Dry eyes - where do I go from here?

[Jasmine]

I am new to this website but i'm so glad i've found it. I've been suffering with dry, painful eyes since I had laser eye surgery (prescription -6.00 and -5.75) two years ago. Although if I think back to my 20's when I wore contact lens more or less continuously, I think my eyes were a little dry then also. The last two years have been a bit of an emotional roller-coaster where at times I have felt utterley hopeless and very depressed. I work as a secretary and use a PC for eight hours a day but I am now considering giving up a job I love, because of the pain that I am having to endure for 5 days a week. Some days when I come home my eyes are so dry and painful that I just have to close them for the rest of the evening.

Over time I have used every eye drop and moistening routine known to man with little or no effect whatsoever. I have punctual plugs inserted in both eyes and am still visiting my Lasik provider, who can offer no real help only to advise me to 'keep on with the drops'.

Some days are worse than others where my eyes will 'flare up', sometimes through lack of sleep, sometimes through dehydration or taking certain medications and other times for absolutely no reason at all!! Everyday can be different and I find this the worse thing of all - the anxiety of not knowing what my eyes will be like when I wake each morning. I use Clinitas gel at night and Celluvisc drops in the day. I also rub a little bit of vaseline in the lower rim of both eyes with a cotton bud when they are feeling very sore. (this may help someone out there).

The strange thing is that I had a cold recently and for two weeks it was absolute heaven as my eyes felt so moist and comfortable it was unreal. Alas, it didn't last long but I realised then how much I have been suffering and how awful this condition really is.

Jasmine x

[LauraK]

Jasmine:

Have you tried Restasis? Restasis can help for tear production, but can several months to work. I too am suffering from dry eye as a result of Lasik surgery. I would also advise getting a second opinion.
If someone would have told me how terrible dry eye, I don't think I could have ever imagined how awful it can be and how it interferes with your daily life.

Do you know if your issue is with low tear quality or quantity?
Best of luck to you.

Laura

[robster]

I know I'm not allowed to mention clinics by name on this website but just by the drops you have been given I know you were treated by the same company as myself. I would demand a second opinion as the company you were treated by are next to useless when it comes to dealing with dry eye. Just to back up what Laura said Restasis is definitely worth a try still waiting for mine to arrive.

[littlemermaid]

Jasmine, So sorry to hear this isn't resolving. I'm hoping you're with a large, specialist hospital NHS eye clinic as well for access to NHS drops and monitoring.

Just to say, we've been using Celluvisc in chronic use 6 or 7/day for 2.5y, but we've switched to just saline Minims (sodium chloride) 0.9% to try to reduce such frequent chemicals on the eye surface, hoping the surface will restore better. We're using them straight from the fridge, as Dr Latkany suggests in his book 'The Dry Eye Remedy'. Saline seems to work the same or better than Celluvisc for us in frequent use (also we get saline easily in bulk on NHS prescription/month to cut cost). We're also finding we don't need a night-time gel if we keep up with warm compress, get good sleep, take care not to dry out, but you may be different.

Are you wearing wraparounds at work? We also have this major problem of staring at the computer all day and I am finding she rarely blinks because the eye surface is desensitised, so there's less prompt to replenish the tear film.

I think Robster ordered Restasis online without prescription, didn't you? I would dearly love to know if anyone has Restasis legit and under supervision in the UK because otherwise I'm going to the US for this to get a formulation (hypersensitive rosacea, we are suffering with bases in chronic use, and Optimmune has an ointment base, yet more unnecessary chemicals).

[Tanner]

Jasmine,

I think it is interesting that you said your eyes were better when you had a cold. Look into a drug that is being developed by mimetogen. I think it is called dm 113. Anyway it is suppose to help the eye secrete mucus. That is my limited understanding of it.

[robster]

An eye specialist that I saw unconnected to my clinic ordered it for me. I will be using it(restasis) under his supervision.

[Jasmine]

Dry eyes - where do I go from here?

Thanks for all your comments, I have found them all extremely helpful. I've been for yet another visit to the Lasik provider - this time he suggested that I have plugs put in all four ducts (just have the bottom one in at the moment) just to 'give me a rest from the dryness'. I'm a bit apprehensive about this because when I had the four plugged last time, although my eyes felt really comfortable, I had tears running down my face almost continuously, not ideal if you have to go to work every day and even worse if you have make-up on!

Regarding obtaining a second opinion - I haven't really looked into this, would I ask my Lasik provider or my GP and would this be a private consultation or can I get one on the NHS? I had heard of Restasis and asked my Lasik provider some time ago but he said the it was a very powerful drug and he didn't want to go down that road at the moment.

I'm not sure if the problem is my tear production, I've just been told that the tiny glands are not producing enough oil and the tears break up really quickly. I would agree with you Littermaid, after two years of continual use of drops etc., I am now finding that my eyes are quite sensitive to anything I put in them, even Celluvisc which is supposed to be preservative free. I'm going to try the saline drops instead to see if they feel more comfortable.

Although I am pleased with my eyesight at present, I feel that it could be a lot sharper if only my eyes weren't so dry. Also I have read that our eyes get drier as we age so I am very concerned that my eyes will become even drier in the future. Oh forgot to mention in my original post that I have also had two corneal abrasions caused through dryness. The pain from this was unbearable and I am now far too nervous to even contemplate stopping the gel at night - althought I would really like to.

Many thanks

Jasmine

[poppy]

I had heard of Restasis and asked my Lasik provider some time ago but he said the it was a very powerful drug and he didn't want to go down that road at the moment.

Your eye doctor is either lying (probably because he can't be bothered getting the restasis for you, it likely involves a lot of paperwork if the UK is anywhere like Australia) or is extremely stupid, possibly both. I would challenge him to back up his comment with facts.

Restasis commonly has side effects, but they are minor and temporary eg burning or stinging that goes away when you stop using them. Restasis is not like steroids, the risk of a serious side effect is virtually nil.

[Hopeful2]

Hi Jasmine,

You would be wise to consider giving Restasis a try. I was very hesitant when my doctor prescribed them at eight months post lasik. . . I feared the stinging or burning that everyone here seems to experience with Restasis. Well at eleven months post lasik, and after two weeks on a light PF steroid, I gave restasis a try. I am thrilled to say that it does not burn. After one week I notice that my eyes are not as dry in the middle of the night. I also believe that my meibomian glands are secreting more oil! I am sooooo glad I decided to give restasis a try. PM me if you have other questions.

[piot0020]

Jasmine,
I have all 4 tear ducts plugged. At first my eyes were always tearing but it just took a few weeks for my eyes to adjust. I still have all 4 of them in and one eye overtears maybe once a day but my eyes feel so much better than what they did before I had all 4 tear ducts plugged. I think you should give it a try, it really works for me.

[Jasmine]

I'm going to give the four punctual plugs a try and see if things improve, trouble is the top ones always seem to fall out rather quickly, how do you manage to keep them in? I've read some where that if the plugs work for you then you can have the tear ducts cauterised to seal them up permanently. I thought I'd also ask my GP to arrange an referral to see a private Eye Specialist as I don't feel that I'm having the help from the Lasik provider I really need at the moment

Also I've ordered some Theratears online because I've read some good reviews - has anyone here had any success with these?

Jasmine?

[Rebecca Petris]

If anybody's looking for Karjade's posts I have moved them all to a new thread - Jasmine you may want to have a look at it as littlemermaid's most recent post was directed to both of you. (sorry I couldn't figure out how to keep a copy in both places)

[AprilShowers]

Jasmine, tread carefully. You only need the top TWO ducts plugged or cauterised, the bottom two are needed for drainage especially if Restasis works, and / or it effects a partial cure. Plugging or cauterising all four ducts means your tears will stream and 'overflow', they will ruin your composure, makeup and evenings. Punctal plugs do come out, I had 'fall out' with mine which was a surprise because I assumed they were permanent. As for artificial tears I have tried them all, whilst Viscotears are the best I would not recommend it - as you must know it lasts ten minutes.

* May I suggest you purchase or obtain: Mini-Plasco STERILE WATER for injections packed in 5ml plastic ampoules, the ones I have are made by B Braun Meshungen, Germany, I'm suggesting that each morning or bedtime you give your eyes a DRINK OF WATER, my indirect meaning is: if somethings is dry then soak it. I also keep in the house Bausch & Lomb Minims, which is ordinary Saline Solution 9%, boxed in 20 small sterile containers marked Use As Required. Viscotears is an oil-lube, these are sterile water absorbed by your eye tissues. Do not use tap water because as we all know it contains chemicals and fluorides to eliminate water-works bugs.

[SunshineinCalgary]

Hi Jasmine,

You said, "because when I had the four plugged last time, although my eyes felt really comfortable, I had tears running down my face almost continuously" If this is the case, I think your condition is much better than a lot of people!! There is HOPE!! I am using Restasis and I have all upper and lower plugged but my tears are not overflowing.

I don't think you should give up your job yet. I have not. Try Restasis for a few months and see how you like it. You may change your mind about your condition. Restasis is a powerful drug but once you start on it, give it a few months don't stop after two weeks. Good luck !

My eye doctor told me that for the less severe dry eye patients, Restasis will give them suffcient tears if you complete the whole treatment (ie. 3- 4 months) For more severe dry eye, you may need BOTH plugs and Restasis to maintain the tear flow. (which I am doing now).

[AprilShowers]

Sunshine In Calgary,

I read your post with great interest, the reason being I asked my UK hospital consultant 'to plug all four of my ducts' and was firmly told they do not advise it and would not do it, the reason given was tear overflow. As you can expect one doctor says one thing and another doctor claims otherwise. Jasmines April 27 post did say "when I had the four plugged last time, although my eyes felt really comfortable [but] I had tears running down my face almost continuously" which confirms my own doctors warning. We all agree when we wake up our eyes are dry and ache, so this suggests last thing at night they 'need a drink'? LittleMermaid a UK resident I will enquire at my hospital pharnacy is Restasis on their list, it wasn't some 2 years ago, so I was given dog oitment which contains 2% clyclosporene. I was told this cost £32.00 per tube for them to buy, approx $ 45.00 US dollars. Mnfr Schering -Plough.