What is it this time!

[CarlM]

So I've had dry eye problems, it happened twice. The first time it lasted 2 months, the second time it lasted 2 weeks - but both those times were different to what I'm experiencing now. For one, they both got progressively better and eventually went away nearly completely - but also the symptoms were different. I used to have a foreign body sensation and my eyes were clearly dry and I could deal with the problem to an extent by staying away from the computer. I could mostly function in general when I was not looking at a computer screen...

Now, my eyes just feel cold whenever they're open, and I don't really get the same foreign body sensation anymore. I have to consciously blink the "cold" or sometimes slightly sore and uncomfortable sensation away. If I forcefully keep my eye open for a few seconds, eventually it'll sting and my eyes will water by themselves, but that doesn't really help. I'm only somewhat comfortable when I close them, or when I pack them up with ointment - and even that's not completely effective. So once again I can't do my job, and what's worse is it's not getting better. I can put products in my eyes and it slightly helps but the only way to treat the symptom properly is to close my eyes. When it started again, I was hopeful that it would subside like it did the first two times, but the way it's progressing, I don't know that it'll get better. I don't know what it is - is it because it's summer? It's not that dry in the summer here. I feel like I might want to see an ophthalmologist but my optometrists looked so confused and helpless that I feel like the only thing I can do is treat the symptoms and hope to be able to work again soon because if not I'll lose my job.

To make it worse, the pharmacy didn't have muro 128 ointment... they gave me muro 128 eyedrops...

I'm posting here and I'm losing my optimism. I see so many people with so many different problems and I'm asking for help, knowing that everyone has a different story. So I don't even know if anyone can help me anymore. Anyway, time to go back to my couch where I've spend most of my last 3 days...

My symptoms have always started after I've used my eyes intensively for extended periods of time (screen and book reading) so I'm wondering if perhaps this is some form of eye strain? Is this possible? Intense eye strain that lasts for days even though I'm spending less than 2 hours at the PC every day?

Edit: I just tried the muro 128 eyedrops... ouch :/... it says it might be uncomfortable but the sting was bad enough that it startled me...

[spmcc]

I used to get that cold feeling on my eyes too... I tried to explain it to my ophthalmologist as they felt "raw", like my insides were exposed to the air. On DEZ, it's called a menthol feeling.

It's really important to have an ophthalmologist helping you. Can you add your location to your profile so we can see the area where you live listed in the top right corner of your posts? (see my BC, Canada?) That way someone can recommend a doctor near you.

Even without seeing a doctor, you can do some at-home, non-medical treatments that really help to get rid of that cold, raw, menthol feeling. Number 1 treatment is moisture chamber glasses. They get rid of that horrible feeling within 10 minutes, I swear!

As for Muro drops, I use them and love them. My ophthalmologist said they are safe to use indefinitely. And once I got over the sting from the high salt concentration, they became my favorite drop.

But Muro drops won't be your only treatment if you have any sort of meibomian gland involvement. This is why it's so important to have a doctor examine and monitor you. For instance, they might recommend warm compresses. Have you tried these? If yes, how do you feel afterwards?

Good luck.

[CarlM]

Thank you for your answer, I added my location.

I assume seeing a ophthalmologist might be difficult or take quite some time around here. Doctors are booked. As for the glasses, well I really don't like the thought of being dependent on those but I might have to go for it eventually... I'm really not fond of it though, especially since I've never worn glasses, my eyesight is perfectly good and I hate wearing glasses! And now I'm afraid of the muro sting... I need me some of that ointment again. How long did it take you to get used to the drops? Because that sting is pretty **** bad :P... My eyes feel like they're on fire and they turn red for a few minutes.

Lastly about the eye compresses, I've used a bunch and I'd say it's hit and miss. They sometimes help, and other times they don't...

Thanks again and cheers

Edit: I'm wearing ski goggles and it helps... the downside is that I'm wearing ski goggles

[spmcc]

Ah, you're in Montreal. I lived in Dollard and later NDG when I was younger. I didn't have any eye troubles then so I personally can't recommend a doctor but hopefully someone in Montreal will read this thread and contact you. I also did some googling and found a Dr. Johanna Choremis MD, Assistant Professor of Ophthalmology, University of Montreal and McGill.

Here is a webpage with some info on her and dry eyes: http://www.eyeschool.ca/program3.htm

Perhaps give her office a call and find out how to get a speedy referral to see her (or maybe her office can recommend another ophthalmologist with dry eye training and experience).

[CarlM]

Thank you - odds are I'll need to contact some specialist before long. The last two times, my symptoms went away without the need for a specialist though, and the fact that the symptoms started (it seems to me) as a result of eye strain makes me think I might be able to deal with this by being more reasonable and changing my habits.

[spmcc]

Edit: I'm wearing ski goggles and it helps... the downside is that I'm wearing ski goggles

I completely understand!! As SAAG recommends, avoid mirrors! But don't the goggles work great?!? And now that you're relatively comfortable, you can think more clearly, read and plan your attack on dry eyes!

For example,
(1) find a doctor who knows what they're doing regarding dry eye,

(2) be aware of your environment e.g., moving/blowing/circulating air, a/c and/or fans, forced air heat, wind... i.e., anything that can irritate your sensitive eye surfaces,

(3) keep track of when your eyes are good and bad (e.g., bad when waking and improving as the day goes on OR good when waking and bad in the late PM etc.). You can use the OSDI (http://www.dryeyezone.com/documents/osdi.pdf),

(4) if you're on the computer a lot and it's a trigger, download software that reminds you to blink (e.g., Blinkers http://www.dryeyezone.com/reminders/index.html) and software that makes the screen easier on your eyes (e.g., f.lux https://justgetflux.com/),

(5) I've recommended this to other newcomers... Please read Rebecca's Coping 101 series located on the Dry Eye Zone homepage. Also the article right underneath it called "How to get a better diagnosis" (scroll halfway down this page: http://www.dryeyezone.com/)

Finally, back to the googles... I also hated wearing 'goggles' because my vision was fine (at the beginning ) *plus* I have facial rosacea and don't like things touching my face. But the relief for my eyes was so great that I now own a bunch of pairs of WileyX and 7Eye with foam seal. Some are sunglasses, some are clear lenses, and I have one transition. If you can find a Harley-Davidson store that sells apparel, you can try on pairs to see how you feel about them. You may not need to wear them 24/7 like I do now, but if you can use the sunglasses when out and the clear lenses when watching TV or using the computer at home that may be all you need to get your eyes on track for a while.

Good luck.

[CarlM]

You're very kind!
I'm still hoping for a "full" recovery like the two other times, I've been careful about my environment and I'm desperately trying to keep track of the evolution of the situation but I find it very difficult. I always have trouble trying to figure out what affects it positively or negatively. A few days ago I ate a whole bunch of fish and 2-3 hours later my eyes felt a whole lot better... Now was that the surge of omega-3 on my system, a coincidence, or something else I did without noticing?

Oh well, I'll keep on going, trying to stay positive. I might be able to get some more work done tomorrow using the goggles x_x

[spmcc]

Yes, oily fish are great because of their omega 3 fatty acids. But I don't know if they work that quickly! You can also try supplements. The doctor at Herzig Eye in TO recommends 2g per day.

[CarlM]

About the Muro 128 drops though, what the hell, 15 seconds of fairly intense burning -_-

[spmcc]

About the Muro 128 drops though, what the hell, 15 seconds of fairly intense burning -_-

I don't know why Muro solution doesn't bother me... it stings, but not too bad. I remember trying NSAID drops a few times (e.g., Nevanac). OMG! They stung so bad that I doubled over, grabbed my eyes, and my nose started streaming! So, I know what you mean. Keep in mind that Muro drops might not be the best drop for you.

About 10 years ago, my ophthalmologist told me to experiment to figure out which OTC drop worked best for me. He told me there were four main active ingredients so I was to try four different drops each for a week and document how my eyes felt (he gave me a form to use).

At that time, he said the four best drops (representing the four main active ingredients) were Refresh Endura, Systane, Liposic, and Artelac.

I conducted the 'experiment' and discovered that one drop was much better for me than the others.

Of course, the choice of drops is different today (I use HyloGel which is very new to Canada and ordered from Shoppers Drug Mart or Pharmaprix)... however, I still think it's a great test to figure things out. Rebecca has a page that lists the drops and their active ingredients (see: http://www.dryeyezone.com/encyclopedia/lubricants.html). I recommend you limit yourself to only those that are preservative-free.

I can't remember exactly the symptoms that were on the form my ophthalmologist gave me to fill out. However, you could use all the possible symptoms of dry eye (e.g., Dryness sensation, foreign body sensation, scratchiness, grittiness, aching, burning, stinging, eyes tire easily, fluctuating vision, eyes easily irritated by warm/cold air, blowing air/wind, fluorescent lights, etc., menthol sensation).

Besides symptoms, also try to keep track of how long any relief lasts.

Just an idea...

[CarlM]

Another thing that seems to make a difference is my nose. My sinuses are raw too, which had me worried maybe I had Sjogren's syndrome, but my mouth is not dry at all, and my eyes can produce tears, I can make my eyes water by intentionally yawning and such. It seems like irrigating my nostrils helps with my eyes because breathing in doesn't bring this menthol feeling up my nose.

Irrigating my nostrils only seems to work for a few minutes though, and I'm not sure why they feel raw. Is there some sort of nose infection that makes the nose dry for a long time? I've had this for a while and it hasn't bothered me very much, at least not in the past.

[spmcc]

It could be that you're in a very low humidity environment... Or it could be related to a medicine you're taking... A good ophthalmologist (I'm neither good nor an ophthalmologist heehee) would hopefully figure this out for you or at least refer you on to another specialist who could piece it together. Blood work for Sjogren's is a no-brainier (keep in mind some people with Sjogren's still test negative). As for an infection, certainly they can swab your nose and eyes to see what grows. In the meantime, you could try adding a humidifier to your room.

[littlemermaid]

Some people with sleep apnoea, which might be noticed in dry sinuses, also have slightly thickened eyelids and therefore a little lagophthalmos, eyes slightly open at night. This can happen if the skin round the eyes has loosened up too. Nighttime a/c would be particularly bad for that. Surgical tape 3M would fix it, I guess, although Rebecca has found a new silicon tape, Mepitac https://www.facebook.com/DryEyeZone?ref=ts&fref=ts

Some people have done better after clearing their bedrooms of allergens too.

Hope you can get to the bottom of this soon. How much screen time is normal for you?

[CarlM]

Thanks for answering again. Humidity in my house is around 40%, which I think is adequate. I'm starting to lose hope since all people talk about is treatment and I don't know how people can live with this their whole lives... Some of the people here are so courageous. I feel like my life is getting so complicated already. I'm 24, I hope to have at least another 50-60 years and with the health problems that'll just continue to pile on as I age, I don't know how I'll deal with this already.

How do people here read for extended periods of time? That's what I do both for a living as a research associate/teacher for my uni and in my free time, AND as a student. I've recently started reading fantasy and now my eye problems are such that I can't imagine myself doing any of those things again. The ski goggles offer a little comfort but it's not perfect - for one I can't be reading for extended periods of time with this, I'll ruin my eyesight because the lens is a bit warped. Moisture chamber glasses might end up being a necessity, but I hate the idea in general plus how do I get ones that fit my face properly...

I try to be optimistic but sometimes I drop the ball... I've been incredibly unproductive this week, and I got some things done today but reading is a chore. Driving to the store is a chore. Talking to people without constantly taking some breaks is hard.... I like to think that it'll pass like it did the last two times and that I'll be able to enjoy a good old lengthy session of reading again, otherwise I'll be an incompetent teacher and research assistant, a sub-par student and a bored guy who's hobbies have to be shelved for the rest of my life. I feel like I might have to come to terms with the idea that all I've been working for and everything I like is now out of my reach.

I've seen 3 optometrists and one GP clinic doctor and what I've heard of essentially all local doctors is so bad that I don't think they can help me. They won't tell me anything I haven't heard here. I tried plenty of eyedrops, kept the ones that work the best for me, I've tried different kinds of compresses, ointments, etc. I need to find me a golden Ophthalmologist and I don't know where to start. I feel like I'll have to go through 15 of then before I find one who'll even recognize that I have a crippling problem that's making my life a living hell in every way except it hasn't yet ruined my sleep. And I love sleep now, I've never liked it before but now it's the only time I'm not suffering. Those doctors see so many patients with worse conditions that there's no doubt in my mind most of them will just send me on my way with eyedrops and hot compresses and act like a little dry eye is not a big deal.

I'm still trying to figure it out but a few more weeks of this and I'll legitimately lose my job and there's not a chance that I'll see a doctor before then.



I spend a lot of time at the PC, sometimes up to 12 hours a day for work and other things. When I'm not at the PC I read. As for the open eyes at night, that might affect me too... I don't know that taping my eyes shut would fix the issues that I have all day long though.

[spmcc]

You seem to be an incredibly well-spoken young man. But if you have any fears about finding that "golden ophthalmologist" who will understand your situation, make copies of your posts here and send them to the ophthalmologist's office in advance of your appointment. That way the doctor can read how this is affecting your work life, school life, and emotions. There will be no doubt to them that this is something serious to you and they need to be serious when treating you... or they should refer you on to a collegue who can do the job. The sooner you get on the right path of treatment, the sooner you will get back to doing what you love.

Again I use the words, "in the meantime", you can perhaps try listening to books instead of reading. That would work for your pleasure reading, but perhaps not for school.

As for getting a quick appointment with an ophthalmologist, if it's the same in Quebec as it is in BC, get on to your GP ASAP. When you get your referral, call the ophthalmologist's office and tell them that you want to be on their cancellation list. That way if someone cancels an appointment, they can call you and offer the earlier date. Then, once you're an ophthalmologist's patient, you'll get quick appointments. I can get in the same week to see my cornea specialist... but you have to become a patient first so please hurry and make that first appointment.

When you see the doctor, please take these beginner questions with you:

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 problems (e.g., lagophthalmos)

It's very important to get a proper diagnosis. That way you'll get good advice here from people in a similar situation, and not waste your time, money, and hope on things that don't apply to you.

Please let us know how things go.