Need opinions: Top 3 Issues / How to cope

[Ccoughlin]

Hi - I'm 9 1/2 months post-LASIK, and continue to have lots of problems. It seems like it was getting better in Nov/Dec, but then I've reverted back to worse in Jan/Feb. Do you think the colder weather contributes?

I went to my doc yesterday - I have MGD and evaporative eye problems, causing dry eyes and deal with some amount of pain. He recommended scleral lenses - how much would those cost, roughly?, and do you think that is a good choice and can help with pain, constant drops and slightly blurry vision?

I'm not sure if I want to make the investment in sclerals, if there is hope that, in time, my nerves could continue to improve my sight and comfort level. Does anyone see lots of improvement in LASIK users, after 10-12 months? Also, does a more humid climate (March/April/May) sometimes help conditions? I'm getting fairly depressed here, having dealth with this for so long. I'm pretty much always wearing glasses now. I tried some contacts, but those didn't work, due to dry eye.

Also, is there any pain medication (ibroprofen, etc.) that can help alleviate the pain?

Having a rough Jan/Feb for sure! take care all, chandra

[patientpatrick]

Hey Chandra. I do believe that the colder weather contributes to the dryness. I had Lasik back in Dec of 2011 and the first month was really hard to deal with, but it got better the following months but marginally. It was interesting because they felt dry but not nec. painful, I think because my nerves haven't had any substantial growth yet. Then I started to feel some pain come spring and felt significantly better in the summer. After the summer, things slowly got worse and come the winter things felt painful.

I had pretty bad morning dryness in the past and have started using Genteal Gel before i go to bed. It has alleviated the morning dryness between 70-90% and has made waking up much easier.

I too have MGD plus aquaeous def. My Schrimer scores were 18 and 19. I had them checked again at the same clinic a few weeks ago and score 5 and 7. No doctor has recommended scleral lenses for me just yet.

Have you tried punctal plugs yet and/or Restasis?
I had temp plugs put in and noticed a 30% relief in my symptoms, I was told the permanent ones do a better job since collagen doesn't fully occlude the punctum.
I've been on Restasis for 2.5 months and have noticed that I use drops less but my eyes still feel gritty and gunky and painful at times.

This is very depressing for me too. My Lasik Doc. keeps saying I'll heal and will get better (how much better and when that will happen he won't say) I've seen 4 other docs in the last few weeks and the consensus is I may or may not get better, I'm wondering if the docs who say I'll get better are just saying that to make me feel better. A side of me keeps reading all the other posts from MDs stating that temporary dryness heals up by 6months and permanent dryness happens when it lingers beyond that time frame.

The point is I'm no longer sure what to believe. I don't care if i have to wear glasses for the rest of my life, or if I'm legally blind w/o them. I just want the dryness and pain to go away.

[bakunin]

The only explanation of why cold weather makes things worse was cornea evaporative hyperalgesia. My eyes get worse in a cold enviroment (so, AC is bad for that reason either). The pain nerves in the cornea have termo-sensors that are activated when the temperature gets down. Warm compress or water vapor gives imediate relief.

[Guest]

The only explanation of why cold weather makes things worse was cornea evaporative hyperalgesia. My eyes get worse in a cold enviroment (so, AC is bad for that reason either). The pain nerves in the cornea have termo-sensors that are activated when the temperature gets down. Warm compress or water vapor gives imediate relief.

Not necessarily the only explanation... when the weather gets cold, the absolute humidity tends to decrease, both indoors and out (do not confuse with relative humidity, which may look ok when it's not). Similarly, when in an AC'd environment, the indoor absolute humidity will decrease. It's the decrease in absolute humidity that causes many of us to have trouble - lowered absolute humidity = faster evaporation of tears.

If you put damp laundry out to dry on a super humid day, it takes longer to dry. If you put that same laundry out on a less humid day, it will dry out faster. Tears are no different.

[tiff]

Chandra, I didn't have LASIK and don't wear contacts so my dry and evaporative eye cause us undetermined. But, I just wanted to say that I feel for you and you aren't alone. I'm in my mid-30s, otherwise healthy and have a great life. Dry eye is causing such depression for me and I hate that it takes over everything. Good luck!

[tommyboy]

chandra - before going down the route of PROSE lenses I would highly recommend getting a confocal done to exam your nerve generation. I went to the BFS about 6 months ago and tried the PROSE lens ... unfortunately the lens did not help me. I was diagnosed with corneal neuralgia and Dr Jacobs, from the BFS set me up with Dr. Hamrah in Boston to have the confocal done which confirmed my diagnosis. I am not suggesting you have corneal neuralgia, but getting fitting for PROSE is expensive and very time consuming ... and the confocal test is simple and fairly inexpensive.

In terms of pain meds I have tried a bunch and right now I am on Tramadol, which is a non narcotic, and seems to help some.

Best of luck,
Tom