Starbursts and ghosting, dry eye sensation without actual dryness.. HELP

[phenix01]

Update, went for a lipiview. I scored 46 and 51. Most of my glands are clogged. 20% of my glands are getting smaller.
Scheduled lipiflow in 4 days. Crossing my fingers as the pain is only increasing.

[phenix01]

Update: 2 months post lipiflow, I'd say the improvement in confort is very little, and there is no improvement on visual symptoms.
My doctors told me however that it took her 3 months to get results after lipiflow.
On the official lipiflow website, they say people that had the condition for 1+ years may take up to 5 months to feel the benefit.

Anyhow, I have my fingers crossed and hoping that Lasik did not ruin my vision. When I use an eye drop at night, I notice that the starbursts go away for a few seconds, therefore hoping the issue is simply the tear film lacking lipids and that it will resolve...

[phenix01]

Update: 5 months after lipiflow. Considerable improvement in comfort, however my eyes are still dry according to Dr, and I still have all the visual disturbance.
Vision still improves dramatically for a few seconds when I use a drop. Hoping my glands will continue improving. Feeling stressed.

[farmgirl]

According to Dr Korb who invented lipiflow he recommends monthly in office expression following lipiflow.

With IPL they recommend a series of 4
Do you use serum drops or have you tried scleral lenses?

[phenix01]

According to Dr Korb who invented lipiflow one treatment doesn't cut it. I think they recommend 3 of them at least or IPL

With IPL they recommend a series of 4
Do you use serum drops or have you tried scleral lenses?

Three treatment? never heard you needed so much. On the lipiflow website they say 5 months to reach full benefit.
I have not tried serum drops or scleral lenses.
I'm running out of ideas to revive my glands.

[farmgirl]

Watch Dr Korbs 4 part video, it starts off in Spanish but you can skip to where he starts to speak, it is very interesting. The part 4 is Q&A and it is interesting as well.

https://www.youtube.com/watch?v=vSShGZfxiFg&t=10s

It is my understanding that Lasik induced dry eye comes about because the nerves that tell your eye to produce a tear have been cut during the procedure and sometimes they never regenerate. Apparently serum drops can be helpful but I am not sure if a year after the fact would be too late. I do know that there are many lasik victims who have had good results with scleral lenses including Rebecca if I am not mistaken (correct me if I am wrong Rebecca). Sclerals of course don't address the underlying MGD so you would still have to continue to pursue treatment for that they only provide symptomatic relief if you can tolerate them.

My doc prefers IPL to lipiflow, is there anyone near you that preforms that procedure. I am happy to hear though that you are somewhat better 5 months post Lipiflow. Perhaps another treatment will increase that if IPL is not available. I have had 3 of the 4 treatments and am starting to improve which makes me happy.

[farmgirl]

My apologies, I just watched Dr Korb again and I am mistaken so I corrected that statement. They recommend regular expression monthly in office following Lipiflow and that the sooner you catch it the better your will recover will be. Depending on how many glands are lost and how long you have had the condition will dictate the speed of recovery.

The 3 in my brain is from his statement that anyone who has had this condition for 3 or more years is considered to be chronic and the expected recovery rate will be 25% after 6 months, 50% after a year so it is a slow process. The younger you are when treated the better the result. He also says that if you have corneal hypersensitivity then the treatment has to be much more effective if you don't have that.

Do you wear moisture chamber glasses because they might really help.

[ebi1368]

phenix01

I am having the same issue as you. My vision after lasik was crystal clear for 2 month and a week. One morning I woke up with sever dry eye and since then I have ghosting, starburst and halo. Ghosting is really annoying. I went to see many optometries and two surgeons. They have no idea why I am having these vision disturbance.

I can feel my eyes are really dry but I do not how I can ghosting just in one night. I did lipiflow yesterday. I can not feel any improvement yet. If it does not get better in two month, I am going to get Seleral lens.

Do you know anybody try these type of lens?

One more question phenix01, does you eyelid feel itchy as well?

[phenix01]

Farmgirl, are you saying it may be normal that I'm still far from good 5 months after lipiflow?

Ebi, my theory is that lasik by cutting the nerves makes your glands idle for a while, glands clogs, and there you have MGD. Never tried the lenses. Eyelids dont feel itchy, only my eyes do.
I'm thinking of trying IPL and/or probing of glands.

[ebi1368]

Do you do warm compress every night?

I find some temporary relief with that. I am also taking omega 3. I do not know if it really helps

[phenix01]

Yes I do the compressed.

update: just had my 5 month Lipiflow follow up. Lipiflow brought my glands unblocked from 2 to 10 on both sides, so I still have half of them blocked. My oil is good quality thanks to fish oil but again half is blocked.

i found about the probing procedure which is the next steps for me. My doc didn’t even know about the procedure. I think probing can be the answer since I need to get those glands unblocked ASAP.

[deep_dry_eye]

Yes I do the compressed.

update: just had my 5 month Lipiflow follow up. Lipiflow brought my glands unblocked from 2 to 10 on both sides, so I still have half of them blocked. My oil is good quality thanks to fish oil but again half is blocked.

i found about the probing procedure which is the next steps for me. My doc didn’t even know about the procedure. I think probing can be the answer since I need to get those glands unblocked ASAP.

I think you can hold off probing if you have no scarred tissue. I had blocked glands too, there are many other options to work on this that could be more effective than probing.

I would definitely do another round of LipiFlow since it helped you. But perhaps more importantly, have you tried IPL? IPL seems to have a lot of success w/ many patients, and many drs are starting to realize this as well.

From a pharmacological perspective, have you tried Antiobiotics and Xiidra/Restasis, both of which can help liquify your oil secretions?

[phenix01]

My lipiflow Dr discouraged me from doing another round of lipiflow, saying it wouldn't change anything.
My probing Dr said probing is my best shot since lipiflow/IPL do a poor job a unblocking glands. I'm having an appointment for probing next Monday. Hoping for the best.

[ebi1368]

My lipiflow Dr discouraged me from doing another round of lipiflow, saying it wouldn't change anything.
My probing Dr said probing is my best shot since lipiflow/IPL do a poor job a unblocking glands. I'm having an appointment for probing next Monday. Hoping for the best.

How did your probing go?

[diydry]

Farmgirl, are you saying it may be normal that I'm still far from good 5 months after lipiflow?

Ebi, my theory is that lasik by cutting the nerves makes your glands idle for a while, glands clogs, and there you have MGD. Never tried the lenses. Eyelids dont feel itchy, only my eyes do.
I'm thinking of trying IPL and/or probing of glands.

That’s my belief too. I think it’s more a theory than anything. No provider i’ve asked (yes, I ask these things!) really understands why lasik worsens MGD, but it can. Since the Meibomian glands are innervated by the corneal nerves, it makes sense they go idle while the cornea heals, and they block up. (In my case I was also told to stop doing warm compresses for several weeks after the lasik because it can dislodge the lasik flap, so this might have also clogged the glands). Although to be fair, I think ANY kind of eye surgery (cataracts) can worsen MGD if you look at the studies. When you have surgery, the body doesn’t like it.

[Quote]
I am having the same issue as you. My vision after lasik was crystal clear for 2 month and a week. One morning I woke up with sever dry eye and since then I have ghosting, starburst and halo. Ghosting is really annoying. I went to see many optometries and two surgeons. They have no idea why I am having these vision disturbance. [\quote]

Same here. I had perfect 20/15 vision after lasik for weeks. Eventually after months of dryness I noticed the ghosting. I think there are a couple possible explanations. The first is that there always was some ghosting post-lasik and once we notice it, because we’re obsessing on our eye condition, it became hard not to notice (many lasik patients have some visual aberrations moreso than before the surgery but it doesn’t bother them). Second, my provider says that the aberrations I see now are due to dryness. Once we fix the dryness most of it will go away. Third, there is some process of “overhealing” where the corneal tissue regrows after several months such that it’s not refracting the light as it did after surgery. I’m not really clear how this works or if this is even measurable.

I also have a strange problem in one eye, where it’s basically like I have a thin layer of Vaseline covering my eye obscuring my vision, but if I blink repeatedly my vision clears up, only for the blurriness to return after a few seconds. I imagine this is related to the mgd and dryness.