Making sense of my Schirmers result.

[Inanna]

Hello all (new here)

I developed dry eye after my Lasik surgery. To be fair, I did not notice it (just a bit the feeling of having something in the eye sometimes). I went to a doctor as I felt I was undercorrected and she told me I had astigmatism (even more than before the surgery), some miopia left and severe dry eyes. She gave me a treatment (cationorm and viscotears), but after a month I am much worse. Now I am having pain and red eyes, which I did not have before. I have seen another doctor, who thinks she made me use too much drops (over 8 times a day) and I have washed off my tear film. He reduced my drops to 4 times a day. The first doctor did a Schirmer after a month and it is:
Left eye: 9
Right eye: 10

She says it is so bad and it must be 20. In internet I read 10-15 is normal. Here I read some of you having Schirmers of less than 6. So... What is it? Good? bad? moderate?

And seriously guys, how the f**ck do you clean vaseline from the eyes in the morning? Sulphuric acid? Salts from Pluto? Holy water from the Jordan river? They changed my viscotears for vaseline and every morning I look like if I sleep in a bucket of grease!

Best

[Angela810]

Vaseline - what a bizarre thing to recommend. I avoid oily ointments because I have found the inflammation to get worse with time. Instead I wear eye seals 4.0 at night - which helps amazingly.

If you do want to wear ointment at night time, you must wipe it off properly in the morning using blephasol or ocusoft. If not the ointment may clog your meibomian glands.

What is you tear break up film time? Your schirmers are not bad, so maybe it's the oil component that is reduced, which can happen after Lasik. Try taking 2000mg omega 3 - theratear supplements are very good. Can you try warm compresses and lid massage to increase the oil?

The following video is good and explains how to do a warm compress and lid massage.

https://www.youtube.com/watch?v=gBgqZsdCYAw

Also only use preservative free eye drops.

When was your Lasik? Basically the nerves need to grow so that sensation comes back and your eyes will be less dry. Its a long waiting process.

[Inanna]

Hello Angela, thanks for your reply!

I don't know my tear break up film time, but the doctor said I had no oil film... Which other doctor think it happened because I used too much drops. I must admit I was feeling much better before using drops! Now I have reduced it to 4x day, let's see if my film comes back. I do warm compresses sometimes, but I don't know if they help. I see blurry right after.
My lasik was almost a year ago, in November 2015.

[farmgirl]

Hi Inanna: I would say based on your results that your eyes are not severely aqueous deficient. I have Sjogrens and when mine were tested the paper stuck to my eyeball and pulled off a chunk of skin. When the doctor came in he said "your eye is very red" to which I replied, oh, they are always red. It wasn't until I got home that I realized what had actually happened. I felt it at the time but didn't realize what had happened until I looked in the mirror. Having said that there is a lot more to dry eye than lack of tear. As I understand it Schirmers is also not a really great diagnostic tool anymore anyhow.

Personally I cannot tolerate ANY oils in my eyes so am unable to use any eye ointments. They make my eyes extremely sore and irritated and blazing bloodshot in the am. I am having trouble understanding this 'washing off the tear film' business. If that were the case then it should correct itself when you stop whatever it was that you were doing that was 'washing off the tear film'.

My experience has been - if I am getting worse, I quit what I am doing and try something else. Often what we put into our eyes to solve one problem creates another. Sometimes less is better. I am sensitive to just about anything I put in my eyes after years of drops. I tolerate no preservatives except systane but I use non preserved systane if I must use it. Recently I have developed contact dermatitis of the eyelid from even that so I switched to Bion tears and I use them only once or twice a day. If I need more (and I do) I use a non preserved saline.

If possible limit your computer time until you feel better as computers are famous for irritating eyes. When you are in the privacy of your own home you can try wearing goggles of some sort to help preserve the moisture on your eye. If that helps then invest in moisture chamber glasses. You can try plugs to see if it helps to have the tear ducts not draining away what tears you do have.

Above all else, take heart, even though you may never be 100% but will improve as you find out what works for you and what doesn't so hang in there...cheers...F/G

[Inanna]

Hello farmgirl,

Same happens to me, the more things I use, the worse. I think I did not explain myself very well: what the doctor meant is that, by using all the drops I washed off the oil film over the eye. I don't really feel great discomfort (I don't have much sensibility in my eyes), but I have had another chronic pan condition for the last 9 years and I am TERRIFIED to add one more.
I hope it will get better, the doctor said some LASIK patients are just slower than others in their recover...

[dryeyeblues]

Hey folks, I wrote a blog article on my Schirmers test (with images) and my Lipiview test. I'm not an expert, but shared my experience and some helpful info.

http://www.lasikdryeyeblues.com/dry-...nt-perspective

Thanks
Matthew
www.lasikdryeyeblues.com