Hello everyone, another dry eye sufferer!

[jesseg2]

Hi everyone,

My name's Jesse and I'm new to the website. I'm hoping to find some answers to my dry eye and maybe share what I've learned as well. I had lasik 12 months ago, and that's when my dry eye problems started. Before lasik I never had any issues with dry eye. In addition, my allergies give me very itchy eyes which further complicate things, particularly this time of the year.

I'm currently seeing a vision therapist, as I have a slight eye convergence deficiency as well. If you're unfamiliar, this means that my eyes point slightly more outward than most, so I have to work harder in order to maintain focus, particularly when reading. This coupled with dry eyes has been a nightmare. I get throbbing headaches daily whenever using the computer, reading, watching tv, etc.

Up until last week, I was using restasis daily, using systane ultra drops as needed, and taking allegra and patanol for eye allergies (which really helps with itchy eyes, but worsens dry eye).

Last week my vision therapist told me to stop taking everything. This includes over the counter drops. He is a firm believer that restasis and OTC drops simply act as a crutch for your eye, and that if you stop using them completely, your eyes will slowly over time begin to produce more tears. He also advised against lid scrubs, saying they're too abrasive. He encourages using hot and cold compresses, chamomile tea bags, and excessive yawning to release tears.

I quit everything cold turkey 4 days ago, and it has been rough. I probably should have weened myself off. Has anyone taken this approach before? I'm trying to stay optimistic.

Also, I'm hoping to get a proper diagnosis of MGD, blepharitis, etc. My last lasik appointment they told me that plugs would be useless because I don't have a drainage issue, my tears just evaporate instantly. They put dye in my eye so I imagine this was a tear break up time test. Is there a directory out there for dry eye docs? I'm located in San Diego CA if anyone knows a great doctor for this. I've tried a couple and they don't seem to know much beyond prescribing restasis.

Thanks guys!

[AprilShowers]

At his stage may I advise you to avoid Doctors for your problem, and to read no matter how long it takes all the posts on this forum, collectively we are the experts on dry eyes, and if you need further reassurance advice then Google the subject. Some simple advice AVOID as if it's the plague - hard detergent soaps esp carbolic soap. Learn to wash your hair and rinse it off then dry it using the towel to protect your eyes, then shave and again avoid wetting the eyes with soapy water. Ordinary soap damage is the overlooked bane of our lives. Another small tip if your filling your car tank with gas / petrol then use the poly-gloves many garages provide free. Petrol pump handles are coated with petroleum gas-grease, which can be transferred on your fingers to your eyes. I have the bad habit of always rubbing my eyes maybe 50 times a day. Also hay fever pollens such as Rape Seed Oil need to be avoided, there's a relationship between MGD and pollen dust which should be investigated. I wish thee well, BW

[Rebecca Petris]

Last week my vision therapist told me to stop taking everything. This includes over the counter drops. He is a firm believer that restasis and OTC drops simply act as a crutch for your eye, and that if you stop using them completely, your eyes will slowly over time begin to produce more tears.

What qualifications does your vision therapist have?

I would not take advice of that kind from anyone who is NOT an ocular surface disease expert. You don't tell someone to stop all Rx and OTC drops unless you really know what you're doing. I think that there can be very good reasons to stop certain drops (many people DO overmedicate for dry eye in spite of allergies, sensitivities to ingredients etc) but I think the reason this one has propounded is nonsense as a general broadbrush principle... If your eyes go dry there's a reason, whether related to aqueous or meibomian gland or something else, and until/unless that's been identified and addressed, for the sake of your corneal health AND vision, your eyes should kept decently hydrated somehow or other unless the dryness is mild.

I disagree with AprilShowers, though I understand why people get cynical about doctors. We're talking about your most important sensory organ, in my opinion it's very important to have a good, QUALIFIED doctor investigating to pin down the real issues and help you on a path to recovering and maintaining things.

I quit everything cold turkey 4 days ago, and it has been rough. I probably should have weened myself off. Has anyone taken this approach before? I'm trying to stay optimistic.

If you have significant dryness I would not quit EVERYTHING. If you are symptomatic I'd be using an unpreserved artificial tear when needed for comfort and to avoid getting too dried out, being especially careful at night when tear production goes down. Protective eyewear is a good way to be able to cut down on drops though.

My last lasik appointment they told me that plugs would be useless because I don't have a drainage issue, my tears just evaporate instantly.

Funny, that's exactly WHY some people get plugs (as opposed to refraining from getting plugs).

Re: local docs, check out the plug a doc forum for San Diego suggestions.

[SunshineinCalgary]

Hi JESSEG,

Welcome to the club. I kind of agree with Rebecca on all three: (I'm using Restasis and both upper and lower plugs.)

1. Don't stop everything all at once. Your condition may go down very fast
2. Use those drops without preservatives
3. If your tears evaporate instantly, there's more reason to use plugs.

I believe our eyes will heal, slowly but gradually. Until we find a miracle drop, artificial tears do provide some kind of temporary relief..

[AprilShowers]

When my problem commenced I had great faith in Doctors and Hospital Eye Consultants. I was completely ignorant of the whole subject, and it never occurred to me so where they? That is why I advised a course-of-self education by reading the posts on this site first before rushing off and placing yourself under there care. Please read the following as fact and what you might encounter!

[1] By reading I learnt about Keratitis, an eye inflammation disease, I mentioned this to a very prominent Eye Consultant who did not appear conversant with the subject, and when I mentioned Cyclosporene to him he had never heard of it? It was I who suggested it was tried but this took 6 months of dropping quiet hints before 'they adopted my suggestion'.

[2] I had two lots of Punctal plugs fitted, both dropped out, again my reading suggested that they needed to be causterised. I regret to say it took 12 months of asking before these hospital experts decided I was right and this procedure was carried out. I'm still puzzled why they did not do it immediately and why I was taken into a major operation/s theatre suite for this very simple 10 minute procedure. It could have been done whilst I was in a cubicle and sat on a chair. It appears the waiting list for the operation theatre is booked for months ahead.

I'm certain that others on this site can confirm and add similar experiences. Need I add that our condition as got in hospitals a certain stigma about it, and maybe this expalins why in m y case I always see trainees, new foreign students, a choice of nationalities with many having a limited knowledge of English. I imagine the USA is far better than here so please add this into the equation. My best doctor is Chinese, Dr Chang, and without him I'd be lost, but the chances of seeing him are 1 in 10 visits.

[AprilShowers]

May I add: I have had this condition in quite a severe way since 1993, 19 years, during this time I have seen two [2] Hospital Eye consultants, one [1] Private Eye-Consultant [paid for] several hospital Eye-Dept Registrars [the assistant to the Consultant] and about 10+, or more hospital appointed eye specialist doctors. Suffice to say my condition has not improved one bit, in fact overall it's gradually got worse. All these men and women eye-professionals are QUALIFIED, but qualified or not my condition as not improved one iota. In England [like the USA perhaps] we have several levels of qualification/s. It must seem strange to our American Cousins but the highest medical respect is accorded to hospital consultants called Mr, e.g. Mr Brown, Mr Roosevelt, if your lucky enough to see a Mr, then your seeing the top-man in that eye-hospital, and, I am speaking here of State Hospitals with 3000+ staff, and maybe 1000+ beds, and enormous eye-care departments. I have also seen 3 neurologists because my optic nerves are 'worn out and shattered; at present they are treating me with Botox to reduce the severity of the symptoms- but no treatment to heal or cure is given. because none is known to them. I mentioned MGD and Blephs have a stigma about them. what I meant was eye-dept are overwhelmed with dry eye patients, caring for these untreatables is on the lowest rung of the medical career ladder. That's my impression, you may see it differerently, lets hope so. I read 1 in 6 of the population over the age of 52-56 have dry eyes?

[littlemermaid]

AprilShowers,
Do they know what's happened to the nerves around your eye? I am thinking you mean botox into these surrounding nerves for blepharospasm? Does it affect the nerves in the eye surface or the optic nerves for vision?

I'm noticing Mr Chang is also at Spire http://www.spirehealthcare.com/leeds/professor-bernard-chang/ so I guess that's an option occasionally.

Jesseg2, Dearly hope you can find an ophthalmologist who can help you heal. You can see how we all try different docs for advice until we settle into a good healing routine.