No luck at the ophthalmologist =(

[CarlM]

So I finally managed to see an ophthalmologist earlier this morning, told him about my recurrent dry eye problem, about the weird "cycle" that seems to mess with me. Lately, it seems like I'll spend 2 weeks with very dry uncomfortable eyes with various symptoms, and then another 2 week being mostly fine. Unfortunately I got there when my symptoms were at a minimum so maybe there was nothing to see.

I asked him questions and the guy seemed to know what he was doing, but he basically said everything looked fine, and that I should put a gel in my eye at night (which I already do) and use eyedrops (which I already do). He ruled out everything else, including punctal plugs which he mentioned and other (nameless) potential treatments. I told him that when it's bad, I literally can't work because it's too uncomfortable, and he didn't see to be concerned or anything. He prescribed some OTC gel and ointment that I've already tried...

I saw him being thoughtful, as if he tried to think of what it could be, or maybe he was considering trying some sort of treatment (perhaps the plugs) but ended up ruling against it. I'm thinking that the plugs are probably the wrong thing to use based on his observations.

And so here I am, back with useless solutions to a life-altering problem. At least I'm not blind ^_^

[cathy8889]

Hey, ive seen three ophthalmologists, the first told me I have must have a propensity to dry eye and told me to use drops, the second never mentioned the word dry eye to me despite having inflamed pinguecula, the third told me I have evaporative dry eye that fluctuates, he sent me on my way with drops. I have an appointment on tuesday and my god I am not leaving there until I have punctual plugs. I dont understand why ophthalmologists are so reluctant to experiment and do something that could actually change someones life. I wish I had known about punctual plugs two years ago, I dont think my eyes would have got so bad. Did he discharge you? I always get discharged by them and the whole i'd be happy to see her in clinic again. Ask for another appointment and really insist on those punctual plugs. Im hoping by next tuesday I have them.

[CarlM]

I'm not sure what being discharged mean but I was not officially told to go or anything, it was more of a matter of fact "that's that" and I left disappointed. It was at some small-ish clinic and not an hospital so maybe the process is different. He didn't give me a new appointment even though I hinted that he might want to see me when the problem came up again but it didn't seem necessary to him. Drops during the day and ointment at night and I was on my way, none the wiser and a little bit more desperate.

Also good luck to you, get em plugs !

[cathy8889]

Sorry I only knew id been discharged because I requested that I have a copy of the letter they sent to my doctor, I'd ask your doctor or the clinic you attended for a copy of the letter, Ive noticed that ophthalmologists tend to forget to tell you things in appointments that they then go on to write in letter to your doctor which could help you a lot o
It sounds like youve been discharged if hes not said its necessary to come back. Sorry they weren't more useful , i've noticed my dry eye fluctuates a lot and im trying to work out what causes it, it sounds like you have similar dry eye to me. When im stressed out my eyes are so much worse, if Ive had a good day and i've been busy doing something i like which let me forget about my eyes for a bit theyre always better.

Its such a mine field :S

lol thank you im going to chain myself to a chair in the waiting room if they say no!

[Rebecca Petris]

I'm not sure what being discharged mean

On the NHS "discharged" basically means, if I remember right: "You're all better now or good enough at any rate so no need to come back. Next please!" (Or alternatively, code for, 'You're obviously a malinger and we're not going to waste our time and tax dollars on you' lol.) In the US the closest we have to that would be (other than actually being fired by the doctors, which occasionally happens): "Well, you've got dry eyes. Here's some artificial tears. Come back in a year." Sounds like you got the Canadian version

Unfortunately so many eye doctors, even good ones, do not speak the language of dry eye symptoms. They have eyes and ears for potentially sight-threatening clinical signs of disease or injury. If you present with lots of symptoms but no dramatic clinical signs, the response you got is pretty typical. It's what we call the classic sign-symptom disconnect. When they say you're OK, they mean clinically nothing to worry about. You, of course, know you have PLENTY to worry about when the symptoms are severe enough to interfere with work. I have a couple of articles about these communication problems, might be helpful to look through for the tips....

[Rebecca Petris]

By the way, did he give any rationale for ruling out plugs? There can be specific reasons, like uncontrolled MGD/bleph, but it may be he just doesn't think you're dry enough to need them or uncomfortable enough to put up with them. You might ask him to reconsider after finding a way to communicate your symptoms more objectively, like bringing in a completed OSDI.

[CarlM]

Well he didn't say much of anything except that my lacri-something surface seemed perfectly fine to him which it very well may be today...

[cathy8889]

Thanks for posting these comments Rebecca, I think you have made some really good points that will help me in my appointment next week. I am going to take along a completed OSDI too.

Carl i'd definitely go back and state your case strongly, I have pinguecula which are clearly an obvious sign of dry yet three ophthalmologists have failed to take my condition seriously. I am truly fed up of beem fobbed off by them. I am going to write down my key points and do as Rebecca says, state my case objectively with supporting evidence.

Thanks again

[CarlM]

Thanks for posting these comments Rebecca, I think you have made some really good points that will help me in my appointment next week. I am going to take along a completed OSDI too.

Carl i'd definitely go back and state your case strongly, I have pinguecula which are clearly an obvious sign of dry yet three ophthalmologists have failed to take my condition seriously. I am truly fed up of beem fobbed off by them. I am going to write down my key points and do as Rebecca says, state my case objectively with supporting evidence.

Thanks again

Well I got this appointment through my GP but my optometrist sent my file to another ophthalmologist a few months ago and the hospital hasn't even called me back (this is apparently normal, for the hospital not to call for months). Though I felt like my ophthalmologist was competent for the most part, to me (and to the people who reviewed him online) he seems like a fairly close minded old guy who's done this his whole life and he feels like he knows everything that needs to be known. I don't think he'd be very open to hearing what I had to say. He wasn't really interested in hearing me tell my story before he shoved lights in my face. I'm not angry, it's just that there are different types of people in the world and I'd be happy to see this doctor if I had a problem which he's used to treat. My mother had a problem fixed with him and everything went great, apparently.

Anyhow so I'll do those things when I get my appointment with another doctor.

[cathy8889]

I would Carl, my condition has got worse and I really wish Id known what I know now at my first appointment. Ive seen three ophthalmologists now, the last one actually asked me to stop asking questions whilst he was examining me which led me to forget to ask a very important question, I feel that a good doctor is someone who listens and is emphathetic, I know now not to waste my time on specialists who are too set in their ways to take another persons plight seriously, definitely too much arrogance within the profession. The last ophthalmologist actually asked me if I knew what evaporation meant and started to explain some detail, using the old oil on water annecdote, I couldnt believe it, I was taught this word when I was 8!

[CarlM]

I would Carl, my condition has got worse and I really wish Id known what I know now at my first appointment. Ive seen three ophthalmologists now, the last one actually asked me to stop asking questions whilst he was examining me which led me to forget to ask a very important question, I feel that a good doctor is someone who listens and is emphathetic, I know now not to waste my time on specialists who are too set in their ways to take another persons plight seriously, definitely too much arrogance within the profession. The last ophthalmologist actually asked me if I knew what evaporation meant and started to explain some detail, using the old oil on water annecdote, I couldnt believe it, I was taught this word when I was 8!

For scientists, doctors can sometimes incredibly disconnected from reality (not in all cases, obviously!). Some are arrogant as all hell, others are confused with what's common knowledge and what's not, and others (thankfully) are amazing!

[cathy8889]

I am so thankful that some are amazing lol I hope the next ophthalmologist I see is!

[CarlM]

This is weird and strangely I noticed this at the ophthalmologist when the technician made me read the letters at the wall while keeping a thing over my left eye... my eyesight with my right eye has degraded quite a bit and letters look fuzzy from a distance... That's annoying. Just a few months ago the optometrist said my eyesight wasn't all that good anymore but not bad enough to justify glasses, and all of a sudden I feel like I need glasses... I don't know if it was gradual and I didn't notice until now, or if it was sudden. Maybe I should get this thing looked at.

Ugh, problems just keep piling on, it's horrible. And whatever it is I sure as hell am not getting Lazik.

[cathy8889]

Hi Carl

I experience blurred vision quite a lot now and photophobia due to my dry eye but according to an optometrist at specsavers I don't have dry eye and The pain I'm experiencing is due to me straining my eyes because I need glasses, needless to say I will not be visiting specsavers again. This dry eye is a nightmare.

Cath

This is weird and strangely I noticed this at the ophthalmologist when the technician made me read the letters at the wall while keeping a thing over my left eye... my eyesight with my right eye has degraded quite a bit and letters look fuzzy from a distance... That's annoying. Just a few months ago the optometrist said my eyesight wasn't all that good anymore but not bad enough to justify glasses, and all of a sudden I feel like I need glasses... I don't know if it was gradual and I didn't notice until now, or if it was sudden. Maybe I should get this thing looked at.

Ugh, problems just keep piling on, it's horrible. And whatever it is I sure as hell am not getting Lazik.