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

[ebi1368]

Hi just following up how is your eyes doing one week after probing?

[diydry]

I also wear swim goggles when I shower and I literally won't leave home without it if I'm traveling or staying at a hotel.

Thanks for the tip. I will start wearing swimming goggle.

Just wondering, what is the cause of your dryness? Has anybody told you, you have cornea irregularities?

I have been to 3 different doctors and they all tell me, my cornea is fine and HOA is not my main issue.
Thanks

My dryness is due to inflammation from sleeping with my eyes open (nocturnal lagopthalmos). I have some corneal irregularity from an abrasion I got that started this mess.

[ebi1368]

Same thing happens to me...when I started using ointment, I noticed I woke up and had such perfect vision for about 4 hours. I'll say this, if you wear swim goggles while you shower, it will help with your dryness. If I took a shower without goggles on, I'd be living in sandpaper cornea city!

Thanks for the tip. I will start wearing swimming goggle.

Just wondering, what is the cause of your dryness? Has anybody told you, you have cornea irregularities?

I have been to 3 different doctors and they all tell me, my cornea is fine and HOA is not my main issue.
Thanks

Yes I also see halo especially when my pupil size is large.

And no my prescription was 2 and 2.25 if I recall correctly.

Something interesting happened to me last night. I put ointment on my eye before going to bed. In the middle of the night I woke up to put drop. I checked my cell phone and I did not see any ghosting. I double checked with both eye and there was no ghosting. Then I wake up in the morning and ghosting was minimal. After taking a shower the ghosting came back as sever as before. I put ointment again and I see it reduces the ghosting and of course increases the glare.

So maybe if I could improve my oil gland, my ghosting get better.

Same thing happens to me...when I started using ointment, I noticed I woke up and had such perfect vision for about 4 hours. I'll say this, if you wear swim goggles while you shower, it will help with your dryness. If I took a shower without goggles on, I'd be living in sandpaper cornea city!

[ebi1368]

Yes I also see halo especially when my pupil size is large.

And no my prescription was 2 and 2.25 if I recall correctly.

Something interesting happened to me last night. I put ointment on my eye before going to bed. In the middle of the night I woke up to put drop. I checked my cell phone and I did not see any ghosting. I double checked with both eye and there was no ghosting. Then I wake up in the morning and ghosting was minimal. After taking a shower the ghosting came back as sever as before. I put ointment again and I see it reduces the ghosting and of course increases the glare.

So maybe if I could improve my oil gland, my ghosting get better.

[diydry]

Yes, it’s clear to me that when my symptoms are better, the aberrations is better. However this is the overall trend, it doesn’t mean I don’t get it, especially with bright lights like the moon or light effects in movies. Putting in drops will also cause distortions but the effect is temporary.

The other thing you rightly mentioned is the pupil issue. I have large pupils so if I go from looking at a dark room to a bright light I will see a large halo or corona around the light for a second or two until my pupil contracts. Again the moon example. Have you noticed anything like that? I also did not notice this right after my lasik, but then again I was a pretty happy camper until dryness began ruling my life. I was very near sighted before my surgery I’m guessing you were too?

If multiple doctors have ruled out any corneal abnormalities or HOAs my guess is it’s not the main issue for you.

The other half of the battle is mental i.e. not obsessing over these imperfections and just accepting that my vision just isn’t as good as pre-surgery. I also try to be grateful that the distortions aren’t so severe that they are disabling as with some lasik victims who have crazy extreme double vision.

[ebi1368]

If your lasik surgeon took a wavefront of the cornea and there are no HOA, then that's a good sign! The other possibility (cynicism alert) is that your surgeon is not being totally honest with you. Why? Because it's important to remember that many lasik patients have some aberrations that were not present before the surgery-- it's simply the reality that cutting one's cornea will rarely be as smooth as the virgin cornea mother nature gave you. So there may be some aberrations, but not bad enough that your surgeon is going to point them out to you, and he doesn't want to freak you out. If you're still concerned you could see an independent corneal specialist and get the wavefront from them. However, my guess as I mentioned before is that this your ghosting is primarily related to the dryness/MGD. Did you read the study on dry eye and tear film dynamics I shared earlier? It uses wavefront to detect visual aberrations induced by the tear film. I'm sharing another related study below.

https://www.ncbi.nlm.nih.gov/pubmed/29907632

https://www.ncbi.nlm.nih.gov/pubmed/30009091

I also had an appointment with an independent surgeon. I asked him about HOA and he did not have clear idea. He mentioned maybe my treatment zone was bigger than my pupil size but when I said I did not have any problem for the first two months he did not have anything to say.

I also went to an opthamlogist and she did corneal topography on me. She did not see anything unusual.

If I have corneal abnormalities, should not it be evident in corneal topography or wavefront?

I remember you were saying your dry eye has got better over the last few month. Do you think your ghosting has gotten better too?

Another interesting fact, when I put eye drop in my eye, my ghosting get even worse.

Thanks

[diydry]

If your lasik surgeon took a wavefront of the cornea and there are no HOA, then that's a good sign! The other possibility (cynicism alert) is that your surgeon is not being totally honest with you. Why? Because it's important to remember that many lasik patients have some aberrations that were not present before the surgery-- it's simply the reality that cutting one's cornea will rarely be as smooth as the virgin cornea mother nature gave you. So there may be some aberrations, but not bad enough that your surgeon is going to point them out to you, and he doesn't want to freak you out. If you're still concerned you could see an independent corneal specialist and get the wavefront from them. However, my guess as I mentioned before is that this your ghosting is primarily related to the dryness/MGD. Did you read the study on dry eye and tear film dynamics I shared earlier? It uses wavefront to detect visual aberrations induced by the tear film. I'm sharing another related study below.

https://www.ncbi.nlm.nih.gov/pubmed/29907632

https://www.ncbi.nlm.nih.gov/pubmed/30009091

[diydry]

Once I got off my antihistamines and all other allergy medications *for several months* my virtually non-existent tears kicked in to regular levels (this was some years ago pre-LASIK). There might still be hope for you if you feel that was a trigger.

[ebi1368]

ebi1368 I looked at your image. What did the doc say about the one on the bottom left? Maybe it would pay to get that one imaged again. It also appears you have partial blinking. I have this problem as well. Don't get too hung up on the lipd layer. I still feel awful even at ~80 LLT.

She said you may rubbed this eye more which did not make sense to me. She also said it could be just the picture.

[ebi1368]

Also antihistamine really really dried out my eyes too so I avoid those like the plague! I’m guessing you’re off them now? So you think your eyes never got better after taking the allergy meds? Sorry I’m trying to find the original post (typing from my smart phone).

No it did not. Taking antihistamines were the point my severe dry eye started

[ebi1368]

phenix01 How your doctor understood you have abnormalities in cornea surface? Did he take a wavefront?

I had another appointment with my surgeon, he took a wavefront from my cornea and he does not think I have any Irregularities. I am quite lost. He does not know what causes the ghosting.
diydryphenix01 have you done cornea topography or wavefront?

Update after probing:

guys, ditch lipiflow and IPL, probing is where it’s at. I did probing yesterday and can already feel a nice difference. I’m in front of my
computer with no burning sensation. My Dr said there’s no point doing lipiflow before opening the glands, it’s a waste of time and money.

anyways I am very happy with probing so far. My eyes feel like normal eyes now. Probing is nice because it is I instant result. It’s not like lipiflow where you leave the clinic not knowing is your glands unblocked. With probing you actually see the oil pop out of the gland. While I was getting probing I could see the oil accumulating in my eye. You also hear and feel the pop of glands unblocking.

unfortunately however, dr told me my visual distortion comes from abnormalities to the surface of the cornea which was caused by lasik. He says he can fix this with a corneoplasty but ugh that’s another surgery ! I was convinced dryness was the cause so this is new to me. I’ll wait however, what is it is dryness and time heals it up..

My doctor will not perform IPL or lipiflow...doesn't attack the problem properly. However I think they're a great adjunct therapy to add comfort. I still feel that if you do your home compress right, you can get results like lipiflow...making lipiflow an expensive compress.

dano6533@gmail.com

what you described is lid wiper epitheliopathy. The lid wiper scratches the dry cornea because it's no longer smooth and supple. I think a 30 minute rose bengal test is necessary to diagnose properly.

diydry

so my corneal specialist looked at the eye with flourescin stain and a volk lens and said, you have an irregular astigmatism from the keratectomy...it looks like a wavy bump. He then said, but hopefully we can correct that by getting the tear film stable. My tear film isn't stable yet so if/when I get there, I'll let you know if he was right. A soft contact lens fixes the issue...so it makes sense.