Naked Eyeballs (chemical exposure)

[Scribbler]

This is my experience with dry eyes from chemical exposure.

4 years ago I had to cover for someone at work on holiday, and was working with some nasty organic solvents in a commercial facility (in australia). I was wearing a large respirator (concerned about breathing it but oblivious to the eye dangers) - which was heavy on my face and pulling my cheeks down, probably exposing the insides of my lower eyelids. (I left that job a few months later)

Long story short - since then I have seen 3 opthamologists and been diagnosed as suffering from 'dry eyes' and 'MGD'. I have had about 5 slit lamp examinations and staining to check the cornea - only thing I am told that can be detected is a quickened tear breakup time, and mild blepharitis - no other visible defects. My eyes look fine according to them. I am wondering though - a chemical fume might damage the goblet cells in a diffuse way, which wouldn't be detectable by the slit lamp, which is designed towards detecting noticeable abrasions.
And I havent had any indepth examination of the MG. One opthamologist did press the lower eyelid and said there was meibum coming out, slightly thick.

When the wind blows in my face I can feel the dryness pain all along the edge of my lower eyelid, and pain extending upwards over the surface of the exposed eye. It feels like my eyeballs are naked. I am very photophobic, glare is a huge problem, especially the sun reflecting off cars. This was an immediate condition, as I have it on my hospital record that the sun was irritating my eyes, and it has continued for 4 years. I have olive skin and black hair, was never sensitive to light before, but now it appears it is a permanent condition.

Dust, any chemical vapour like household cleaning liquids, cigarette smoke, permanent marker pens, all give me pain, severity depending on exposure. After bad exposures it is like having a really bad sunburn on the surface of the eye. This can take 3 weeks to get back to 'normal'. I also have pain sometimes in my face around the worse eye, extending down to my cheek. Also the last 6 months I have noticed negative afterimage effects. Everything looks about 5% strange, but more noticable reading books etc.

So photophobia and corneal sensitivity to atmospheric pollutants are my 2 debilitating problems, the other dry eye symptoms I get sometimes but are very manageable, and don't really affect me at all. I've never had the sticky eyelid sensation - my top eyelid functions normally. The pain is all in and around the lower eyelid and the surface of the eye.

Its been enough to greatly affect my life. I can no longer swim in chlorine pools (I used to swim laps 5 times a week) and I can no longer paint with oil or acrylic paint (oil painting was my main hobby). Can't drive at night or on sunny days. Driving at night is like being in a Painful Carnival of Lights. Driving in sunshine is too dangerous, I am constantly trying to avoid the glare with one hand or the sunshade, and stop focussing on the traffic. I try and avoid going outside during full midday sunshine. I used to be a sun worshipper and love tanning. Can't sit in smoking areas at pubs. Have to wear some sort of eyewear all the time. I have found that if I don't go outside for a week, I can use a laptop for 8 hours a day. When I've been outside in the sun though, using computers or watching screens becomes painful.

I am wondering if anyone knows of someone who has had dry eye from chemical expsoure/burn. I would be interested to know if any treatment actually worked. Organic solvents dissolve and remove fats from human tissue. I think the chemicals probably destroyed some of the MG and goblet cells, so don't think any treatment will be able to get me back to normal. Theres eyelid narrowing and sclerical lenses, but I'm not so sure about these. I havent tried restasis as my problems are not due to inflammation.

I had both eyes plugged but it didnt really help. I've been using autologous serum now for 8 weeks. I've been told the cornea has great healing properties, but also that dry eye can lead to further loss of goblet cells, so not sure what to believe.

Time machine would be the best cure, go back and tell myself to forget about breathing protection, just protect those eyeballs. Other than that, I think my best option is to try move to a weak-sun-damp place like the UK - if only the UK visas were not so difficult.

H.

[eyes78]

I'm so sorry to hear of your troubles. I recently decided that I needed to start wearing moisture goggles, and when I do, my eyes feel really good. It sounds like this is something that might help you - they would block out the air and if you got them with tinted lenses, they would also block out glare/bright light.

[MichelleM]

I believe my dry eye is from high levels of Radon (radiation) exposure. I've been suffering miserably for 2 years. Dry eye, my tears evaporate in less than a second. MGD and Blepharospasm. I drive very little because I can't. The light drives me crazy. Little TV or movies. Reading is hard. I blink all the time. I spend a great deal of time wih my eyes closed. My eyes are also exhausted. I can't paint either nor do I like any kind of chemical. Just this week I received my first round of botox shots around both eyes and forehead. It has worked wonders. I'm barely blinking except for what would be normal, I can tolerate light and work isn't so difficult. I'm surprised at how much better my eyes feel.

Michelle

[Scribbler]

Thanks eyes78, yea i do have a whole range of goggles and sunglasses with seals, they are what let me lead a semi-normal life, forgot to add them into my story Even the darkest ones dont stop pain from australian sunshine or pain from random chemical fumes, my two remaining problems.

[Scribbler]

MichelleM - sounds like we have very similar symptoms. I'm very interested in the fact botox has helped you...i've never heard of that as a treatmemt for dry eye. After 4 years i have been hinking this is permanent. Could you tell me a bit more about the treatmemt, was it administered by an opthamologist? How many more rounds of injections are you expecting to have? What is the science behind it, does it have something to do with the mg or nerves around the eye? Thanks

[MichelleM]

Hi Haden,
You mentioned being diagnosed with mild Blepharospasm, me too and because of that I am a contsant blinker. Do you blink or clamp your eyelids? The botox injections are to stop or minimize the excessive blinking. Yes, it does paralyze some of the nerves around your eyes and forehead. Hurts a little but not too bad. My aphthalmologist sent me to Oculoplastics for the shots. You need someone who understands Blepharospasm. I asked that Doctor if the shots would help with the light sensitivity and she thought that was more of an issue because of my dry eyes however since getting the shots I have had relief with all of my eye problems. They are not near as dry, the light doesn't bother me as much. I normally wear two pair of sunglasses when I go outside and a lot of the time one pair even when I'm inside. My eyes are usually bone dry. I can't stand the heat from a blow dryer and even the heat from my stove when I'm cooking drives me eyes crazy. My Doctor said the shots generally last 3 to 4 months and these are for life.
Also concerning the chemical sensitivity we both seem to have has your Doctor recommended an Ionic air purifier? I use one right next to me at work. It does help me. Also my Doctor has me using saline drops whenever I feel I've come in contact with a chemical to clean them. I work for a printing company so whenever I walk through the production area I use my drops as soon as I get back to my desk. Do you use any kind of eyelid scrub? I use coconut oil on a makeup remover pad so I'm not rubbing any chemicals into my eyes. Unfortunately one of the side effects of Botox is dry eye, however I am not experiencing that yet but I'm new at it so I don't know how it will effect me long term. I think it's worth at least checking into for you. I know the misery of living with dry eye and all that goes with it. I hope you can get some relief.

[Scribbler]

Hii Michelle, my exposure happened at a printing company. Did yours happen in the workplace? Was it a short exposure or longterm like over years? In australia if you lose an eye at work the recommended compensation is 100k. So i dont think its even worth trying to get compensation, opthamologists can't see any problems, its all just my subjective account, i could just be making this all up. No i have very mild blepharitis, just a bit of inflammation, not the excessive blinking. After reading about the possible side effects of botox its not worth it in my case. I was using baby shampoo to clean my eyelids but even that irritated them sometimes, so i started using just hot water and a face cloth. But ill give the coconut oil a go. If you live in a hot dry place have you been to a cool cloudy place like amsterdam or the UK? I actually had already planned to go to the UK 6 months after this happened, and while i was there i thought my eyes had healed. But within 2 weeks of returning all the problems returned. Thats why i believe it is the sun that is the main problem and that cascades down to all the other problems. In amsterdam the air was so soft and the sun was so weak. I can recommend a pair of sunglasses for outside, you should only need yhe one pair - its the Bolle Tracker 2 shade 5, made for welding, they fit so well and are cheap.

[Scribbler]

Just to add those sunglasses are not polarised, but i have found them better than the normal sunglasses with polarization. I am buying polarised clipons and will find a way to attach them to the front.

[MichelleM]

Hi Haden,
I misread your original post and thought you had Blepharospasm. Yes, there are some scary side effects to botox and I hesitated to try it but it's a huge relief to be able to open my eyes but probably wouldn't be helpful to you. The Doctors tell me how healthy my eyes are otherwise but my symptoms are terrible. Mine is obvious though with my blinking. Thanks for the information on the sunglasses. I will check into that. I will try to make a long story short... a previous neighbor buried a 1,000 gallon oil tank, used to heat furnaces years ago. The law was to empty them before they were buried but this one was buried full and eventually eroded. oil bubbled up in the yard and some into another neighbors yard. Grass, plants and trees died. I think that is why I had such high levels of radon in my home. I have since had it fixed and rechecked just last month, still good. The reason I believe this was the problem is because my precious dog and cat suffered greatly. My dog developed terrible dry eyes, hers were pitted looking even and also she blinked all the time and kept them closed much of the time. She passed away in April from kidney failure. My cat developed respiratory problems and then a tumor grew between his eyes. I lost him a year ago Oct. It has been a devastating time for me. I don't think my issue is from work but that is the worst place for me. My eyes don't like any kind of odors. I live in Iowa but I do love the cooler cloudy days and have often wondered if there would be a better place to be for my eyes. If I could only pack up my family and friends and take them with me. I have a church I love to visit about 1 1/2 hours away. My friends and I go and make a day of it. Today was the first day in two years that I have visited this church and had no sunglasses on AND my eyes were wide open. Can not begin to tell you how awesome that was. I still do some blinking but nothing like I was.

[Scribbler]

Thats a sad story Michelle, Im sorry to hear that. I knew i was working with hazardous chemicals but to get these problems from someone elses negligence is terrible. My last job was just in an office, but then they bought a new machine that gave off an odour so i resigned that week.
I wish i had a problem that had clear clinical signs and could be solved through medical treatment! The serum drops are way better than store bought drops. Valium could be an option in your case too, i tried it for another problem once and it is amazingly effective at relaxing muscles. Ill be interested to know how you are in 6 months and if the botox is still working. If you reply to this thread i will get the email notification. Hopefully we can meet more people on this site that have dry eye from chemical exposure to learn of any beneficial treatments.

[MichelleM]

Hi Haden,
Thank you. I'm going to ask my Doctor about valium. We have also talked about the serum drops as an option but we haven't done it yet. I sincerely hope you find a solution for your eye problems. I will keep you posted on the botox and please keep me posted if you do find something that works. I'm always searching.

[Rebecca Petris]

I am wondering if anyone knows of someone who has had dry eye from chemical expsoure/burn.

I am sorry to hear your story!

I have known a few people over the years who had dry eye from chemical burns. Usually they ended up in PROSE lenses eventually.

Some of your story reminds me of the people who had long term damage from exposure to broken hallide lights (see uvlightburns.com... the 'miracles' tab has a bit of a synopsis). Photophobia, corneal sensitivity... it's a familiar pattern and sometimes happens when there are not any really dramatic clinical signs. PROSE is the first thing I would think of for that situation.

[Scribbler]

Thanks Rebecca, that was some good information in there. Kellie who had the uv burns had those lenses made in 2007 - i wonder if anyone has heard from her recently? No news is good news probably.
I guess people like michelle and i might have partial limbal stem cell deficiency. From reading about it thats what it sounds like, along with some mgd. I remember i had a slight haze on the lower eyes after the injury, which is talked about here

http://www.aao.org/publications/eyen...402/pearls.cfm

i will have to find out if in vivo confocal microscopy is offered anywhere in oz/nz.

I am surprised 3 different othamologists have not broughtup the possibility of partial LSCD, when i clearly explained how i got lots of hazardous chemical fumes in my eyes. For the time being i will carry on with the serum drops and avoid sunlight. A prose or prokera lens on my worse eye would definitely be something id be keen on trying, although i heard there's possibilityof corneal ulcers.

[Scribbler]

Sorry for typos, really hard typing on a tablet

[MichelleM]

Hey there Haden and Rebecca. Good articles from both of you, thank you. Rebecca, you mentioned PROSE lenses. I was supposed to get fitted for scleral lenses in Sept. but my Doctor wanted to try some other contacts first. I didn't do well with them because of my dryness and constant blinking they rolled up in the corner of my eyes. Sad thing is my eyes are so miserable all the time I didn't even realize they were folded in half until I tried to take them out. Now we are trying the botox thing but I am concerned about long term side effects. I want to revisit with my Doctor about the scleral lenses but can you tell me if they help with the blinking too? Since they have moisture in them I'm thinking they might help as I don't blink when I'm in the shower or right climate. Thank you.