Would love advice before I begin this quest!

[JanJan]

Hello everyone,

I'm hoping to get some advice before I embark upon treatment for dry eyes since so many of you seem to have been there/done that!

I'm a 48 y/o woman. Six months ago I started getting extremely blurred vision. This would occur after a few hours of being at at work and resolve after being home for about an hour. I had no other symptoms - no burning/irritation/itchiness. I thought it was just due to my age and the fact that it was finally time for glasses.

I was completely surprised to get a diagnosis of severe dry eyes. I was told to use eye drops, hot compresses and to take flax seed or fish oil. I've done the drops and oil for a few months with little relief. I saw the optometrist for followup on Friday and he recommended two weeks of steroid eye drops followed by Restasis. Since I'd really rather not use steroids, he said I could try the Restasis alone but that I'd probably have too much irritation. I haven't started them yet and have visions that it will be like dropping bleach into my eyes! Is it not a good idea to start Restasis before using steroid eye drops?

Most importantly, should I be seeing an opthalmologist and not trusting an optometrist about this? Any advice would be very much appreciated.

[Gretchen]

No pain or irritation? Wow, you are lucky!

If you have no inflammation, I am thinking that frequent artificial tears should help. You could try something like Lacriserts - you can search the web and the boards for information.

As for Restasis and steroids if you are not having pain and irritation? I kind of question this...Restasis helps with inflammation but it does not sound like you are inflamed. If you want to give it a shot, there is no real danger. The doc probably prescribed Alrex or Lotemax as the steroid and these are very light weight and low risk - many folks are on Alrex for years for allergies with no complications. Or you could try the Restasis just by itself and see if you can manage without the steroid phase-in. Restasis did not bother my eyes and so I did the steroids for only 3 days before I discovered that I could go without.

As for and Opthamologist vs Optomotrist, you would think that the former is going to be better. But let me tell you that with dry eye that is not true. As a matter of a fact many on here have been through a ton of docs and big eye clinics before they got the help they needed with a good Optometrist with an interest in dry eye. A dry eye specialist is what you need - don't worry about the letters after the name.

Good luck and hth,
Gretchen

[mary kenny badami]

JanJan,

Regarding qualifications of doctors: I agree 100% with what Gretchen said in the previous post -- in the USA "ophthalmologists" are typically MDs who specialize in treating diseases of the eyes . . . whereas "optometrists" are highly trained docs who perform eye exams prior to prescribing glasses or contact lenses, and often see and treat, day in and day out, problems such as "dry eyes."

There's no harm in getting a "second opinion," of course <other than the trouble of the trip and the expenses involved>, but I think that -- as Gretchen has already said -- you shouldn't get hung up on the letters after the name, but rather consider whether the doc and his/her practice specialize in treating folks with potential or actual diagnoses of dry eyes!

[bvendig]

embarking upon treatment

hello,
in my case i've seen both but i find that they generally say the same thing which is
1. eye drops & warm compresses
2. flax seed oil & fish oil
3. restasis (with 2 weeks of antibiotics)
4. punctal plugs

restasis hasn't helped me and it does cause a little bit of discomfort but it's not horrible. at least not in my experience.
hugs, betty

Hello everyone,

I'm hoping to get some advice before I embark upon treatment for dry eyes since so many of you seem to have been there/done that!

I'm a 48 y/o woman. Six months ago I started getting extremely blurred vision. This would occur after a few hours of being at at work and resolve after being home for about an hour. I had no other symptoms - no burning/irritation/itchiness. I thought it was just due to my age and the fact that it was finally time for glasses.

I was completely surprised to get a diagnosis of severe dry eyes. I was told to use eye drops, hot compresses and to take flax seed or fish oil. I've done the drops and oil for a few months with little relief. I saw the optometrist for followup on Friday and he recommended two weeks of steroid eye drops followed by Restasis. Since I'd really rather not use steroids, he said I could try the Restasis alone but that I'd probably have too much irritation. I haven't started them yet and have visions that it will be like dropping bleach into my eyes! Is it not a good idea to start Restasis before using steroid eye drops?

Most importantly, should I be seeing an opthalmologist and not trusting an optometrist about this? Any advice would be very much appreciated.

[bvendig]

advice

hi janjan
one more thing that i forgot to mention is to drink LOTS of liquids.
i wasn't told that by a doctor but many people in this group have mentioned it and i drink probably about 12 glasses of water/liquids a day.
hugs, betty

Hello everyone,

I'm hoping to get some advice before I embark upon treatment for dry eyes since so many of you seem to have been there/done that!

I'm a 48 y/o woman. Six months ago I started getting extremely blurred vision. This would occur after a few hours of being at at work and resolve after being home for about an hour. I had no other symptoms - no burning/irritation/itchiness. I thought it was just due to my age and the fact that it was finally time for glasses.

I was completely surprised to get a diagnosis of severe dry eyes. I was told to use eye drops, hot compresses and to take flax seed or fish oil. I've done the drops and oil for a few months with little relief. I saw the optometrist for followup on Friday and he recommended two weeks of steroid eye drops followed by Restasis. Since I'd really rather not use steroids, he said I could try the Restasis alone but that I'd probably have too much irritation. I haven't started them yet and have visions that it will be like dropping bleach into my eyes! Is it not a good idea to start Restasis before using steroid eye drops?

Most importantly, should I be seeing an opthalmologist and not trusting an optometrist about this? Any advice would be very much appreciated.

[LasikRelatedDES]

Let me say one thing regarding optometrists versus ophthalmologists....

When this all first flared up for me, I first went to a kind, caring optometrist who was very concerned and promised he would get me better. Unfortunately, I was convinced by an MD that I should be going to an ophthalmologist. So, I dropped the optometrist and was subsequently misdiagnosed and mistreated by an awful ophthalmologist.

By the time I realized my mistake my insurance expired... and I just got worse and worse. If only I had stuck with that optometrist!

[Rebecca Petris]

Chiming in on the age-old OD vs MD question

The main problem we face with ophthalmologists, IMHO, is simply that relatively few corneal specialists are actually interested enough in ocular surface disease to achieve a level of competence sufficient for folks like us.

This is also true of optometrists.

But when we walk in the specialist's door, our expectations, naturally enough, are higher. So when s/he turns out to be one of the majority whose boat isn't floated by dry eye, the disappointment - or, depending how many you've already seen, disillusionment - is greater.

There are hidden gems out there in both professions. When you find one, please post about them in the Plug-A-Doc forum and also send 'em my way so I can list them in our directory for others to find

[Rebecca Petris]

Hi JanJan & welcome!

I was completely surprised to get a diagnosis of severe dry eyes.

No matter what kind of doctor you're going to... I'm going to suggest at the next appointment you push for a more detailed diagnosis. Here's an article about this that may be helpful. From their recommendation so far I'm assuming they're seeing meibomian gland dysfunction... but even in that case more detail would be helpful, i.e. are your oil glands chronically plugged? Or just not producing? Inflamed or no? etc.

I was told to use eye drops, hot compresses and to take flax seed or fish oil. I've done the drops and oil for a few months with little relief.

Have you done the compresses?

[JanJan]

Follow-Up from Jan

Thanks so much for all the comments and advice.

It seems what most of you took away from my question was the optometrist vs. opthalmologist issue. My concern in that regard is that I think I'd feel more comfortable being under a physician's care if I choose to take steroids...for anything.

I'm happy to hear that I might be able to tolerate Restasis without a course of steroids in conjunction.

No, I haven't been very compliant about the hot compresses. The optometrist even gave me a great tip about using microwave-cooked small red potatoes wrapped in a wet washcloth. I think I do have plugged glands (as evidenced by the dry eye as well as loss of a lot of lashes). Should I definitely make more of an effort in that regard?

Also, the optometrist tried to sell me "dry eye syndrome goggle moisture chambers glasses"...which seemed like a good idea but I thought the $60 price tag was rather high. Are they worth it?

[Rebecca Petris]

My concern in that regard is that I think I'd feel more comfortable being under a physician's care if I choose to take steroids...for anything.

Understood. It's up to you. Personally I would not feel differently about an optometrist vs. an ophthamologist for prescribing steroids. A smart, capable, observant eye doctor who listens to my concerns is all I'd stipulate for.

No, I haven't been very compliant about the hot compresses. The optometrist even gave me a great tip about using microwave-cooked small red potatoes wrapped in a wet washcloth. I think I do have plugged glands (as evidenced by the dry eye as well as loss of a lot of lashes). Should I definitely make more of an effort in that regard?

If you have plugged glands then there is a strong probability that consistent heat treatment (I'm talking daily for weeks/months) will improve the condition of the glands. If the doctor is pushing heat hopefully that means he's got reason to believe it will help.

Also, the optometrist tried to sell me "dry eye syndrome goggle moisture chambers glasses"...which seemed like a good idea but I thought the $60 price tag was rather high. Are they worth it?

People often pay hundreds of dollars for moisture chambers and yes they are worth it. They don't help all people equally of course.

[Lucy]

Be careful an opthalmologist doesn't try to "sell" you Lasik surgery or PRK to "fix up your problem." An optometrist wouldn't/couldn't do this surgery. This isn't meant to be sarcastic, it's happened as we've read about the results here. Lucy

[mary kenny badami]

JanJan,

Have you read the book "The Dry Eye Remedy" by Dr. Latkany? It's available on this website through "the dry eye shop" (see the link, the big blue teardrop at the top of your screen?). It was originally sold at modest cost, and lately -- thanks to the courtesy of the Sjogren's Foundation -- you might still be able to order it via "the dry eye shop" for free by just paying the shipping cost.

Also, if traveling from where you live into New York City is practical, I doubt that you will find a better qualified doctor who specializes in the diagnosis and treatment of dry eyes than Dr. Latkany.

Yes, more than a few members here have found help via warm compresses, including the "microwaved potato" trick.
Others prefer the convenience of a microwaveable "Rice Baggy" -- a cloth-covered item with uncooked rice inside, which -- unlike the average potato -- is re-usable.
Rice baggies and replacement covers are also available for modest cost here at the shop.

I agree with Rebecca, that it will likely take weeks, if not months, of faithful use of hot compresses in order to get a suitable result.
Tedious but necessary if the source of your problem (not sure from your posts if that IS your diagnosis), anyway, tedious but necessary IF the source of your problem is blocked oil glands.

DISCLAIMERS: Although I have zero financial ties to The Dry Eye Shop other than having been a long-term customer, I have enormous appreciation of the products available there.
And while I have never visited Dr. Latkany myself, I am inclined to trust the many testimonials from members of this website who assert that he has been of great help to them.