5 months of treatment and no improvement

[mstar82]

I went to my GP in early June as my left eye was really red and closed of its own free will. He referred me to an opthamologist who recommended two weeks of eye drops.
I went back after two weeks and he found no improvement so put me on antibiotics for three months, dyoxycline. Went back last week and still no improvement- on the camera where he puts yellow dye in my eye the left eye is black with holes in.
He initially said I had corneal damage and its reversible. Now its been four months with no improvement and Im worried. I have googled it and the sites only talk about extreme cases which do not respond to treatment, which is me!
He's now referred me to a surgeon next week, which has worried me eve
Has anyone been in a smilar situation? Or know of someone who has? I can't find similar stories on the internet.

[bakunin]

Hi mstar82,

but what your diagnosis is, if you had one?

I would go to other doctor to have a second opinion.

Here on this board you will find plenty of people (maybe most people here) that don't respond to treatments. Myself included.

[mstar82]

I've not been given a diagnosis, but he has talked about dry eye as if it is the diagnosis. What I'm worried about is the corneal damage that hasn't got better, does this mean its permanent? My sight has got worse and I have halos around lights etc.

[Rebecca Petris]

DON'T PANIC, definitely! The cornea can take a lot of beatings from surface disease without getting into any 'irreversible' territory. It's designed with a phenomenal self-repair capability, thankfully!

How does your doctor define "corneal damage"? Is he seeing dry spots? staining? scarring? How much is your vision affected and is it constant?

Can you share with us a bit about your symptoms?

If you've been prescribed doxy, then they've probably diagnosed you with some kind of meibomian gland dysfunction (they do not prescribe doxy for aqueous deficient type dry eye) but you should ask about this to be sure.

Why are you being referred to a surgeon - do they just mean a specialist who can get into more details of your diagnosis and has more treatment options, or are they talking about some kind of surgery? Any chance you have what they call map dot fingerprint dystrophy? Are you getting erosions?

[mstar82]

Thanks for your reply.

My symptoms are a red eye which closes on its own. It gets sore too. As soon as I'm a bit tired it closes completely.

I have to put drops in hourly, use viscotears at night and take 100mg of doxycline a day. I have been doing this treatment for just over 2 months.

He says I have erosions on my cornea. I'm not sure what the technical term is but I had yellow dye put in both eyes and he takes a picture with a microscope. The right eye is green and smooth and the left is black with 'pools and flecks'. I have seen him three times since June and he took a picture each time with no improvement.

He said he's referring me to the surgeon so ' someone else can have a look', as he said in his experience it should have sorted out now.

What should I ask the surgeon? Really appreciate advice as I can't find out anything. By the way, I'm in the UK.

[mstar82]

I saw the surgeon today and he has confirmed dry eye syndrome. He said might right eye has a blink to tear rate of 5 and left 9. He said 10 was normal. He was really dismissive, said it was common and sent me away with more eye drops. He also said I can never wear contact lenses again. I am so angry: he's discharged me dispute the fact my eye is red and drooped most of the time. I feel so ugly, especially now I can't wear contact lenses. Also he said laser eye surgery, which I have always wanted, is a complete no go. I argued that all treatments havent worked and he said I haven't used them enough! Are doctors usually so dismissive?!

[tearless2]

Some ignorant doctors are dismissive. I have seen 2 opthamologists before I found anoptometrist who is helpful and specializes in dry eye. I also had to go through 1 GP before I found one who wasn't dismissive of possible sjogren's. "It's all in your head- your blood tests are normal so there's no way you could have this - here's some anti-anxiety drugs". Lovely.

Seriously, you have to wade through some eye doctors until you find one who has some experience with dry eye. The ones who see patients who are blind and have glaucome while sucessfully being able to treat these individuals have no training, experience, or sympathy sometimes with dry eye.

Where do you live, maybe someone here has a good doc to recommend.

[littlemermaid]

http://www.drfosterhealth.co.uk/ This website might help you find a cornea and anterior segment consultant ophthalmologist you are comfortable with for good advice. You can go back to the GP to get NHS referral to another eye doc on the basis your eye is untreated, or if you want to go private, just phone the doc's secretary.

When looking for a dry eye or ocular surface disease ophthalmologist, I look at the regional teaching hospital ophthalmology consultant list first, because they are more likely to be up to date on conditions and treatment and have a better support team than local hospitals plus emergency eye clinic if needed.

As Tearless says, it is also helpful to find a dry eye optometrist for advice and monitoring. Also they can refer straight into the eye clinics with more confidence and knowledge than GPs, and are more likely to have local knowledge on ophthalmologists, NHS and private. Careful they don't just try to flog you whatever eyedrops are expiring away on their shelves.

Does the ophth think you have blepharitis? http://www.nhs.uk/conditions/Blephar...roduction.aspx

www.nhs.uk/conditions/Dry-eye-syndrome/Pages/Introduction.aspx?url=Pages/what-is-it.aspx

www.cks.nhs.uk/blepharitis/management/detailed_answers/view_all_detailed_answers#
www.cks.nhs.uk/red_eye/management/scenario_red_eye#332543004
The NHS Clinical Guidelines are useful to understand what the docs' referral criteria are.

It's always helpful to start your own treatment file and take it to consultations. If you haven't got a patient copy of the consultants' diagnosis letters, you can get copies from the GP.

www.goodhopeeyeclinic.org.uk/ This is a nice kind treatment website. You're not mentioning warm compresses for blepharitis or meibomian gland disorder, if that's the diagnosis, so this might be helpful.

[Road Wanderer]

I am so sorry you are experiencing such poor service with your eye professional, and I use that term loosely! Find another Opthamologist! Unless one has experienced what we all go through in my opinion, should be more ready to find a solution to the problem. I have the best doctors and I hope you find another one as well. Don't be so hard on yourself about not being able to wear contacts. There are some really beautiful, sytlish glasses out there. I'm not sure how the health care system in the UK works but I am blessed to be able to find doctors that care deeply for their patients here in the US. I wish you well. Please don't give up.