Am I a dry eye patient.. ? Help me understand

[lux7]

Hi all,

I know the question might sound plain silly, but I really don't know.

CONTACT LENSES
When I wear contact lenses I don't have any pain or "foreign body" feeling, but my eyes get red, especially the left one, and stay so for the day after.


RED EYES
Sometimes I notice some redness in my eyes, but again never any pain or any strange feeling.


EYE CRUST
Rarely I do wake up with a bit of crust around my eyes, but very rarely, maybe it's due to environment condition or because of dust.


GENERAL SENSATION
I have a -5 prescription, so my eyes aren't perfect, I do have quite a bit of light sensitivity when standing in direct sunlight and a bit of sensitive eyes in general (that's partly why they get red with CL probably).
However I don't have any pain or discomfort.



WHAT DOCTORS SAID
The two doctors I've been to were part of a LASIK check up, so maybe they're not 100% trustworthy.
They said I don't have any dry eye condition they could see from the slit machine and I didn't seem a dry eye patient.


SCHIRMER RESULTS
schirmer II (the one with numbing drops that dry your eyes)
I did it some days ago because I'm thinking about LASIK.
I had my eyes shut.
The result was 7 for my right eye and 14 for my left one (I expected it to be the other way around).

Schirmer
I did again as part of a check up for LASIK. I got a drop before doing, but it wasn't the painful one I had for the Schirmer 2.
I don't think I even kept the papers long enough as tears started coming out quite soon.
This time I had my eyes open.
I told the doctor I had 4 in a previous check up (didn't remember well, it was actually 7) and she mentioned that maybe the first one hadn't been done properly.




What's your opinion?

[kymbo71]

Hi, I am not a professional by any means but I did work as a optometric technician for several years and I now have SLK and dry eye. I wore contact lens for over 15 years as well. As far as the Schirmer scores, I have been told by many eye doctors that this test is notoriously inaccurate. So many variables can alter the score. When the doctor applies stain to your eye and looks with the slit lamp, they should be able to see any irritation from dry eye. From experience I can tell you that in the past when my eyes were irritated from my contacts they always feel better with the contacts in. The contact creates a barrier between your lid and your cornea. As soon as my contact lens was out is when I could feel the difference, it always felt like my contact was still in when it was not. Not sure what solution you use but I always had a lot of protein build up and had to use Clear Care and also used a daily cleaner like Miraflow. Also what material are your lenses made of? Sometimes you can develop an intolerance to certain materials, especially silicone hydrogel. What you are explaining sounds more contact lens related to me, but I am not a doctor just over 10 year experience working in contact lenses.

[lux7]

Hi, I am not a professional by any means but I did work as a optometric technician for several years and I now have SLK and dry eye. I wore contact lens for over 15 years as well. As far as the Schirmer scores, I have been told by many eye doctors that this test is notoriously inaccurate. So many variables can alter the score. When the doctor applies stain to your eye and looks with the slit lamp, they should be able to see any irritation from dry eye. From experience I can tell you that in the past when my eyes were irritated from my contacts they always feel better with the contacts in. The contact creates a barrier between your lid and your cornea. As soon as my contact lens was out is when I could feel the difference, it always felt like my contact was still in when it was not. Not sure what solution you use but I always had a lot of protein build up and had to use Clear Care and also used a daily cleaner like Miraflow. Also what material are your lenses made of? Sometimes you can develop an intolerance to certain materials, especially silicone hydrogel. What you are explaining sounds more contact lens related to me, but I am not a doctor just over 10 year experience working in contact lenses.

Thanks for the explanation Kymbo!

So you are saying the slip lamp is actually the best way to check for a dry eye?

[kymbo71]

There are many ways a doctor can test for dry eye. The slit lamp and stain are the most reliable. The Schirmer's test is just one tool, but not always accurate. If you are not experiencing any discomfort, pain or irritation I would not think it is dry eye. My eyes are always burning, irritation and even itch sometimes. They are very red as well. You definitely need a more definitive diagnosis, so I would go back and get that diagnosis.

[DryInDenver]

Did you get LASIK or are you just thinking about it?

If you haven't, DON'T GET LASIK. I was a contact lens wearer and had similar symptoms to you. I actually think contacts might be hurt the eye over time. But, I had the crusty eye in the morning, a low shirmer score, and had gotten to the point that contacts were not comfortable to wear. I wish my LASIK surgeon had been more honest and disclosed that these symptoms of dry eye INCREASE YOUR RISK of horrible dry debilitating dry eye complications after lasik. My thought is that you should switch to glasses. I wish I could go back in time and do the same.

Now when I go in and see my LASIK doc for a follow up, he looks at my eye in the slit lens and tells me it doesn't look like I have dry eye. That is less than helpful to me. So as with some the other dry eye tests, I don't think that you can depend on that as your sole indicator either.

[kymbo71]

No, I have not had LASIK! I have a condition called annismetropia, which means I have a huge difference in the prescription on my two eyes, so I can not wear glasses. That is the only reason I was thinking of LASIK. But I will NEVER have a laser near my eyes now! Right now and for the last 10 months I have been wearing glasses with only the right eye corrected and NO correction in my left eye (which I am legally blind in). It has been a very difficult year. I was diagnosed with SLK in November and had Conjunctiva Resection surgery in January. I believe this surgery caused my dry eye. The surgeon of course said it did not, but I still have my doubts. I have never had any dry eye until now! I think you need to see a new doctor until someone gives you a proper diagnosis. In the meantime, do you take any supplements, drops, etc?

[lux7]

Did you get LASIK or are you just thinking about it?

If you haven't, DON'T GET LASIK. I was a contact lens wearer and had similar symptoms to you. I actually think contacts might be hurt the eye over time. But, I had the crusty eye in the morning, a low shirmer score, and had gotten to the point that contacts were not comfortable to wear. I wish my LASIK surgeon had been more honest and disclosed that these symptoms of dry eye INCREASE YOUR RISK of horrible dry debilitating dry eye complications after lasik. My thought is that you should switch to glasses. I wish I could go back in time and do the same.

Now when I go in and see my LASIK doc for a follow up, he looks at my eye in the slit lens and tells me it doesn't look like I have dry eye. That is less than helpful to me. So as with some the other dry eye tests, I don't think that you can depend on that as your sole indicator either.

No, but I'm considering LASIK, for me going without glasses would be a dream.
I'm quite light-sensitive and sunglasses in summer would be very useful.

I actually almost always use glasses.

I'm really sorry to hear about your experience and it saddens to hear about those doctors failing to treat people like they would deserve.
How are you doing now, are you on drops?

[lux7]

No, I have not had LASIK! I have a condition called annismetropia, which means I have a huge difference in the prescription on my two eyes, so I can not wear glasses. That is the only reason I was thinking of LASIK. But I will NEVER have a laser near my eyes now! Right now and for the last 10 months I have been wearing glasses with only the right eye corrected and NO correction in my left eye (which I am legally blind in). It has been a very difficult year. I was diagnosed with SLK in November and had Conjunctiva Resection surgery in January. I believe this surgery caused my dry eye. The surgeon of course said it did not, but I still have my doubts. I have never had any dry eye until now! I think you need to see a new doctor until someone gives you a proper diagnosis. In the meantime, do you take any supplements, drops, etc?

Not taking anything and not having troubles at all, that's why I'm not even sure whether or not I'm a dry eye patient.

About your bad year, I totally understand your point, though not health related, I've recently been through a bad period myself. Gotta be strong.
It might be interesting for you there's a new procedure though that's called "SMILE" that doesn't cut a flap. The dry eye consequences are much reduced, it might be worth for you to be looking into that.

[runnergirl]

Hi Lux 7,

I think you should get an opinion from an opthamalogist if you think you have dry eye. I dont trust the Lasik people because I had lasik 7 years ago and now I am suffering from extreme dry eye from the Lasik. The Lasik people will tell you what you want to hear so you will get the Lasik. When I think back, I wore contact lenses for many years and I think my eyes were a little dry and a little sensetive just from that usage. But now, I wish I never had Lasik. If I could go back, I would not have it. I have no other problems or diseases, but this is enough. I can barely keep my eyes open these days due to sensitivity. So, please dont have lasik and maybe you just have a touch of dry eye due to contact lense wear. Maybe your eyes just need a break. Run far from the Lasik door! Just my opinion. Sue

[DryInDenver]

No, but I'm considering LASIK, for me going without glasses would be a dream.
I'm quite light-sensitive and sunglasses in summer would be very useful.

I actually almost always use glasses.

I'm really sorry to hear about your experience and it saddens to hear about those doctors failing to treat people like they would deserve.
How are you doing now, are you on drops?

Lux7,

Its been 9 months since I had lasik and I've had very little if any improvement. I use Refresh Plus every 5-20 minutes depending on what I'm doing and how tired I am. I also take FML (a mild steroid) and Restasis twice daily and have lower plugs in. I just recently quit using doxy and haven't noticed much change with or without it. I also wear WileyX Echos if I am awake.

Regarding the Shirmer test, I spoke to Dr. Gemoules and his opinion on the Shirmer test helped me understand why it is still used despite so many people saying it is not an accurate predictor of dry eye. Basically he said it is worthless unless it is low.

[DryInDenver]

No, I have not had LASIK! I have a condition called annismetropia, which means I have a huge difference in the prescription on my two eyes, so I can not wear glasses. That is the only reason I was thinking of LASIK. But I will NEVER have a laser near my eyes now! Right now and for the last 10 months I have been wearing glasses with only the right eye corrected and NO correction in my left eye (which I am legally blind in). It has been a very difficult year. I was diagnosed with SLK in November and had Conjunctiva Resection surgery in January. I believe this surgery caused my dry eye. The surgeon of course said it did not, but I still have my doubts. I have never had any dry eye until now! I think you need to see a new doctor until someone gives you a proper diagnosis. In the meantime, do you take any supplements, drops, etc?

Kymbo, just a though, have you considered Sclerals? Would that possibly help your situation? I've been looking in to them and am going to try lenses from Dr. Gemoules in Dallas (who I found recommended by other patients on this site). I emailed his office through his contact us link on his website one night and he emailed me directly back and forth a few times the very next day. If you haven't looked into it yet, he may be able to quickly and easily give you an opinion whether or not it might help.

His website is laserfitlens.com. L8trgator wrote a great synopsis of the process in another posting http://www.dryeyezone.com/talk/showt...light=gemoules