Please help!

[Dotanne]

This is the first time I have done this but I am so pleased to find this site.
I had Custom Lasik on 20 October 2004 and after having sore eyes for a while was told I have dry eyes and there is no cure. I was given an assortment of drops to try. After a return visit he tested with strips of paper and I had temporary plugs inserted and two weeks(Early April) later a more permanant plug was put in my left eye. I returned on 20 May as I was still not happy and he tested my eyes (at about 5 pm as my 4 pm appointment was postponed) and said I had no tears and put a permanent plug in the other eye and temp ones in the upper lids. He said there is no cure - and said I must have had dry eyes before the op (I had never heard of dry eyes or ever used drops and had no problems) and it was my age and gender that werre the problem. (Why didn't he tell me that before the op?) I am now 60. Should I get more plugs put in?
I am miserable and uncomfortable and I struggle to keep my life as normal as possible. Depression has set in. After reading other stories I realise I am not alone - but I am the only one in New Zealand that I know of with this sort of dry eyes. (I'd love to know of anyone else!!) My depression lifted substantially after reading through all the info on this site. Thank you so much Rebecca and others.
Here are my queries: The Dr offered steroid drops and then decided to put in the second plug. What are other's experiences of these drops? Should I try them? REstasis is not available here.
Since the second plug was put in I get soreness on and off in the outside corner of my eyelids especially with the second plugged eye (It has more tears I think as it feels wetter) What does this mean? I am using Theratear drops during the day(been trying them for a month now - did use Refresh Plus and tried Bion tears too) and Visco tears at night but have just obtained some Systane drops from Australia which I am trying at night. I have to put in drops several times a night. However my eyes feel best just as I wake up and get worse as the day goes on. They are quite burning by the afternoon and I resort to the hot wet facecloth(heat in microwave) frequently as well as drops, and I love the shower. I also put cold water on my eyelids and use glasses as much as I can.
Can one use drops too often?
I seem to get a burning dryness feeling in the back of my nose as the day goes on (relief with steam) and sinus type aches under my worst eye. Also an achy feeling around the eyeball. My eyes just want to give up looking!!
I take St Johns Wort and Flaxseed capsules and a Nutravite capsule for eye health plus some extra vitamins. I have just started using progesterone cream for menopause symptoms and the same people have just started me on some 5HTP for the depression - take 2 at night (or 3 if needed). Has anyone had any experience with these affecting the eyes?
We normally go on holiday in July but I am scared to leave home because of the problems I might get. (It is wintertime here).
Sorry I have written so much - it gives me some hope to be able to learn from other's experiences and I have so much life left to live - I am a very healthy active person.
Cheers to you all!
Dotanne

[Rebecca Petris]

Dotanne,

Welcome to Dry Eye Talk!!

He said there is no cure - and said I must have had dry eyes before the op (I had never heard of dry eyes or ever used drops and had no problems) and it was my age and gender that werre the problem. (Why didn't he tell me that before the op?)

Why indeed! Dry eye is the single most frequently reported complication or side effect from laser eye surgery; this is well known to refractive surgeons and it is stated in most consent forms. It is imperative that doctors review the patient's history carefully for signs of dry eye and test thoroughly for dry eye before considering any form of laser eye surgery (but particularly LASIK due to the flap creation process severing so many nerves). Your age and gender make this even more important.

The Dr offered steroid drops and then decided to put in the second plug. What are other's experiences of these drops? Should I try them?

Speaking as a layperson I think this is a reasonable step to try. However, they can only be used for a limited time and your eye pressure has to be monitored carefully.

I am using Theratear drops during the day(been trying them for a month now - did use Refresh Plus and tried Bion tears too) and Visco tears at night but have just obtained some Systane drops from Australia which I am trying at night. I have to put in drops several times a night. However my eyes feel best just as I wake up and get worse as the day goes on. They are quite burning by the afternoon and I resort to the hot wet facecloth(heat in microwave) frequently as well as drops, and I love the shower. I also put cold water on my eyelids and use glasses as much as I can.
Can one use drops too often?

Re nighttime: Consider some increased form of protection, such as an eye guard. I used to use plastic wrap over my eyes sometimes. Make sure there are no air ducts pumping heated dry eye anywhere near you. Maybe consider a humidifier in the bedroom.

Re daytime trends: Best in the morning is actually the opposite of what a lot of people here experience (where eyes are very sore and sometimes "stuck" in the morning). Makes me think again of environmental factors (eg heating) making things worse during the day. Glasses help prevent too much evaporation and irritation from moving air; I wear non prescription glasses sometimes myself. You sound like a good candidate for Panoptx dry eye glasses - I've never used them myself but there are many fans on the site here who I'm sure would be glad to tell you about them. Hot compresses might give you more daytime relief too. Everyone has a different approach. My favourite is a little muslin bag of rice that I heat briefly in the microwave. Cindy does something similar with a stocking. I'd also try morning lid scrubs. And, next time you see the doctor, ask him if he sees any signs of blepharitis.

And yes, you can use drops too often. It really depends what kind of dry eye you have. But we've certainly observed that some patients see improvement when they reduce eyedrop use. Tears have a complex composition that no artificial tear can mimic and using too many of some kinds of tears will wash some of the good stuff right out of your eyes, leaving them more vulnerable.

I seem to get a burning dryness feeling in the back of my nose as the day goes on (relief with steam) and sinus type aches under my worst eye. Also an achy feeling around the eyeball.

I'm familiar with the ache under the eye but not the nose. Anybody else experienced this?

I have just started using progesterone cream for menopause symptoms and the same people have just started me on some 5HTP for the depression - take 2 at night (or 3 if needed).

Many antidepressants exacerbate dry eye symptoms, unfortunately. Patients often experiment till they find the one that works best with the least side effects. I'd have a talk with whoever is prescribing both drugs about what you're experiencing with your eyes.

We normally go on holiday in July but I am scared to leave home because of the problems I might get.

If ultimately you don't feel up to it, don't force yourself. However before you give up the idea, check in with others here. Many travel regularly and have tips for managing while flying etc.

Lucy had a good phrase for flying after LASIK. (Long time ago - was it SE or D'Eyealogues, I can't even remember.) "Drink up, lube up, cover up" - or something along those lines.

[Gaye]

Welcome Dotanne

Welcome! I sorry you have ended up here with the rest of us, but you have found a great website and a really nice group of people to share ideas with about your dry eye problem. I fly quite a bit and usually dread what it does to my eyes, but I will use a thicker eye drop (like a liquid gel) during the flight. I also drink lots of water to keep me hydrated. If it is an overnight flight, I use GenTeal Gel. We have been having a problem with availability here in the U.S., but my daughter found a website for a company in Australia that says they have it. That site is:

www.nationalpharmacies.com.au/shop.php

It might be worth a try for you. Many of us here can't make it through the night without it.

As for 5-HTP, I take it every night (50mg) before bed. It helps with sleep and is supposed to help with seratonin production, which helps depression. It does not bother my dry eye problem at all. Again, it is sure worth a try for you.

Good luck!

[jcorbett]

Dotanne - I don't know much about progesterone, but I have heard that testosterone and other meds prescribed for menopausal symptome have actually helped dry eye.

[Dotanne]

[/QUOTE=Dotanne]
Apparently progesterone produces testosterone. I have cream that is applied each night. I had a saliva test to measure my progesterone level to know how much cream to apply.

[Dotanne]

Welcome! I sorry you have ended up here with the rest of us, but you have found a great website and a really nice group of people to share ideas with about your dry eye problem. I fly quite a bit and usually dread what it does to my eyes, but I will use a thicker eye drop (like a liquid gel) during the flight. I also drink lots of water to keep me hydrated. If it is an overnight flight, I use GenTeal Gel. We have been having a problem with availability here in the U.S., but my daughter found a website for a company in Australia that says they have it. That site is:

www.nationalpharmacies.com.au/shop.php

It might be worth a try for you. Many of us here can't make it through the night without it.

As for 5-HTP, I take it every night (50mg) before bed. It helps with sleep and is supposed to help with seratonin production, which helps depression. It does not bother my dry eye problem at all. Again, it is sure worth a try for you.

Good luck!

Thanks for your support Gaye. I must see if they have Genteal Gel in NZ - quite possible if it is in Australia though we are a little behind them in getting new meds. I did get some Systane drops from a website in Australia (they will not be in NZ until August) called homepharmacy.com.au and they were here (NZ) within a week. I am trialing them now - They are quite thick - can't see for a minute or 2 - so I only use them at night. I seem to need to add a drop of a lighter drop to help them spread so they are comfortable. I have used Viscotears a lot at night as my eyes stay 'cleaner' and not so irritated. My lids don't seem to stick together like some of the others. I hope the cetrimide preservative is OK.
I am glad to hear the 5HTP is OK.
Dotanne