My Story So Far......

[Racer200]

Hello,

I was fine until about mid June and I was working outside that day replacing some wood. That afternoon I could have sworn I had something in my eye. Felt like I had sawdust or something in it. That night my eye watered alot and I tried watching a movie and it seemed like the TV was ten times brighter than usual. I even checked the settings thinking someone had changed them.

Since that point in time and it may not have had anything to do with it but I've been struggling with light sensitivity. My eyes also burn really bad. I alomost feel like I have a fever. While I'm working at the computer and sitting at my desk I'm fine. If I turn to talk to someone the overhead fluorescent lights make my eyes sensitive and feel scratchy and I start blinking and wanting to rub my eyes. If I turn back around and go back to the computer or paperwork my eyes return to normal. I'm sitting here now typing this on a 24" LCD monitor and I feel no pain or dry feeling at all. It just seems so strange that I have no symtoms at all till I get in certain types of light. Get back out of that light again and I'm back to feeling normal.

I basically feel fine except when you introduce certain type of lights into my life. I can even stand outside in normal daylight and have no symptons but when I get in the car and start driving it feels like I need to blink and close my eyes. If I sit in my car and eat lunch I have no symptons but as soon as I drive down the road a little bit the problems kick in. I can sit in my home office on the computer or reading a book and I'm fine but if I go into our living or family rooms the sensitivity starts. Even pulling the blinds doesn't seem to help. TV watching in those rooms is really a struggle.

I've been to my optometrist numerous times and even bought new glasses. His first response was I had dry eyes. We tried the temp plugs and there was no change at all. I use Refresh Tears or Thera Tears and they do not help at all. I can put Refresh Tears in and try and watch TV and it makes no difference at all. The Doctor tried some steroid drops (prednisolone) thinking I had Iritis and it didn't help. Tried some allergy drops (Elestat) and Clartin D pills but neither one helped. I used Restasis for two weeks and seemed a little better in one regard but it made my eyes worse in others (Blurry vision,Halos and burning ) and that made life in front of the computer screen worse so work was really a struggle.

I was finally referred to an Ophthalmologist last week. It seemed like a whirlwind visit and was over before I knew it. He looked into my eyes and said you have some serious inflammation and redness going on. He then said I had a case of Blepharitis and gave me Azasite and Lotemax and said try a warm compress at night and mentioned if these didn't work they might try Botox injections. Before I knew it he was gone and the nurse filled out the prescription form. It felt like a really rushed visit. It seems like they are not looking for the cause of the light sensitivity. He is also a Lasik surgery clinic (3 of them) and he also has a plastic surgeon on site. I don't know I just don't feel like I got a real good checkup. To busy of a place I think and he can make more off the lasik people. Anyway I go back next Tuesday. So far the drugs haven't helped. I felt really good yesterday but last night I tried to watch a movie and was miserable. Just when you think you feel better you try and do something normal and it knocks you back. I'm starting to get pretty depressed about it. I can't seem to do the things I enjoy the most (I'm a big movie nut) and that is depressing.

Sorry for the long post but I just wanted to post and tell somebody what's going on with me. Not sure where to turn next. Maybe some experts here can shed some light on my ongoing problems.

Thanks,

Jim

[Teri]

Hey Jim. Welcome to the DEZ.

I wish I had more helpful advice...but it sounds like you need to find a doctor who will take his/her time to really examine you and give you a good diagnosis. Have you checked out the "Plug a Doc" section or the "Dry Eye Doc Yellow Pages"? Maybe there is a recommended doctor in your vicinity.

I do know that some of the drops you mention (restasis, azasite) can take a while to really work. Restasis can takke 2-6 months to really take effect. You need to know if your eyes are really dry (if that's your problem), and, if so, what is causing the dryness (aqueous deficiency? MGD/blepharitis? ocular rosacea?).

There is also a really good page somewhere on here with a checklist or worksheet to fill out and take to your next appointment. (I don't remember where it is? Maybe someone else knows where the link is?)

I hope you can get to the bottom of this, and I wish I had more ideas how to help.
Teri

[Rebecca Petris]

Jim, welcome.

My first thought on reading this...

H
I was fine until about mid June and I was working outside that day replacing some wood. That afternoon I could have sworn I had something in my eye. Felt like I had sawdust or something in it.

...is that perhaps you were right. The light sensitivity would be consistent with a mild corneal abrasion. Furthermore an abrasion can damage the structural integrity of your epithelium. It's just a guess, and may not be the right fit, but might be worth pursuing with another corneal specialist at any rate to rule it out. You may want to read up here about RCEs and ABMD.

One of the problems with getting diagnosed is that "ocular surface disease" includes so many different conditions and many of us have more than one. Pinning them down, and most of all establishing which one or ones are responsible for our symptoms, is a challenging process and it is not unusual to see several doctors before getting any of the right answers. The best hope is to get to the right kind of doctor AND be armed with as many questions as possible. I am sorry about your whirlwind appointment. My suggestion for how to have a better experience is to prepare a really good 1-page summary of your situation and questions (include details of your symptoms including time of day etc, and any adverse history) and FAX it to the doctor a day before the appointment. Bring a copy with you and refer to it to help keep you on track and to slow down the doctor.

Question for you: Do you have any difficulty at all in the early morning with eye pain or "sticky eyelids"?

I would suggest trying some Dwelle from our shop here and see if it helps with the light sensitivity.

[liz56]

Jim, welcome.

My first thought on reading this...

...is that perhaps you were right. The light sensitivity would be consistent with a mild corneal abrasion. Furthermore an abrasion can damage the structural integrity of your epithelium. It's just a guess, and may not be the right fit, but might be worth pursuing with another corneal specialist at any rate to rule it out. You may want to read up here about RCEs and ABMD.

Yep, that was what I thought, too. It may be that your vision is not altered, because the abrasion could have happened on an area that is not near the pupil.

Jim, you might want to read some of the posts on RCE's, which can be caused by a corneal dystrophy or an injury, and, I would highly recommend seeing a corneal specialist who will listen to your history as well as symptoms. If it is RCE's, it's a tough one to diagnose.

I hope that you find answers AND relief!

--Liz

[Racer200]

Hello again and thanks for all the great tips.

When I went to my regular eye doctor he put some yellow dye in my eyes and checked everything out and said I didn't have any eye injury but he seemed to focus more on dry eyes than anything else. Sometimes it's almost like they don't listen to you. On my last visit he could see how I was struggling with the fluorescent lights and blinking and trying to shield my eyes. He always talked about all his patients with dry eyes and how much he has helped them so I asked him if he has any patients with dry eyes that do what I'm doing right now. He said no and and I said well then we need to do something to correct this. That's when he agreed to give me a referral to an Ophthalmologist.

I had doubts about the Ophthalmologist when I saw his card and looked up his web site. Everything is geared towards the lasik/corrective surgery side of the business. I even contacted the office to make sure he would see me for problems like I'm having. Anyway I just expected more of an exam than the brief time (under 10 minutes) I spent with the doctor. I really didn't get a chance to explain anything or ask any questions. I only recognized the word Blepharitis because I had seen mention of it here He said if these drops didn't do the trick he would have me talk to his in house plastic surgeon to set up Botox treatments. I just feel he is pushing that awful quick before finding the actual cause of the light sensitivity. Does that sound about right??

I'll read up on some of your suggestions. I have my follow-up visit Tuesday and if that doesn't go any better I'm seeing my regular MD for some other stuff soon and I'm sure I can get a different referral from him.

Thanks for all the suggestions and if you have anything else to add please keep it coming. I need all the help I can get

Jim

[Racer200]

Jim, welcome.

Question for you: Do you have any difficulty at all in the early morning with eye pain or "sticky eyelids"?

I would suggest trying some Dwelle from our shop here and see if it helps with the light sensitivity.

Hi Rebecca,

Nothing unusal or strange in the mornings. No sticky eyes. Since all of this started my eyes are usually very red in the mornings. Seems like my eyes always feel tired. I get up and use a hot wash cloth on my eyes and put in some Thera Tear drops. I feel fine till I hit the living room to watch some morning news and the light coming from the windows sets things in motion (blinking,squniting etc.) Then when I leave for work I struggle on the drive even with sun glasses. I park the truck and walk in and by the time I get to my desk no symptons at all. Then I'm fine till I get a good dose of fluorescent lights.

It's a vicious cycle

Jim

[Racer200]

Had my second appointment yesterday. Got there at 3:50 for my 4:00 appointment and the place was packed. They told me they were running about 1/2 hour behind. They fnally came and got me at 5:05. Nurse talked to me a few minutes before the doc came in. He asked if things were any better and I said no. He said continue with the drops and we need to set you up with our plastic surgeon for some Botox treatments. I said before we do anything else I would like to ask a few questions.

He answered some of the questions but finally just said we don't know why some people blink with bright lights. It's called blepharospasm and the treatment is Botox. He said it was more of a neurological problem than an actual vision problem. He then said I would probably be better off seeing a neurologist before they do anything else.

He said I do not have any eye injury. I told him the story but it didn't matter. He briefly shined a light in my eyes and said I still had some crusting on my eyelids He seemed to loose his patience as I asked more questions. I could tell he was wanting out of there since there were still 5 or 6 people in the waiting room.

Anyway not a warm and fuzzy feeling from that appointemnt at all.
I think I will go back to my plan of going to my regular MD and going over all of it with him and see if he feels I need to see another opthamologist (which he can give me a referral to) or a neurologist or whatever.

So that's my update...

Jim