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Problems reading w/dry eye and insufficiency both

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  • Problems reading w/dry eye and insufficiency both

    I am two years post ICL. I can only see large print with reading glasses, or really large print (have internet screen on my 42" tv right now). I can read emails and type on the tv screen but if I try to read a downloaded book on a screen my eyes hurt too much to concentrate for long. For books, it's paper only.

    Before my collamer lenses, I did have dry eyes. I could not wear contacts and was stuck in glasses with a -12 prescription for 2 1/2 years, very irritating. But zero discomfort unless I tried to put contacts in.

    Now, my symptoms are blurry vision near and far (it goes constantly in and out of focus), constant pain and discomfort from dry eyes including waking up at night from it, double vision, headaches, inability to concentrate and nausea when reading (these two are due to convergence and divergence insufficiency which I did not have pre surgery), fatigue in the early evening, and fatigue when reading.

    I had a bad reaction to the prednisone, a pressure spike of 39, and a vitreous detachment resulting in permanent floaters in my left eye so due to that and astigmatism in my left I mostly lean on my right eye.

    Right after the surgery I started trying reading glasses of +1 and two years later I'm up to +2.5 and getting worse. This is for reading large print only. I can no longer read newspapers or most books unless they come in large print. I have prism glasses with a prism of 10 and reading glass rx of I think 2.5 but to read one page of regular print with them, makes me so exhausted I can't sit up. even though they do help to focus the print. I think the exhaustion has to do with the dry eyes.

    Surgery is a risk factor for early onset presbyobia, I don't have any other risk factors, it doesn't run in my family, and it happened to me starting the day of surgery (age 34) so I think it's safe to say the surgery caused the early onset of the presbyopia. Given my other family members experiences I would say at least 10 years earlier than it would have been.

    Just imagine you have stayed up extremely late and in addition to that you are in a warm dark quiet room with a pillow in front of you listening to the most boring lecture you've ever heard in your life and you feel as if someone has made your eyelids weigh a pound each. If I try to read regular print with the prisms it's like that. If I try to read regular print with reading glasses I just can't see it.

    I feel like I've tried everything but I hope I haven't. Pre-surgery I did have plugs, no result, I've been on restasis 5 years, no result there, I use refresh plus drops and recently asked for a pre-auth to try and get those covered because I am using them more and more often and can't afford them, did try fish oil, did try doxycycline but only for 30 days because they didn't tell me it takes at least that long, and I tell all the docs that I didn't give it a fair shake but none have re-prescribed it to me, did try eye scrubs, ointments, and warm compresses no luck, post-surgery: did try some drop they told me was a pain reliever like "ibuprofen" for the eyes, post-surgery, and t did nothing but sting like nothing I've ever felt and hurt for 20 minutes, did try Alrex and had a reaction to the preservative in it. If I forgot to list something please bring it up.

    I have not tried goggles, in fact wearing them after surgery was the only thing I ever remember making my eyes feel better. I have not tried a humidifier. I have not tried serum eye drops. All these things cost money I do not have right now but I hope to get them in the future. I do know sometimes DME is covered but it has to be from an authorized supplier and forget that. DME suppliers will only do things like adult diapers and wheelchairs, nothing they consider "obscure." However, I did manage to get my over the counter preservative free drops covered with a pre-authorization. The pharmacy has them on order so we'll see what they give me. I couldn't afford them anymore. Watching tv for an hour I might use drops 15 times.

    I swear I am not a person who loves to complain, despite all that. I am a positive person and don't really talk about this with anyone. The only other health problem I have is grinding and tmj, which also causes headaches so the headaches are probably an overlap of both causes. Also, some doctors have commented that insufficiency and needing reading glasses are normal when you're "older" even though I was 34 when I had the surgery and my 70 year old parents do not have these problems. The insuffiencies can't be the whole problem because closing one eye doesn't clear up my vision.

    Thanks for listening and if there is anything I missed please let me know what it is. Maybe next year when I get my tax return I may be able to pay for it so don't hold back.

  • #2
    have you been checked for conjunctivochalasis (CCH)? it's basically loose conjunctiva in your fornix that takes up all that space in your tear reservoir and the space in the tear meniscus too. the symptoms caused by CCH dry eye are different from aqueous tear deficiency dry eye in a couple of ways. like the down gaze is much worse (reading, golfing, knitting etc) because when you look down, the loose conjunctiva bunches up even more and causes friction or something like that. also, since cch is a mechanical issue with the anatomy of the eye, it can't be corrected by eye drops or restasis or plugs.

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    • #3
      i just read this abstract: http://www.ncbi.nlm.nih.gov/pubmed/23583167

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