Help !

[jammie_t]

Hi,

I'm at 25 year old who has worn soft lenses all day everyday for about 12 - 14 years without any problem up until about 7 months ago when i started a course of isotretinoin (accutane) for mild but very persistant acne.

I took the drug (40mg and then 60mg doses) for approx 8 weeks then I developed an eye infection in my left eye and within a week or two another eye infection in the right eye.

I stopped taking the drug and was referred to a consultant who told me to stop wearing lenses until further notice. I did this for approx 2 months and on his advice I re-introduced lenses about twice a week, however I have found I could only wear them for about 4 hours before they get really sore and red.

It has now been 5 months since I stopped taking the drug and my eyes are still sore during work (I use a computer all day) and therefore wear eye glasses. I get some wear out of contacts during the evening and weekends but as mentioned before my eyes do get sore and my wear time is very limited.

I went to see my consultant this week and he has said that my eyes look ''fine'' (this was after a long day at work infront of the computer) but as I am still having problems he plugged by bottom puncta with temporary plugs which apparently dissolve within days and told me to continue to use the vismed multi which I have used since I first developed problems.

I haven't really noticed any real benefit from the plugs which have now been in for two days.

Over the past few months I have tried a number of different lenses; proclear dailies, acuvue oasis, moist & advance and now H20 extreme all of which give a very similar wear time and result i.e. sore eyes.

In addition I started a course of theratears last week which I hope will help what has been previously described as a ''mild'' dry eye.

I'm looking for any ideas/suggestions/advice as to help with this situation !

Could a different type of lense help ? i.e. RGP ???

Cheers,
Jammie.

[Stanza]

one of the proclear lenses has a good record for dry eye patients, they have one that's very flat, not sure it's the dailies though - I'm pretty sure you should try longer term soft lenses, I think the dailies are poor quality. But it sounds like you may still have problems Maybe try some 6monthly or yearly ones and see if you can wear them for shorter times? You may have to reduce to a number of limited hours. Sucks I know, I've the same problem. I had RGPs years ago and had even more probs but you should probably give them ago if you've the money to keep trying more. It should normally work ok for most people - though it sounds like you might be on the losing side of the contacts battle - I hope not but...

[Rebecca Petris]

Welcome Jammie,

I think frankly that there's no point trying more types of contact lenses until and unless any underlying condition is completely under control. Otherwise contacts will only aggravate things.

Accutane is known to be associated with dry eye problems. I think that it does so partly or mostly by affecting the oil glands in the eyelids. I would suggest first off reading up on meibomian gland dysfunction (MGD) on this site (or wherever). Next time you see a doctor, go prepared with a list of questions... moderate in length so you don't scare them away but enough to get a more detailed diagnosis. Ask them to examine and talk to you about your meibomian glands and ask whether they see any signs of blepharitis.

As far as work goes... read up on some of the computer use tips here, like using software reminders to blink more frequently and take frequent rests and keeping your eyes well lubricated while using the computer. If possible, moisture-retaining glasses are always a good idea.

I haven't really noticed any real benefit from the plugs which have now been in for two days.

Two days is too early to know whether they'll help.

[Zarla]

You could ask to try Optima 38 or Zero 6. These are conventional soft contact lens which you clean every day and change after about 6 months. They're low water content. I have had mild dry eye for 10 years and I couldn't wear any of the ones you mention but I was fine with these (my right eye still is). They might not work for you but are definitely worth trying.