamber glasses? Yeah I'm going to have to do some more research here. Would that be for only at night? Getting to the end of the work day without being in pain is kind of the challenge right now.
              It's work I have in mind. Try this - download the dry eye shop catalog and scroll to Page 4 (Moisture Retaining Eyewear) - there's a page of explanation of what this is and why, and a page with a table to help narrow down what types might be most appropriate for an individual. Not trying to push my products on you, in fact you're best off going to a local sports optical or Harley Davidson shop, just want you to see the kind of thing I'm talking about. Also scroll down to the eyewear section of the forum archives, there's a lot of talk about them.

              Part of the problem is that in addition to the dry eye, I'm pretty sure I have instances of regular eye strain and just tired eyes
              This goes hand in hand with dry eye. And yes it becomes difficult to figure out what's the source of discomfort.

              The guy I saw last (who diagnosed it finally with the Schirmer’s) was an experienced surgeon who deals with all kinds of cataracts, macular degeneration,etc. I was the youngest person in his waiting room the one time I went by at least 3 decades. If I can get back in with him I'm willing to bet he could figure it out...
              Sounds like a general practice ophthalmologist. I'd be looking for either a really good optometrist who works with dry eye a lot, or a corneal specialist ophthalmologist (but not one whose practice is dominated by LASIK... if that's possible). Get a referral from someone here if possible.
              Rebecca Petris
              The Dry Eye Foundation
              dryeyefoundation.org
              800-484-0244

              Comment


              • #8
                Thanks all for the advice!
                -John
                Winston-Salem, NC

                Comment


                • #9
                  I am also in my thirties, am a long time contact lens wearer, and took accutane when I was a teenager. I hear you on the contacts, it has been hard to give them up. I just can't imagine my life without them. I really don't like th way I look with them, I have a long narrow face with a long nose and they just don't look great. Plus, it's harder to do sports in them and I'm still looking for prescription swim goggles that fit my face and don't let the water in, like the last pair I spent money on.

                  I agree with Rebecca's suggestion on finding a dry eye specialist (perhaps an optometrist) who can tell you are your mgd's are doing or if you are aqueous deficient. There are specific treatments for both that might help. Does a warm rice baggy compress help?

                  Comment


                  • #10
                    Thanks again all for the advice. Here is an update a few days in from my first post:

                    The situation at work has gotten so bad in the afternoons that for the time being I’ve had to go back to contacts at work. I know this is not ideal, but I simply can’t afford to lose any more time in the productivity department because my eyes are hurting so bad. It’s starting to affect my work. I don’t know if it is the shield effect of the contacts or what, but I am able to work when wearing them. My eyes don't feel great, but they feel much better than when the lenses are not in. I’m not sure entirely why this has gotten so bad just over the past week or so; I have been wearing mostly glasses at work for nearly two years now, and while it’s not a walk in the park to manage the dry eye, I’ve been able to do it. But here lately, the afternoons in particular have been just absolutely unbearable.

                    In the treatment dept. I tried the Genteal gel for severe dry eye starting late last week. This worked like a charm and I thought I had found the trick for about 4 days. Then Monday at work was horrible, and the gel went back into the category of just about everything else I try – it provides relief for half an hour or so and then the effect is gone. Genteal also has left a burning feel in my eyes this week where it didn’t when I first started. So, back to the drawing board there. I had also tried Systane Balance. This works “ok” for a brief period of time, but makes my eyes burn as well.

                    In the advice department, not to brush off the suggestion but I have to be honest and say I don’t really see myself wearing some kind of goggles or wrap around moisture retaining system at work. Maybe for at night or at home later, but I deal with enough crazy issues during the day without having to add the stigma / questions that would be associated with something like that as well. Feel free to disagree with that, I would not blame you, but I need to be honest and say I just don’t see that happening. Yeah, I know – it was the vanity of not wanting to wear glasses 20 years ago that got me into this mess in the first place probably.

                    The plan for now I think is going to be contacts whenever I am staring at the computer and glasses at all other times trying to manage with the drops. I have an appointment in two weeks with my optometrist to begin reviewing all of this again. My hope would be that he can somehow get me comfortable enough to be in glasses all of the time but for whatever reason right now that just doesn’t seem to be in the cards at this exact moment. I would like to try Freshkote again. I tried samples of that with this same doctor last year and remember thinking that it might have been working better than some of the other stuff. But I didn’t pursue it via prescription after the samples ran out.

                    Am I really physically hurting my eyes (other than perpetuating the dry eye) by continuing to wear contacts during the day? I’ve been told more than once by the doctor that despite my dry eye, my corneas and eyes in general present very healthy, and do not appear to have been damaged in any way. I know I have a slightly elevated risk already of retinal detachment later due to myopia, but are my contacts thinning / thickening my corneas in any way or anything like that by continuing to wear them? I guess what I am trying to get to is will continuing to wear my contacts do anything else to my eyes (short term / long term) other than continuing to make them dry? I’m already dealing with that. I highly suspect the answer there in the damage department is a “yes” in at least some way after all that I have researched over the past two years, so I really do want to be able to quit the contacts. At least for the short term however I cannot see how I have another option right now.

                    Thanks all for hanging in with me. I am very frustrated right now. I know it’s unlikely my eyes and tear film will ever be “perfect” again, but I would at least like it to be manageable. Right now that seems like a very distant goal.
                    -John
                    Winston-Salem, NC

                    Comment


                    • #11
                      Am I really physically hurting my eyes (other than perpetuating the dry eye) by continuing to wear contacts during the day? I’ve been told more than once by the doctor that despite my dry eye, my corneas and eyes in general present very healthy, and do not appear to have been damaged in any way. I know I have a slightly elevated risk already of retinal detachment later due to myopia, but are my contacts thinning / thickening my corneas in any way or anything like that by continuing to wear them? I guess what I am trying to get to is will continuing to wear my contacts do anything else to my eyes (short term / long term) other than continuing to make them dry?
                      Lenses aren't going to dangerously thin/thicken your corneas in some mysterious way or present any risk to your retinas to the best of my knowledge. But you really need doctors to tell you the answer to this kind of question not just opinions from fellow patients. It's too important to let yourself be swayed by what any of us here think.

                      But even setting aside any possible of unknown risks, I don't think this is as simple as a choice of whether to perpetuate dryness with contacts as a tradeoff for better daytime comfort. It's a bigger picture issue of what sure sounds like progressively deteriorating ocular surface health due to (based on your description/diagnoses) severe aqueous deficient dry eye as a minimum - and how to eliminate things that will exacerbate it and introduce things that will improve it (both clinically and symptomatically) and reverse the downward spiral that it sounds like you're experiencing. It's a slow road, and that's frustrating to all of us, but without significant steps in the right direction it's hard to get to the destination.
                      Rebecca Petris
                      The Dry Eye Foundation
                      dryeyefoundation.org
                      800-484-0244

                      Comment


                      • #12
                        I figure you'll continue with the contacts until you just can't anymore---which is what most of us did. For myself, I went the way of continuing contacts because I could wear the 7Eye glasses with them, which helped a lot, but eventually that, too, became intolerable. As to whether it will physically harm your eyes---I don't think anybody could really know the answer to that, at least in the general sense. Having a constant state of wetness (when wearing soft contacts) with moderate inflammation going on may be less than ideal, because we just don't know the long term effects. Inflammation can damage tear glands and meibomian glands, which have much to do with the comfort of your eyes---even if your corneas are healthy.

                        For me the key to comfort with Genteal Gel and even FreshKote is based on "limited" use---the gel only at night, and the FreshKote no more that 3-4 times a day. Any more than that, and they become an irritant. That's why it's so important to find a few things to use that protect the eyes that AREN't drops or gels.

                        Having to work 10 hours a day at the computer puts your eyes under terrible strain. Office air, not blinking enough, near focusing stress. These may be equally as harmful as wearing contacts. One would hope that you don't get into "crisis mode" where suddenly you can't wear contacts at all, your eyes are a mess, and you have to wear moisture goggles at work just to make it through the day. I would guess that your continuing to wear contacts at 10-12 hrs a day 5 days a week doesn't really give your eyes a chance to respond to nighttime eye protection, gels, and drops. They just don't have enough downtime to heal.

                        You could come up with a PLAN to wean off of the contacts when you have vacation or extended leave time from work---with lots of rest, nighttime protection, and maybe a trial of prescription moisture chamber goggles.

                        Calli

                        Comment


                        • #13
                          Originally posted by calli66 View Post
                          I would guess that your continuing to wear contacts at 10-12 hrs a day 5 days a week doesn't really give your eyes a chance to respond to nighttime eye protection, gels, and drops. They just don't have enough downtime to heal.

                          You could come up with a PLAN to wean off of the contacts when you have vacation or extended leave time from work---with lots of rest, nighttime protection, and maybe a trial of prescription moisture chamber goggles.
                          Calli
                          Thanks Calli. My confusion around this is I thought I was already weaned off the contacts. I have worn them only when exercising and maybe one day per week besides that for nearly 2 years now. The flare-up with being uncomfortable with glasses is a fairly recent thing. I won't say my eyes had gone back to being an oasis before, but I was generally able to manage with drops for a good while after I mostly shelved the contacts.

                          I do know that it's much harder to manage when the computer screen is involved. For example glasses and drops while driving generally seem to work out fine....
                          -John
                          Winston-Salem, NC

                          Comment


                          • #14
                            Originally posted by Rebecca Petris View Post
                            I don't think this is as simple as a choice of whether to perpetuate dryness with contacts as a tradeoff for better daytime comfort. It's a bigger picture issue of what sure sounds like progressively deteriorating ocular surface health due to (based on your description/diagnoses) severe aqueous deficient dry eye as a minimum - and how to eliminate things that will exacerbate it and introduce things that will improve it (both clinically and symptomatically) and reverse the downward spiral that it sounds like you're experiencing.
                            Thanks Rebecca,

                            I agree with you this is more about long-term health of the ocular surface than it is a simple choice between contacts and glasses. I think my rhetoric so far probably sounds like just the opposite mainly because I'm in flare-up crisis mode, and that seems to be one of the only things left I have control over. I can choose in the morning whether I think it will be a better day with contacts vs. glasses; I can't choose whether whatever the newest drop or treatment is will work. So far most havent.

                            I have tried to give up contacts (and mostly with success so far, which is what is so strange about this to me) due to the fact that I thought they would always hinder any progress I was able to make with the dry eye as long as I was wearing them. I would never know how much better it might be if I was not still wearing contacts.

                            I'm going back to my original optometrist on the 20th of this month, which was the first appointment I could get. I'm taking the OSDI sheet with me, and will be determined to see if I can't get more information on whether this is just acqueous deficiency, or MGD, or both. This is the doc who referred me in the past to other opthamologists, so I am hopeful that he will help me continue to go further in the right direction. In the meantime, I am trying to be patient (this is after all an inconvenice, chronic disease - it is not life threatening). I know you all know how hard that is!
                            -John
                            Winston-Salem, NC

                            Comment


                            • #15
                              Don't forget to look through all the advice on computer use with dry eye. Every little bit helps. There's a wealth of experiences here in the archives. For me, looking down on my screen (not straight or up) makes a big difference as it reduces the exposed area of the eyes, and I have to consciously blink frequently, and I use the f.lux automated background color adjusting program which another member introduced us to.
                              Rebecca Petris
                              The Dry Eye Foundation
                              dryeyefoundation.org
                              800-484-0244

                              Comment

                              Working...
                              X