New UK member post LASIK dry.

[quattroboy]

Hi there.

A quick intro.

Brand new dry eye sufferer after having LASIK last November (2017). Long story short, I already had MGD before the procedure, which was never picked up.

Now going through the usual adjustment phase and trying to find a way to get my life back. First thing seems to be accepting what has happened to me and working out the best routine to manage my dry eye.

Looking for treatment options over and above the basic stuff available on the NHS, so will be looking for plenty of advice. Already gained loads from reading existing posts.

Many thanks to those who spend the time posting and sharing.

Living in sunny Manchester in the UK.

[diydry]

Thank for sharing and welcome. My story is a lot like yours. LASIK in August 2017, which exacerbated pre-existing MGD. About 9 months after LASIK I am hopeful that my corneal nerves are starting to kick-in again judging by improved schirmer scores and symptoms, unfortunately my MGD has persisted in its new inflamed state. What has helped me the most is a strong off-label steroid but this is a temporarily fix as far as I can tell. My experience has been that it gets easier once you work out a routine and begin to let go of the frustration/anxiety of the condition (which I have not done so well, to be perfectly honest). It's amazing how much energy is spent trying new treatments while in crisis mode, but I think time is the best medicine along with a healthy diet and lifestyle and letting go of emotional difficulties, if possible. Good luck!

[quattroboy]

Thanks, diydry.

Yes, the emotional adjustment is the hardest, until April I thought I would get better like any other operation.

It's crazy that some LASIK providers still aren't screening people properly for existing dry eye before telling them they're ideal candidates.

[diydry]

It is crazy. Improper screening and downplaying of the risks occurred in my case for sure. I speculate it's fairly widespread because a lot of patients seem to consult multiple surgeons and get told similar things. Also crazy that it's an international problem. I would think in the UK or Canada you would have better pre-op screening and patient counseling than in America where the profit motive is so high, but maybe not.

All that said, you can still get better! I think it's just going to take more time for us. Best to think in terms of progress made over a longer period of time. I remember someone on this forum once said they re-evaluated their progress every 3-6 months, and that was a more reliable indicator of the direction of healing. Otherwise day in and day out it's hard to tell.

[quattroboy]

The UK LASIK industry is the same, unregulated and driven a lot by sales targets. Unfortunately, I was stupid enough to go to a large high street provider, who I thought I could trust with my eye health!

I hope your right about the time to heal but I'm trying to move my thinking on to getting my life back, just started CBT to help with the mental health side and planning to start a Wellness for health course afterward.

Still pursuing the medical side as I've really had much support from the company who did the LASIK, kept telling me a didn't have MGD and my lids looked healthy. I went for an independent Lippiview and discovered I've lost half my glands because I'm a partial blinker. My oils seem fine but I did do a Lippiflow session to see if it helps.

Seeing a consultant next week to discuss my options, also trying to be my own health advocate by pursuing stuff that simply isn't available on our NHS. Unfortunately, dry eye isn't a priority for it.

My family has been ace, I really don't know where I'd be without their support.

I hope you continue to see an improvement in your dry eye.

One day at a time.

[MGD1701]

You are so smart/active to get LipiView done.
Did dr recommend you something and identify your causes/problems, such as inflammation?
LipiFlow helped me about 65%.

[MGD1701]

I also did LipiView but dr did not even take gland images. Actually received almost 0 info.
Pitty otherwise I could compare as I recently did 2nd one.

[quattroboy]

No inflammation, all my blinks (19 observed in both eyes) were partial, which means my glands on my nose side have gone :-(.

My lipid layer is thin as a result (.80 in the left, .70 in the right).

Did a Lippiflow just to see if it made a difference, tbh not noticed anything two and bit weeks in.

The main recommendation was blinking exercises, god knows how many years I've not been blinking properly.

My basal tears are still effected by the LASIK, 7 months in.

[MGD1701]

Interesting to know that only recommendation was blinking exercises.
No warm compress? then why make LipiFlow?
LipiFlow is to unblock glands. Does it make sense? Just curious!!

[quattroboy]

I'm doing warm compress and massage using the eyepiece massager. I think more to preserve my remaining glands as long as possible. There was some sign of anterior blepharitis, so using lid scrubs.

After the Lipiview we discussed the quality of my oil was observed, a little bit on the thick side. The Lippiflow call was marginal but I decided to give it a go to try and improve my tear break up time.

To be honest, at that time I was still looking for magic answers to solve my problem. I'm in a better place now and trying to accept I need to deal with being another LASIK victim and there aren't any silver bullets to put my eyes back to last year.

[MGD1701]

Hi
omega 3
I would add this to thin the oil etc. For a better result from LipiFlow too.
I wish my doctors told me this - unfortunatley none.

[quattroboy]

Yes thank you, forgot to mention also taking high dose Omega 3 supplement (I believe DHA is the one to look for) and flaxseed supplement, plus I'm eating loads more oily fish.

Forgotten how much I enjoy mackerel and sardines.

[quattroboy]

Had a very positive consultation with my new eye consultant on Tuesday. I took a list of everything that's happened and the various things I've tried to manage my dry eye.

Firstly I learned my cornea isn't showing any staining, its all on the inside whites of my eye (near my nose), with my left eye worse than my right. He even let my wife look!

Didn't mess about 4 weeks on Dropodex steroid drops and Ikervis. Shocked I really didn't see that coming, NHS in the UK doesn't hand out Ikervis left and right.

I really was prepared to access Ikervis on a private prescription (I think Ikervis is around £100 for a months supply privately). So to be able to get it on a standard NHS prescription is massive.

He's positive he can help me manage things.

It makes a huge difference for someone to take what you're going through seriously.

[MGD1701]

Hi quattroboy

Thanks for sharing great news.

lipid layer: yours 80 &70 are pretty good, almost normal, right?
What makes you discomfort then? just curious!

Did dr recommend you anything new?

Thanks again for sharing.

[quattroboy]

Normal (I believe) is over 100. I have a tear break uptime of around 3 seconds. Which, before LASIK, didn't seem to bother me as I never was aware of dry eye. Looking back now there were one or two signs but nothing serious.

Now my eyes are sore, red and just seem to be constantly itching and irritated. If I get cocky and don't keep on top of my eye drops, the corner of my eyes become even worse to a point I can't keep my eyes open. Also, my eyes seem to be producing this white, sticky and stringy discharge. Which I find very disconcerting.

His findings around the staining pointing to those corners explain why I tend to feel it the most there. The lippiview showed I had no glands left in those inner corners, top or bottom. Also when I blink, my lids on those corners don't touch (partial blinking), hence the gland drop out and leaving the corners of my eyes constantly exposed to the environment.

I'm guessing but ironically when I wore glasses I guess they provided some protection to my eyes.

His recommendations are the steroid drops four times a day with Ikervis before bed.

Continue using my other drops as required and keep up with the eye bag.

He did place lower plugs but I've tried plugs and they just fall out. Reckon I've lost my left one already!

I was using Castor oil drops overnight, I really couldn't get on with ointments or gels, just seemed to make things worse. Also used it sometimes in the day to get some relief. He's asked me to stop so he can track my progress using the new approach.

Shame because I did find the Castor oil drops very soothing and did seem to encourage my eyes to either produce more tears and/or stop the ones I had evaporating away.