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if the corneal nerves have neuropathy and have regenerated into an ultra sensitive state, would corneal replacement be an option to kind of try to regrow the nerves correctly? A desperate option, but when you are in situations like mine and some others on this board you will do anything even if it has a 5% chance of resolving the issue.
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I'm also interested in this...though my condition is not exactly the same. Eye is anesthetized from trigeminal nerve surgery causing amongst other things severe DES, very prone to RCEs, tho with regimen have been doing well. No erosions in 5 mos. Have EBMD, and it's active, cornea is degenerating. Have constant gritty feeling in eye, pain, etc. If RCEs return, or EBMD accelerates, may have to consider corneal transplant per corneal specialist. I'm just trying to educate myself, I don't need one now, hope it doesn't come to that. Socratese, I'm so sorry that you're in such exquisite pain. Does anything help at all? I can't have any air/breeze/cold/heat/wind hit my eye either. I use 7eye Rx glasses to at least diminish pain from these, as well as just drying effect of plain old air. Would these decrease your pain at least from elements?
Maria -
Hi socrates,
You have asked a question that I have been way to reluctant to even think about. Every time it has entered my mind I have thought no one would consider corneal transplant as a suitable treatment for dry eye. But obviously others have given this some thought.
My doctor mentioned yesterday that maybe I have some neuropathy developing. I do however notice some pattern to my pain. I am usually fine through the night and in the morning. I am very emotional right now and if I have cried, then my eyes will be more sore. Sometimes I can identify the pain as a pain at the upper most right corner of my eyeball. I believe that when I feel this in the evening it is a sign of eyestrain. Yes, lasik gave me unbalanced vision along with dry eye.
You have probably already searched this, but it sounds like there are some pain medications that might work. I now that after one week on antidepressants I seemed to have less eye pain. . . too bad I didn't like the side effects they produced.
I am going to go back to trying a remedy that I used to treat post neuralgic shingles pain. I figure nerves are nerves, so maybe the same treatment might help with 'neuralgic' eye pain. I found this remedy on Lorna Vanderhaeghe's web site. She is a biochemist who has come out with a woman's line of natural herbal treatments. She suggested taking Moducare along with vitamin B12. My daughter and I both developed shingles in the fall. We both started with this treatment. I would have to say that within 2 weeks I noticed less pain in the area where I had the shingles. My daughter also reported that she had less pain. We both continued to improve and no longer had any residual pain. Once I had the lasik done I was afraid of how the supplements were going to effect my dry eye so I stopped the treatment. The pain returned, but in a milder form. I do think that I will give this regimen a go again to see if it helps with whatever nerve pain I may be feeling.
It'll be interesting to see what the docs have to say about a corneal transplant.Comment
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Hi,
Corneal transplantation is the last resort for many corneal problems but generally simply having severe dry eye is not an indication for for penetrating keratoplasty. I hope I uderstand your question and problem correctly though. If you don't have a neurotrophic keratopathy (a non healing ulcer due to deseased nerves in the cornea) that may get infected or produce a visually significant scar, the cornea replacement carries more risks than benefits. Also, in this procedure, the nerves are also cut to put the transplant in.
Hope it helps.
Sincerely,
Irina Ganelis, M.D.
http://www.GanelisMD.comComment
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Dr. Ganelis, thank you for providing essential information. Since this site is where I've learned most of what I know about DES and other eye conditions, I appreciate greatly your input. I will be making an appt with a new corneal specialist who specializes in DES in the coming months. I would be ecstatic if she would be as knowledgeable as you, and as open to discussion.
MariaComment
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