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Dry eyes at when I lay down/at night - LASIK causing eye aches/ head aches

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  • Dry eyes at when I lay down/at night - LASIK causing eye aches/ head aches

    Hi everyone,

    I've found this forum in my efforts to relieve some of the symptoms of dry eye after my LASIK surgery in Sept 2013 (now March 2014). Prior to LASIK, I would occasionally get some dry eyes at night, but would only be once a month or something and it was never painful, but it might wake me up, and it would always go away. For clarities sake, I do not have any dry eye issues during the day, at all.

    However, since the LASIK, this has gotten to be far worse, like every night. The weird thing is...it only happens when I lay down. I don't even have to be sleeping. I could be laying on my couch and after 30 minutes, I notice my eyes starting to dry out. Then I sit back up, go make a PBJ, and I'm fine again. At night, it gets to the point of unbearable, waking me up usually around 330 with eyes that feels like pieces of dried fruit. As days go on, it starts to make my eyes ache, then slowly turns into a headache.

    Whats sad about this is that I contacted the LASIK center about this, and they said that it has nothing to do with LASIK. So I found a different doctor who inspected my eyes and he clearly saw damage being done to my eye due to dry eyes and got me on Prednisolone to get the inflammation under control, but it didn't prevent the eyes from drying out when I lay down. After stopping use of Prednisolone, the achy eyes are coming back This is highly depressing and my sleep is largely crap, and its affecting my life, just being more tired, losing motivation to go workout, etc

    I have also tried just about every night time dry eye product, and I get the same result, waking up at 3 or 4 in the morning in pain. I also used a night time mask for a while, but it didnt help. I also have two humidifiers in my room. I even take omega acid, luteine, flaxseed, and coconut oil supplements to try and help with this.

    I do have a theory though...probably not a good one, but the only one I could come up with: When I lay down, the direction of tear flow changes, which may be directed more to the puncta. Basically, water running down hill and into my nasal cavity. How do you punctal plugs work? Are they worthwhile?

    Does anyone else have this issue?? How do you guys deal with dry eyes at night/laying down? If you guys know of any additional night time products, I would probably try them! Being a chemist, I've been researching this and I find that most artificial tears are just that...artificial. I've been reading articles and want to design tears that are as close to a natural tear film as possible! This pain is terrible...I really hope I don't have this the rest of my life LASIK is not worth this

  • #2
    My dry eyes started back in the 90s with pain upon waking. I was told this is classic meibomian gland dysfunction (MGD). The issue centers around blinking which pulls oil/lipids out of the glands and distributes it across the eye surfaces. When we stop/don't blink, the eyes go downhill. Often people with MGD feel better during the day... That's how it was with me for the first few years.

    Usually, people with dry eyes from lack of tears/aqueous are better after sleeping and deteriorate during the day. Tseng has a paper in Cornea Oct 2011 explaining his take on this... See abstract here http://www.ncbi.nlm.nih.gov/pubmed/21912234

    It's been important for me to find the best drop/gel/ointment (for me!) to use at night and to cover my eyes. I prefer Muro solution and HyloGel with Glad Press N Seal covering my eyes filled with moisture.

    As for something natural, I hope you discover it! You may find autologous serum drops made from you own blood useful. As for plugs, there are 10-day dissolvable that you can start with to see if they help retain tears. However, if it's oil/lipids you need and not tears, you'll probably just have overflow of tears with no great help to the MGs.

    If you let us know where you're located, someone may be able to recommend a doctor who really understands dry eye and MGD. Wishing you the best.
    Last edited by spmcc; 09-Mar-2014, 17:16. Reason: Added

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    • #3
      I agree with what spmcc said, and also add, a common cause of night dryness is incomplete closure of the eyelids while sleeping. If that's the case and like myself, you can't tolerate the plastic wrap on your eyes, you can try a pair of Tranquileyes Onyix goggles, available on this site. That's what works for me, along with Refresh PM which has a high mineral oil content. It helps replace the lipids that are lacking in MGD.

      Comment


      • #4
        That's true, Nightbird. Incomplete closure is another common factor.

        Here is a list of general 'beginner' questions that you should ask your doctor:

        1) How is my tear quantity?
        2) Do you see any dry spots?
        3) Can you check for staining?
        4) Can you press on my meibomian (oil) glands? Are they releasing oil? Is the oil clear and flowing freely? If not, what does it look like?
        5) Do you see any signs of allergies?
        6) Do I have any lid closure or blinking problems?

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        • #5
          Hi my eyes r badly dry but now comfortable. however when i lie down my tears fall out unless i have ointment in with a drop of theratears gel. i can't lie down during day unless im propped up with pillows .
          i would highly recommend plugs because then u should b more confortable with a pool of eyedrops in eye at night .
          Permanent umbrella type i prefer which though permanent they can easily b removed by opthomologist .
          http://www.hymntime.com/tch/htm/a/l/l/t/allthings.htm

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          • #6
            Originally posted by spmcc View Post
            I prefer Muro solution and HyloGel with Glad Press N Seal covering my eyes filled with moisture.
            Does the Muro solution stop your eyelids from sticking to your eyeballs? That's the problem I have - it's been a long winter and my eyes are not impressed... bad sticking overnight these past few months. Wondering if I ought to try Muro...

            When you say you use both, do you just use a drop Muro, then a drop of HyloGel and head off to sleep?

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            • #7
              Originally posted by SAAG View Post
              Does the Muro solution stop your eyelids from sticking to your eyeballs? That's the problem I have - it's been a long winter and my eyes are not impressed... bad sticking overnight these past few months. Wondering if I ought to try Muro...

              When you say you use both, do you just use a drop Muro, then a drop of HyloGel and head off to sleep?
              Hi SAAG,

              What I do is *fill* my eyes with HyloGel... I'd say 6-7 pumps of the gel per eye. Then I cover my eyes with Glad Press N Seal. I always wake up ~3 hours later with dry eye, but I can't stand the thought of opening my eyes wide to put more HyloGel so that's when I drip in the Muro solution. Then I re-seal my eyes to sleep again. Then repeat in another ~3 hours.

              I've been generally able to the avoid the HUGE pain that I had for the first years... but there's still discomfort everyday.

              Winter is always the worst time of year for me. But our winters in Victoria are never "bad". I can't imagine what it's like for everyone else in Canada and the US with the extreme cold that hit this winter.

              Comment


              • #8
                Is this a post-LASIK issue spmcc? Or a constant way of life?

                Comment


                • #9
                  Originally posted by thegreataus View Post
                  Is this a post-LASIK issue spmcc? Or a constant way of life?
                  Hi thegreataus,

                  No, I am not post-any refractive surgery. I have ocular rosacea. One day I was fine and the next I couldn't sleep without eyes drying up. I've since found that it's not too unusual for a bunch of conditions that cause MGD.

                  How have things been going for you? Have you had any luck finding a doctor (and treatments) to help? Keep us posted here on what's going on, okay?

                  All the best.

                  Comment


                  • #10
                    Originally posted by spmcc View Post
                    Hi SAAG,

                    What I do is *fill* my eyes with HyloGel... I'd say 6-7 pumps of the gel per eye. Then I cover my eyes with Glad Press N Seal. I always wake up ~3 hours later with dry eye, but I can't stand the thought of opening my eyes wide to put more HyloGel so that's when I drip in the Muro solution. Then I re-seal my eyes to sleep again. Then repeat in another ~3 hours.
                    Cool - good to know - I appreciate the info!

                    I was at the lid specialist yesterday (asking about re-cauterizing left upper puncta... turns out the good news is he did a great job and can no longer even see a pin prick hole where the puncta used to be... bad news is, no quick fix with cautery again)... anyhow...

                    I asked him what he thought about my experimenting with Muro, and he said it won't hurt me, so if I want to try it, go for it. Had a better night the last couple though, so maybe I won't need to do it after all... we'll see...

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                    • #11
                      Originally posted by SAAG View Post
                      Cool - good to know - I appreciate the info!

                      I was at the lid specialist yesterday (asking about re-cauterizing left upper puncta... turns out the good news is he did a great job and can no longer even see a pin prick hole where the puncta used to be... bad news is, no quick fix with cautery again)... anyhow...

                      I asked him what he thought about my experimenting with Muro, and he said it won't hurt me, so if I want to try it, go for it. Had a better night the last couple though, so maybe I won't need to do it after all... we'll see...
                      I cross my fingers while they do cautery, hoping that it/they stay closed! haha

                      Yes, when I started using Muro solution, I asked my cornea specialist about it. He said it was fine to use indefinitely. Another benefit is cost (much less expensive than single-use PF vials!)

                      Good luck. I hope improvement keeps on!

                      Comment


                      • #12
                        I don't use Muro, but another generic sodium chloride ointment (Cusi Antiedema)

                        It's by far and away the most comfortable product I've used overnight since I had Lasek last year. I don't wake up in the middle of the night with dry eyes now, I haven't had a single corneal erosion since I started using it, and it last at least 8 hours. Much more effective than Lacri-lube etc. for me.

                        Comment


                        • #13
                          Originally posted by Jovver View Post
                          I don't use Muro, but another generic sodium chloride ointment (Cusi Antiedema)

                          It's by far and away the most comfortable product I've used overnight since I had Lasek last year. I don't wake up in the middle of the night with dry eyes now, I haven't had a single corneal erosion since I started using it, and it last at least 8 hours. Much more effective than Lacri-lube etc. for me.
                          Wow! Another strong endorsement! So it even makes the dryness itself feel better? Amazing! Might pick myself up a box of ointment and a bottle of Muro drops when I'm at work today... is a good time to experiment, since worst case if they make my eyes worse, I don't have anything important coming up this week

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                          • #14
                            Originally posted by Jovver View Post
                            I don't use Muro, but another generic sodium chloride ointment (Cusi Antiedema)

                            It's by far and away the most comfortable product I've used overnight since I had Lasek last year. I don't wake up in the middle of the night with dry eyes now, I haven't had a single corneal erosion since I started using it, and it last at least 8 hours. Much more effective than Lacri-lube etc. for me.
                            Could you maybe put a link to a product or two? Maybe even from Amazon?? I have amazon prime...love it!

                            I've also read somewhere that the top puncta and the bottom puncta both have different drain rates on the tears. Has anyone else seen this or have something to suggest this discrepancy in the puncta?

                            Comment


                            • #15
                              Originally posted by thegreataus View Post
                              Could you maybe put a link to a product or two? Maybe even from Amazon?? I have amazon prime...love it!

                              I've also read somewhere that the top puncta and the bottom puncta both have different drain rates on the tears. Has anyone else seen this or have something to suggest this discrepancy in the puncta?
                              If you go to amazon, just type in "Muro 128 ointment" (preferred by people with RCEs and EMBD/mat dot). The result will bring up Muro ointment plus generic alternatives (e.g., Sodium Chloride 5% Ophthalmic Ointment 0 .12 oz (3. 5 gm)).

                              You can also search amazon for "Muro 128 solution" which are the liquid drops that I prefer (I can't tolerate the ointment).

                              You're correct about how we're told there are different drain rates between upper and lower punta. I've been told 70-80% of tears drain from the lower and 20-30% drain from the upper. I guess someone measured this somehow!

                              There's also kind of a difference in how plus fit and feel comparing the lower and upper punta. The lowers are relatively comfortable for many people wrt umbrella style plugs. But, because the upper puncta "point more" towards the eye surface, often people find umbrella plugs annoying (feeling them "scratch" the eye surface).

                              Still, most doctors start with plugging the lowers.

                              Thegreataus -- Are you in the US? Are you near Boston by any chance? I'd recommend a doctor there (Korb).

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