Depressed and despondent.

[Jack]

I am new here. I can't tell if I have dry eye, even after visits to at least 10 different eye doctors and surgeons. But I very much do have a severe eye problem.

I have some of the symptoms of dry eye, to be sure, but only in the outer corner of my right eye. For some time I believed this was not dry eye but the result of revision surgery to correct scleral show from previous cosmetic surgery. Occulopoastic surgeons concurred, but not one of them seedm to know for sure.

I have tried many different eye drops, none of them make a difference or help. Most seem to sting and do not good at all.

I wonder who is the world's expert on dry eye, and should I go see him/her? Anybody know?

[epicjinx]

I am new here. I can't tell if I have dry eye, even after visits to at least 10 different eye doctors and surgeons. But I very much do have a severe eye problem.

I have some of the symptoms of dry eye, to be sure, but only in the outer corner of my right eye. For some time I believed this was not dry eye but the result of revision surgery to correct scleral show from previous cosmetic surgery. Occulopoastic surgeons concurred, but not one of them seedm to know for sure.

I have tried many different eye drops, none of them make a difference or help. Most seem to sting and do not good at all.

I wonder who is the world's expert on dry eye, and should I go see him/her? Anybody know?

First of, where abouts are you? UK/USA etc? Once you are able to say - people maybe be able to help with input. Eye drops dont work because it doesn't treat the main problem only masks symptoms.

[Rebecca Petris]

Hi Jack, Welcome!

I am new here. I can't tell if I have dry eye, even after visits to at least 10 different eye doctors and surgeons. But I very much do have a severe eye problem.

What kind of doctors and what have they diagnosed you with?

Corneal specialist ophthalmologist - one that works more with disease than, say, LASIK and cataract - would be the best equipped type of doctor to get you a more detailed diagnosis. However, it's not at all unusual for people with dry eye to get variations in their diagnosis with every specialist that they visit. This is definitely not as simple as going to the world's expert. There's a lot of experts, and some of them are tuned more to one issue than another. Echoing epicjinx... geographic clues would help with ideas.

[Rebecca Petris]

Eye drops dont work because it doesn't treat the main problem only masks symptoms.

Have to say I disagree with this kind of generalization (although I avoid drops, myself, and I think many people could, who aren't). It depends what you consider the main problem... and also whether the medical issues are actually addressable - because in some situations, they aren't. In patients with severe aqueous deficient dry eye for example, drops aren't used to "mask" symptoms, they're used to keep the corneas safe and comfortable.

[Guest]

Rebecca, and epicjinx, and many thanks for your reply. I am a US citizen from Hawaii who lives in Indonesia. Here's some more info:

My main problem, in fact, is actually getting a diagnosis that makes sense. To wit:

I had cosmetic surgery on my lower eye lids, and then two surgeries to correct a bad job. Immediately after those revision surgeries I suffered from an troublsome irritation in the outer corner of my right eye, that felt like an eye lash was poking me, along with other strange and uncomfortable sensations.

It went away after a few weeks, and I then went for 3 years with no probelms at all, and happy.

Then, about 2 years ago, the irritation came back and got worse, and developed into an even more complicated irritation, still all concentrated in the outer corner of my right eye. Some but not all of the symptoms sound like dry eye from what I have been reading.

I went to see several occulopoastic surgeons who said my lower eyelid was still too taut, and that I should do an operation to give it more laxity by raising my cheek and inserting a skin graft.
I thought that was a crazy idea because I feel it was precisely operations to "raise the lower eye lid to remove tautness" that caused the problem in the first place.

The other doctors I saw - both opthamologists and occuloplastic surgeons - said they had no idea what was causing my problem. I felt that they were more honest. All the doctors I have seen said my eyes were "not that dry" and they determined this by putting a paper strip into my lower eye lid as well as putting drops in my eye and looking at it through their (microscope thing?)

Last week, I was told I have blepharitis. Maybe. But after reading about this, I am unsure. Perhaps yes, but I don't think that's the entire problem even if so. My irritation is strictly limited to the outer corner of my eye, and seems to be related to scar tissue, or perhaps the tightness the docters referred to.

Many thanks for any ideas/input you may have.

[Jack]

Hi Jack, Welcome!


What kind of doctors and what have they diagnosed you with?........Echoing epicjinx... geographic clues would help with ideas.

Rebecca and epicjinx many thanks for your reply.

I have been to see both opthamologists and occuloplastic surgeons, because I believe it was occuloplstic revision surgery that caused my problem.

Three of them, all located in Los Angeles and all of them from the same medical School (UCLA) said my lower eye lid was being pulled down because it lacks tension, and I should do an operation to fix that. Yet, I believe that it was precisely such an operation to ad laxity that caused the problem in the first place, and so I am suspicious of this dignosis.

Three other occulopostic surgeons said they have no idea what my diagnosis would be. All of them said I did not have much of a dry eye problem, until 10 days ago, when a repeate visit fo one of the occulopoastic surgeons suggested that I have blepharitis.

Reading about blepharitis, I can't say I am convinced.

My symptoms do somewhat sound like dry eye, but they are really only limited to the outer corner of my right eye. Does that count?

I've run out of ideas, hope, and guidance for what to do next, except for this one thing:

That outer corner is very very rounded, and exposes much more of my eye than normal. Two doctors have told me I might want to try a small terrsorhaphy because that roundedness might in fact be the cause of my problem.

Many thanks for any help or comments you can offer.

[WellEyes]

HelloJack,

I have had similar problem in the sense that no eye doctor could really diagnose correctly for more than a year. It looked like a dry eye after my upper blepharoplasty. To cut it short, it seems that I have mild dry eye with the main problem being neuropathic pain. Corneal neuropathy is a disease neither neurologists nor ophthalmologists really know about. It has a very complex working with dry eye. According to some research it might even cause dry eye. If it's the small fibres, also impossible to diagnose with evidence. It is some kind of trigeminal neuropathy. Do you have fibromyalgia?

I am still struggling with it.

[Guest]

HelloJack,

I have had similar problem in the sense that no eye doctor could really diagnose correctly for more than a year. It looked like a dry eye after my upper blepharoplasty. To cut it short, it seems that I have mild dry eye with the main problem being neuropathic pain. Corneal neuropathy is a disease neither neurologists nor ophthalmologists really know about. It has a very complex working with dry eye. According to some research it might even cause dry eye. If it's the small fibres, also impossible to diagnose with evidence. It is some kind of trigeminal neuropathy. Do you have fibromyalgia?

I am still struggling with it.

Many thanks for your comment!

And very interesting info. I don't have fibromyalgia, no, but I may have what you are describing. In fact, some of the doctors I have seen suggested it might be some sort of nerve damage, but only one of them suggested something I try, which is the anti-depressant Amitriptyline which is often prescribed not for depression but for nerve pain. I did try that, and it might have helped, but I stopped taking it before I could really tell, because I read it becomes addictive over time.

[Jack]

HelloJack,

I have had similar problem in the sense that no eye doctor could really diagnose correctly for more than a year. It looked like a dry eye after my upper blepharoplasty. To cut it short, it seems that I have mild dry eye with the main problem being neuropathic pain. Corneal neuropathy is a disease neither neurologists nor ophthalmologists really know about. It has a very complex working with dry eye. According to some research it might even cause dry eye. If it's the small fibres, also impossible to diagnose with evidence. It is some kind of trigeminal neuropathy. Do you have fibromyalgia?

I am still struggling with it.

Many thanks for that comment! No I don't have fibromyalgia but may have what you are describing, yes. Corneal neuropathy.

I have tried Amitriptyline, an anti-depressant also prescribed for nerve pain, but did not continue it long enough to tell if it helps - Im afraid of the addiction problems I have read about.

[epicjinx]

Have to say I disagree with this kind of generalization (although I avoid drops, myself, and I think many people could, who aren't). It depends what you consider the main problem... and also whether the medical issues are actually addressable - because in some situations, they aren't. In patients with severe aqueous deficient dry eye for example, drops aren't used to "mask" symptoms, they're used to keep the corneas safe and comfortable.

Its just i find eye drops dont help as much when treating the problem, but thats just what i think. It's just for me i was on eye drops pretty much a year and a half and it didnt help much for me, not saying itll be the same for everyone, main problem for me id say treating inflammation is a start, i just dont think eye drops help as much as getting to the root problem - they may help others, and they may not help others. I just feel like it masks symptoms as they have never really helped me, (dont intend on arguments just my view )

[Alix]

I am new here. I can't tell if I have dry eye, even after visits to at least 10 different eye doctors and surgeons. But I very much do have a severe eye problem.

I have some of the symptoms of dry eye, to be sure, but only in the outer corner of my right eye. For some time I believed this was not dry eye but the result of revision surgery to correct scleral show from previous cosmetic surgery. Occulopoastic surgeons concurred, but not one of them seedm to know for sure.

I have tried many different eye drops, none of them make a difference or help. Most seem to sting and do not good at all.

I wonder who is the world's expert on dry eye, and should I go see him/her? Anybody know?

Hi I am sorry to hear your story. Your symptoms are similar to mine in that its just the outer corners of my eyes that are burning badly - they have been feeling sore and dry for almost a year now but a schirmer test I had done a couple of months ago when the doctor ripped the test strip off my eyeball really did set things off and the burning is now excruciating.

I was wondering, have you had Lipiview? When I had this done, I was given the most coherent diagnosis so far, and that was that my eyes were inflamed and dry because I was a partial blinker.

They said partial blinking was most common in people who have had eye surgery like yourself, and people who have worn contact lenses or use computers alot like myself.

I am still on the journey of trying to find a solution to my problem, but the first step is to find the correct diagnosis.

I truly hope you find a good doctor where you are, I am not having much luck here in the UK...

[WellEyes]

Many thanks for that comment! No I don't have fibromyalgia but may have what you are describing, yes. Corneal neuropathy.

I have tried Amitriptyline, an anti-depressant also prescribed for nerve pain, but did not continue it long enough to tell if it helps - Im afraid of the addiction problems I have read about.

In my case, antidepressants dry my eyes so much that they are not an option. My life quality is so badly influenced that I am not concerned about addiction. The only concern about neuropathy pain drugs (actually anti-epileptic drugs like Lyrica, Gabapentin and Tegretol), there are many comments that their effect is randomly fluctuating and vanishing in time. Tegretol is the one that is said to work the best for trigeminal neuropathy. That's the only one I have not tried yet but not so keen on those medicines as they have horrific side effects. At the moment I am trying acupuncture. So far no benefit. I can judge better after a few more sessions. I'm suffering from extremely sensitive eye surface (to wind and air conditioning) and severe photophobia, and burning.

Further there seems to be electrical stimulation therapy which might be worth trying but so far they don't know how to detect the origin of the problem- let alone solve it. There are some researches being done but we are not there yet. For the time being, I don't have a choice but count on my body's natural healing ability and time....

Is your pain constant or fluctuating? Do you wake up with pain as soon as you open your eyes or even before you open your eyes?

[Jack]

Hi I am sorry to hear your story. Your symptoms are similar to mine in that its just the outer corners of my eyes that are burning badly - they have been feeling sore and dry for almost a year now but a schirmer test I had done a couple of months ago when the doctor ripped the test strip off my eyeball really did set things off and the burning is now excruciating.

I was wondering, have you had Lipiview? When I had this done, I was given the most coherent diagnosis so far, and that was that my eyes were inflamed and dry because I was a partial blinker.

They said partial blinking was most common in people who have had eye surgery like yourself, and people who have worn contact lenses or use computers alot like myself.

I am still on the journey of trying to find a solution to my problem, but the first step is to find the correct diagnosis.

I truly hope you find a good doctor where you are, I am not having much luck here in the UK...

Alix, many thanks for your response. I have not heard of "Lipiview" but will start reading about it. I don't think partial blinking is my problem, but could be. Yeah, "finding the correct diagnosis" - that is my problem in a nutshell, exactly.

[Jack]

Is your pain constant or fluctuating? Do you wake up with pain as soon as you open your eyes or even before you open your eyes?

WellEyes, I would not call my problem "pain" so much as an "irritation", that takes several distinctly diff forms, wach of which comes and goes in severity. But I can always, alwasy, feel something, and so I'm in a constant state of frustration.

[farmgirl]

Lipiview will tell you if that eye closes properly, I think that is the most important thing to establish. It could be just not closing properly at night as well.