Why aren't both my eyes affected?

[DKott27]

So I've had blepharitus, mgd, dry eye...Im not even sure anymore for years. It's been awful. But my right eye is completely fine. Only my left eye is gritty, scratchy, and unbearably dry. This stumps all the doctors. Any ideas?

[CharlieGreenEyes]

Have your doctors done the proper tests on both eyes? For several years, I wasn't tested or looked at properly. I have much more severe symptoms in one eye (sometimes the other eye feels fine - although I'm scared it might start to go bad too!). From what I've been told, sometimes you only get symptoms in one eye but still have it in both. If it is unilateral, there's surely an underlying cause (another condition perhaps)? Could you have a lazy eye? My worse eye is my "good" eye because I have a lazy eye (never corrected properly in childhood), which is why one of mine is worse. Maybe see if that's your problem.

[MGD1701]

Or maybe nerve/cell issues which need more sophisticated machine to detect? Just a thought!

[DKott27]

Thanks for the advice. I'll try to look into that. I've seen many doctors. Most just say sorry, this is something your just gonna have to deal with. No in depth tests have been done. I wouldnt know where to start.

[DKott27]

I noticed I don't blink at all. My face muscles are so tense all the time. I used to be on klonopin and when I took that it cut the discomfort in half. I don't know of it's because it relaxed my muscles?

[CharlieGreenEyes]

Have you seen any doctor recommended on here? I can relate to how hard it is to find a doctor who listens and actually takes this seriously. I found my new opth by reading this forum and seeing someone's name being suggested. I feel better about seeing someone who has been recommended on here because I know they've been helpful to others and so aren't as dismissive. I don't think you're in the UK (don't think we have klonopin here) but if you are, I can tell you who I saw.

Klonopin's a sedative? I've taken sleeping pills every so often - partly when the eye pain has been so bad and I can't sleep, but I try to avoid unless it's an emergency because apparently these sorts of drugs can actually cause (and make worse) dry eyes.

I don't know who deals with nerve/cell issues, but I guess you need to see an opth who has expertise in this area if that might be the problem? MGD1701 or someone else (sorry for forgetting who - I have to skim read with my eyes at the moment) mentioned something about blinking exercises. I was going to google for info on the internet. I guess that might also help you?

If it's lazy eye you need to see orthoptics (that's what it is in the UK, I'm not sure if there's another name in other countries). I've seen one before but then moved house. I'm now waiting for a new appointment.

For me, the lazy eye sort of perpetuates the situation. My worse eye for dryness is my good eye for vision. So it kind of does all the work and never gets the rest if needs because of the severe dryeness. So that might be what's happending for you. Although, unlike you, I do have dryness/MGD in my other eye. They just aren't severe (hopefully this won't change as I don't want two bad eyes!).

I think you need to really stress just how badly the condition is impacting on your life. Also if it really is just one eye, that really does need to be checked out. Tell your doctor that you're concerned because of the unilateral issue. I wrote down bullet points and it seems to have helped get me more help from the doctor (although I'm still far from better) than any other time.

[Hokucat]

Hi. Actually, MGD1701 and Charlie might have a point about you possibly having nerve/cell issues in one eye. From what I've read, the Klonopin you say helps with the discomfort is also used for seizures/epilepsy. There used to be compounded lacosamide eye drops discovered by Dr. Rosenthal that helped patients with corneal neuralgia, which is also a seizure/epilepsy drug. Unfortunately lacosimide is currently not available to compound as an eye drop, I think something to do with patent rights related to the brand name Vimpat, but am not certain.

https://www.aao.org/eyenet/article/a...eal-neuropathy

So it may be worthwhile to see a specialist who has a confocal microscope, which can see if you have corneal nerve damage.

Some people have found autologous serum tears help their corneal nerves heal, as well as with other dry eye conditions.

Also, here are some blinking exercises, there are different versions but I use this one:

http://www.skyvisioncenters.com/blog...exercises-app/

[DKott27]

Thanks for the advice! I will look into all of this.

[DKott27]

How do I go about finding a doctor who specializes in Corneal Neuropathy?

[Hokucat]

I think most major universities that practice ophthalmology have confocal microscopes to diagnose if you have corneal neuralgia. Do you live in the U.S.?

[DKott27]

So I have an appointment with an optometrist who specializes in dry eye. They said he is going to do something called eye mapping which when I looked it up is also referred to as corneal topography. Will this possibly show something if it is a nerve or cell issue?

[Hokucat]

I believe corneal topography makes a 3D map of the curvature of the surface of your cornea, I don't think it helps diagnose corneal nerve damage. I think a confocal microscope is required to diagnose this. But you could ask this doctor about it. Also, to my knowledge, most dry eye specialists are usually ophthalmologists...