Dr. said dry eye symptoms despite not-so-obvious ocular surface irritation. How? Why?

[JJdryeye]

One of the first ophthalmologists I saw was Dr. Perez with Bascom Palmer in Miami. I was told he is more involved with the dry eye patients, and administers their blood serum drops. Anyhow, after he examined my eyes, he told me that my ocular surface irritation was not as obvious under their instruments, so the chance of the serum drops helping me was less (and he was right, they didn't help at all). But he went on to say that "most people with 'severe' dry eye have very obvious ocular surface irritation, problems they can see with their instruments. And that some people are in my category instead, where it's not as obvious under their instruments, he knows the symptoms are real, they just don't know why". This was a few years ago when I saw him, and since I was just starting this dry eye journey I didn't really know what to ask him back then, but I felt that maybe someone here could offer some insight into what his explanation could be eluding to?

It's confusing because my eyes are always bloodshot and constantly burn. I have low to moderate Shirmer's scores.

[DryLondoner]

JJdryeye, I'm very similiar. An ophthalmologists I saw said he could see no signs of inflammation or irritation, yet my eyes feel gritty, tired and itchy and I have foreign body sensation in both eyes and they get bloodshot (which they are only a little when I wake up, but they get more so if I'm outside, or rushing about).

He was adamant he could see nothing wrong, no pathological (is that the right word?!) symptoms he could treat. Another ophthalmologists thinks I have hypersensitive eyes, and the sensitivity needs to be reduced (whatever that means), but again he could not see any inflammation or irritation, even though I can feel it and I have low Schirmer scores, much lower in the eye which is worse.

I realise this doesn't help you, but so you know there are others out there who feel your pain. I'll update here if I find out more.

[JJdryeye]

JJdryeye, I'm very similiar. An ophthalmologists I saw said he could see no signs of inflammation or irritation, yet my eyes feel gritty, tired and itchy and I have foreign body sensation in both eyes and they get bloodshot (which they are only a little when I wake up, but they get more so if I'm outside, or rushing about).

He was adamant he could see nothing wrong, no pathological (is that the right word?!) symptoms he could treat. Another ophthalmologists thinks I have hypersensitive eyes, and the sensitivity needs to be reduced (whatever that means), but again he could not see any inflammation or irritation, even though I can feel it and I have low Schirmer scores, much lower in the eye which is worse.

I realise this doesn't help you, but so you know there are others out there who feel your pain. I'll update here if I find out more.

That's interesting. I'm glad to know I'm not the only one. Would you say your dry eye is moderate or severe? I feel like I'm more in the moderate category with frequent flare ups in the severe category. I'd like to know what the treatment is for hypersensitive eyes. I think my next step is to get a meibography done and see if my glands look normal.

[DryLondoner]

Moderate, and mild in my left eye. I too have flare ups, if I stay indoors, which I am trying to do as much as possible to help with healing, they look and feel ok. No pain, no burning, a slight amount of rubbing and itchiness if I come into contact with dust (like when I decided to de-dust my bed this morning, big mistake).

My opth. wants me to try contact lenses to reduce the sensitivity. He doesn't think it's allergy based as I don't have GPC or any other signs of allergy which he can see through his fancy kit, but I think it is, as I know when I come into contact with dust I sneeze and my eyes itch and get red. Even though no-one can confirm it's allergy I'm now considering desensitisation.