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My story: dry eyes 2 years after lasik !

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  • My story: dry eyes 2 years after lasik !

    Hi all !! I am using this forum for 1 year now, and I am finally writing my first message, in order to share my experience and frustration, with the hope that some of you might have the time to read this long post, and might have some answers that none of the many doctors that I have consultated were able to provide.

    I've got my FemtoLasik with the Zeiss M90 machine exactly 2 years ago in a well known clinic in Italy. Things went roughly good for the first 6 months (excluding 1 month of serious dryness that I have easily reecovered with 3 weeks regime of ThealozDuo, then things went great for the following 2 months), but the situation collapsed the day after I've got the usual 6 months check. I do not what went wrong, probably the shirmer test, or the drops used to measure the pressure of the eyes, but from the following day eyes were dry, and artificial drops useless. It has been a year and half since then, and the eyes have not recovered yet.

    My eyes before LASIK were robust and healthy. I was a regular user of contact lenses since the age of 14 (i ve got my LASIK at 38). I could have used contact lenses (Acuvue Oasys) indefinitely without any single problem (I was able to use them for more than 15 hours per day, and sometimes due to frequent intercontinental flights, I could have used them also for 24 hours without any issue). I have never used any artificial drops in my life, never had eye infection, inflammation of conjunctivitis. My eyes were great, but given that I knew that contact lenses were not healthy for the eyes, I decided to go for LASIK before my 40s. I discovered too late that LASIK is much worst than contact lenses.

    At the visit the Dr identified me as a perfect candidate, although my Shirmer (at 5 minutes) were not great, 6mm (left eye) 8 mm(right eye). But, my OSDI was 0, and when she asked for any simptomes of dry eyes, I had not clue what she was talking about. So, we decided to go ahead with the procedure.

    I did not use my contact lenses for 2 months before going through LASIK, in order to make eyes healthiest possible before the procedure. I started TOBRADEX a few days before, and continued this for the following 3 weeks. Together with ThealozDuo (artificial drops). The only thing that I did wrong was that after the surgery, I forgot to put artificial drops when I arrived at home, and I suffered of major burning sensation for a few hours (I was not able to keep my eyes open), than I started using artificial drops and things got normal. The day after my eyes were watering a lot for the full day, but my vision was ok, and although not perfect, I guess all this was in the order of usual post-lasik recovering.

    The first month and half things were fine, slowly recovering, without any significant bad simptomes..things got just better day by day, without major symptomes of dry eyes. I stoped using regularly artificial drops after 3 weeks following LASIK, and I started using them only randomly, just for washing the eye before going to sleep, for example, for precaution. After this period, a night I had to work till late in front of the computer, and on the following day something started bothering my eyes. Not really drynes yet, but floating and some simptomes of inflammation. I started checking different ophthalmologist (not the same of the surgery), and they just noted simptomes of conjunctivitis (but nothing serious, so not sure whether they have been really concerned about it). So, they just put me on Lotemax for a few days, and systane ultra. Things went up and down, until a 4th doctor 1 month later, put me on 4 drops per day of ThealozDuo for 1 month. This solved everything after a few days. I stopped using the drops, and I had my life back. All this happened on a very hot and dry summer.

    Then, I had the already mentioned 6 months check, and boom, my eyes collapsed together with my certainties about my life. My shirmer at the 6 month check was 2 left eye and 5 right eye, but eyes did not bother me at all, till that day. After that, my eyes had dry eyes simptomes. I tried to solve this with artificial drops for the first 2 months, but it did not help. I actually started thinking that I was allergic to eye drops. Then, I ve got diagnosized with mild Blepharities, something that of course I have never heard about before. I tried to threat this with Blephaclean and first TOBRADEX for a couple of weeks, then switched to Lotemax for the following period. In the meantime, artificial drops did not really help. I visited many doctors including people at Moorfield Hospital in London.

    Today, I have still dry eyes simptomes, which go from dryness and burining (luckily this happens more rarely). I have some floating some times, but also long period of no simptomes. I can live without simptomes for a full month, and things fall apart after that for another long period. I tried warm compress, but did not work much, different artificial drops (I am using HycosanExtra a that moment), but if I use them or not, it does not make any difference. So, I usually do not use any artificial tiers for the full day. Tried chloramphenicol ointment for 1 month and azysit drops. I am using Omega3 for more than a year, and keep cleaning my eyelids with Blephaclean. My eyes are watery (at least more watery than 1 year ago I feel), at least when my eyes are not totally inflamed. My eyes lids are puffy, and red. But, luckily my eye ballls have never been red, they are just white. I have also the impression that they are always wet, just because I always see a line of wetness between the eye lids and the eye ball. However, who really actually knows. I did not get any Shirmer test over the last year and half (also because I am now very afraid about it). But, doctors say that my problem is not about tiers production, but evaporative, so MGD. My eyes do not like strong lights, such as traffic lights and light of cars, but this only during the day, and I have the impression that this mostly depends from the level of the inflammation. Often, they do not like the brightness of computer screen. But, I have the impression that when eyes feel good, they are less bothered by lights. So, this might only depends from inflammation, and not from the surgery itself. My night vision is anyway always perfect, and I do not suffer from glares at all.

    All ophthalmologists that I have visited (around 10 different ones) agree that I should not have the problems that I have, and based on what they see on my eyes, they all keep telling me that my eyes will heal, they are just taking more time than expected. Of course, I am very discouraged and I do not trust doctors anymore. However, I have been already enourmously long with this post, so I will safe you from my frustration, sadness and desperation for all this.

    This is my first post, so sorry for having been so looong. As you can imagine I had all this on my belly for a while, and I wanted to share all information as possible, with the hope that some of you might suggest anything, or just want to share some thoughts trying to explain why all this is happening. I have an enormous amount of questions that I hope some of you might feel interested in engaging with: Did I do something wrong with the postSurgery? Was it a bad reaction to tobradex or other artificial tiers? Am I allergic to something? Was I not a right candidate for LASIK such as I have been told to be? or why this is happening? And what can I do differently. And, please forgive me the classic one, based on all details that I have shared here, for those who have seen this kind of post tons of times: will I ever heal, and take my life back?

    Thanks a million to those who had the time to read this long post, and have any thoughts, suggestions, for ideas to share. Or, let me know if you have any further questions about details that I have missed to include to this post.
    Last edited by OcchiSecchi; 13-Apr-2017, 02:43.

  • #2
    thanks for sharing your story with us, i know its not easy to open up and just knowing others are out there in this situation can help so much.
    I dont know if this will help but i have a very close friend who had lasik ten years ago, they didn't follow any of the instructions for after care, they wore heavy makeup (yes eye liner! and glitter on there lids) and and went out drinking the next day in a club, they did not use the drops of the eye shield (to drunk) and had no idea the risk they took (they know now! i make sure they do) BUT they didnt get dry eye, they had no issues.
    i hope this helps, in some way to see that sometimes there is nothing we could of done to change things. sounds like you where really careful and have done nothing wrong.
    i find it interesting that your eyes stream, to make this says allergies! the fact dry eye can go away too for months on end is typical of this (though can be other issues, like hormones but im inclined to think allergies) maybe worth seeing an allergies specialist? i read a post on here about a lady who had blood tests but the didnt show allergies but she went ahead and had allergies shots and her dry eye went away. to be honest its the main reason im trying allergies shots too! worth a try i think.
    People have recovered, so can we.
    www.twitter.com/EyeGirlfriend)

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    • #3
      Thank you waterbee for your comment, and i tend to agree with you that I did everything right, at leat this is what all doctors keep telling me too, together with the fact that my eyes look perfect and the lasik has been perfectly done. (Something that I almost hate to hear, because how can be a Lasik be sucesfull if I have still so many problems?). I am just in doubt about the initial not great shirmer test value, and probably I should have used more drops after the surgery. But, apparently lasik is sucesfull also for those you have issues with contact lenses, so I believed that I had nothing to fear. This is why I thought that probably I had just a bad reaction to the many drops used, especially Tobradex. Anybody have ever heard anything like bad reactions to Tobradex?

      Anyway, yes, to try some anti allergy drops is on my to-do list. A few weeks ago my latest doctor suggested to use Opatanol, but I did not start yet since I have become very much afraid to use anything on my eyes. But, I will give a try soon.

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      • #4
        Just to add, as far as I know, I do not have any health issue, and I have been vegetarian for the last 5 years. So, I thought to have a healthy diet (but, I might be wrong with this). Just, I tend to have high cholesterol, and lately my calves are hitching in the morning and when I go to bed. I find this weird, and worth it to mention, just in case anybody have already heard about anything similar or have similar experience.

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        • #5
          Hi OcchiSecchi. I'm sorry you have been through so much. Appreciate you taking the time to give us the full picture. You will get better, it may just take time to find the thing or combination of things that work for you. This is the right place to get ideas on what can help.

          Have you looked into autologous serum tears? These are eye drops made from the serum in your blood, which has similar properties to your natural tears. These have helped some people with healing of the surface of their eyes and nerves damaged from Lasik and from other issues.

          Also, have you explored scleral lenses? These are nickel-sized dome-shaped gas permeable lenses that vault over your corneas to bathe them with a layer of saline, and the edges of the lens sit on the scleral/white part of your eyes. If you are able to wear them, they could give you some immediate relief. Sclerals have had increasing success to help manage the symptoms of dry eyes due to Lasik and otherwise, as well as can correct your vision if needed. I wear my Boston PROSE sclerals 12+ hours a day, and could not do all I do daily without them. Below is a link to the PROSE sclerals that give a good description of sclerals in general (there are other brands, but I think this one explains sclerals well):

          http://www.bostonsight.org/PROSE/PRO...ats/Post-LASIK

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          • #6
            Hi Hokucat, thank you for your note and advices. I did not check autologous serum drops yet. I heard about it, but none of the many doctors consulted suggested this, so i m waiting that any of them will suggest and instruct what to do. I found disarming that dr do not discuss with us all available options, and we need to find solutions ourselves. Are they going to be resolutive, or will need to use them for the rest of my life?

            As for the scleral lenses, i am intrigued by the option, and i might give a try at some point. For the moment i mostly hope to find the causes of this mess, and solve this from the roots. With the hope this is not an utopia

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            • #7
              I think how long one needs to use autologous serum drops depends on the individual situation. You're right not many doctors recommend these drops, but it is slowly becoming more mainstream and they should at least be familiar with what these can do. Often the difficulty prescribing them is having a lab that will draw your blood and spin it to separate the serum, and finding a compounding pharmacy to deliver the serum to refrigerated or frozen, that has the proper facilities (clean room) and knows the specific process to make these drops. Perhaps ask your doctors if these drops could benefit your condition. You could reach out in this forum to try to find a lab and compounding pharmacy, if your doctors are unaware of resources to handle this.

              Totally agree sclerals are an option after you exhausted most others. I just wanted to make sure you were aware of sclerals to potentially help manage the symptoms, given you've been struggling for two years already. It's always best to find the cause and get that fixed, but that could take awhile, and you might need something like this to help get more daily functioning and comfort back in the meantime.
              Last edited by Hokucat; 14-Apr-2017, 12:08.

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              • #8
                Hi All,

                i have just learned about the existence of corneal evaporative hyperalgesia, and since I do not have major visible signs of dryness, I was wondering how it is possible to diagnotisize this eventual condition. Thanks for any information any of you might have on this.

                at the same time, I was also wondering if there is a relation between dry eyes and our brain. I mean, I have noted that every time my eyes are well, it happens to think: " let's hope I have finally healed", and they day after all symptomes come back. Even when I lived an entire month simptomes free. Can we have the power to create the problem, also when this does not actually exist? Sorry if this might sound silly, but like all here I m just desperately looking for a cause and solution. Thanks !

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                • #9
                  Hi all, I am back in the forum in order to update you on my developments. The important news is that I went to visit Dr. Badoulin group at the hospital vingt-cinque in Paris. It was a good experience since it was the first visit i had focusing only on dry eyes. They had a good assesment of my eyelids, and mostly important, they used confocal microscope to check my nerve regrowth. This was important because is the only way to understand how the eye recovered from the lasik.

                  Results: My​​​ shirmer test is 5mm on both eyes (it was 6 and 8 before the lasik), my tbut was 2 sec, which is the main problem for my case. Shape of some my lacrimal canals were curvy and not healthy, but others were fine. Nerve have apparently regrowth well, and in a good shape. The Dr. was optimistic that we can solve this, and suggested to start a cycle of ikervis (cyclosporine in Europe), with the idea to eliminate inflammation from some cells in the cornea, and try to get our from the vicious cycle + eye lids higiene. As for simptomes they appear and disappear for a few weeks, which is of course very stressful and invalidating.

                  This is just an update for the community, for me as a sort of diary, but may be somebody has something to say about these new data? Are they alarming? Thank you for reading, and good luck all.

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                  • #10
                    Hi OcchiSecchi

                    Thanks for sharing.
                    Did Prof/Dr. Badoulin suggest you lid hygiene products particularly for the inflammation?
                    What kind of inflammation you have? bacteria or demodex??

                    Thanks!
                    Last edited by MGD1701; 14-Jul-2017, 09:26.

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                    • #11
                      I didn't meet Dr. Badoulin, but one of his team. He didn't not specify which kind of inflammation I have. He said it was blepharitis, and that it was not too bad. But, nothing more than that. Are there any difference among bacteria and demodex? As for the hygiene, just warm compress a few days per week and blephaclean. I am however considering to use coconut oil.

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                      • #12
                        Dear Occhi Secchi, I hope you will recover soon with all your effort. Since you are from Italy, I would like to ask you whether you have heard about AMX drops developed by an Italian doctor Emiliano Ghinelli? It says that these drops can be helpful for dry eyes as well.

                        https://www.healio.com/ophthalmology...helial-defects

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                        • #13
                          Hi heard about AMX, but never been in touch with Dr.Ghinelli. have you heard about any good experience with these drops?
                          Last edited by OcchiSecchi; 14-Jul-2017, 13:48.

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                          • #14
                            Hi OcchiSecchi,
                            Your Question: Are there any difference among bacteria and demodex?

                            I think there are different. tea tree oil is effective to deal with demodex.

                            Comment


                            • #15
                              Originally posted by OcchiSecchi View Post
                              Hi heard about AMX, but never been in touch with Dr.Ghinelli. have you heard about any good experience with these drops?
                              The doctor did an English presentation here with before and after images:

                              https://www.youtube.com/watch?v=1LXSQKWHyBY

                              Also before and after images on this page under New Treatment Strategies:
                              http://www.ophthalmologymanagement.c...ent-strategies

                              I also made a post with some translated articles:

                              http://www.dryeyezone.com/talk/forum...ps-hamt-eu-amx

                              Wish they were available in the UK.
                              Sufferer due to Toxic Epidermal Necrolysis.
                              Avatar art by corsariomarcio

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