Confocal Microscopy

[DryLondoner]

I saw a consultant at Moorfields privately, he lectures in this area and was really quite nice and talked me through all my photos and took time to answer many of my questions. If there is anyone who has had any refractive surgery and has not had this done, I would recommend it. It took about 30 minutes and was not painful in the least.

My results showed that I did not have as much nerve growth as would be expected at 11 months post LASIK. The confocal allows them to really zoom in to your eye, about 600 times. So the images are much more detailed compared to a slit lamp. He said I have no signs of inflammation and he very much doubts I have an allergy (something about cytokines?!), which is good. Also my epithelium on one eye is a bit thin, on my worse eye actually.

I'm really glad I had this done, I now know that the pain is real and why I have it. I understand they may be more to the nerves, e.g. they may be growing back abnormally etc. but I can't think about that, I'll go mad!

He has recommended I do blinking exercises and limit PC work to keep my eyes moist. From my LipiView, I know I only blink partially and my lipid layer is deficient so I've been doing these already. I know some people on here have used serum drops to help with nerve regeneration so that is my next step.

It would be great to get advice from anyone who has used serum post LASIK. Or any other advice on nerve regrowth.

[tealeaf]

Hi DryLondoner,
What questions to ask after the Confocal Microscopy results? How do you do the blinking exercises? How does a thin epithelium affect the eyes? What type of serum help in nerve regrowth?

Apologies for the many questions. I am going to see another opth. at the eye centre this upcoming Tue. This opth. actually suggested to put in silicone plugs for me half year ago. Thus, I may ask her about Confocal Microscopy.

[DryLondoner]

Hi TeaLeaf - hope you are doing ok.

The questions were about what he was explaining. What some of the more technical language he used meant.

Blinking exercises: http://www.andrewgasson.co.uk/info_blinking.htm

Autologous serum - this is made from your own blood, takes a while to have an effect however. I am hoping I can get this in KL.

Good luck with your plug fitting!

Do your eyes burn? My eyes have been awful for the past couple of days. I am covering them at night now, which I think helps.

[tealeaf]

DryLondoner,
My eyes burn at times. Recently, with the temporary eye plugs, they are slightly better.
Before going to bed, I will apply vidisic gel to my eyes and cover them with eye masks. Recently, I add humidifier in the room. Not sure if eye gel will help you.

[DryLondoner]

Glad to hear the plugs are working, I want to try them again. I did once, but I think it might have fallen out.

I need to try a gel before sleeping...but now I must go and pack!

[djlasik]

I had lasik over 4.5 years ago. The serum drops are working for me in healing the nerves.

I started serum tears last October. I had my eyes scanned back in December 2013 and my nerves were down 70%. I had them scanned again in March 2014 and the nerves were down 60%. In June 2014 the scans showed that I was down 50%.

I thought that It would be a good idea to bump up the serum percentage thinking I would heal quicker. I am currently taking about 20% serum. My doctor stated that if I went higher my nerves could grow back incorrectly and that I could cause a whole set of other problems. He said it's best to start with a low % and move up if there wasn't regrowth.

[runnergirl]

I wonder if this would work for me. I am 8 years post lasik and I began to have these dry eye problems 2 years ago. all the doctors ever offered me were plugs and botox for blepharospasm. I have no other problems or diseases (Praise God above)so the only thing I can think of as to why I have this bad dry eye is my lasik. Wonder why they never offered to try this for me. I am going to bring it up this Friday at my appointment. thanks for posting

[DryLondoner]

I had lasik over 4.5 years ago. The serum drops are working for me in healing the nerves.

I started serum tears last October. I had my eyes scanned back in December 2013 and my nerves were down 70%. I had them scanned again in March 2014 and the nerves were down 60%. In June 2014 the scans showed that I was down 50%.

I thought that It would be a good idea to bump up the serum percentage thinking I would heal quicker. I am currently taking about 20% serum. My doctor stated that if I went higher my nerves could grow back incorrectly and that I could cause a whole set of other problems. He said it's best to start with a low % and move up if there wasn't regrowth.

Are Great news regarding serum helping you. With nerve growth are you finding your eyes are more comfortable?

Thanks for letting me know about the possibility of abnormal nerve growth. Scary stuff.

[DryLondoner]

I wonder if this would work for me. I am 8 years post lasik and I began to have these dry eye problems 2 years ago. all the doctors ever offered me were plugs and botox for blepharospasm. I have no other problems or diseases (Praise God above)so the only thing I can think of as to why I have this bad dry eye is my lasik. Wonder why they never offered to try this for me. I am going to bring it up this Friday at my appointment. thanks for posting

Had it not been for this forum I wouldn't have known about the confocal. None of the docs I've seen have mentioned it. Strange, right? I had to strange it privately. The scan is of a part of your cornea, if I understand correctly, it can't look at all your nerves, so might not always yield answers. Have you tried serum drops before?

[tealeaf]

DryLondoner,

No opth. offered the confocal for me too (I have seen 4-5 opth. over the last 11 months). I am going to call the eye hospital today to enquire on the serum drops as well as the confocal. Thanks for the info.

[tealeaf]

I started serum tears last October. I had my eyes scanned back in December 2013 and my nerves were down 70%. I had them scanned again in March 2014 and the nerves were down 60%. In June 2014 the scans showed that I was down 50%.

Hi djlasik, that's very good news. With the nerve growing from 70% to 50%, do you feel your eyes less dry?

[runnergirl]

HI DryLondoner,

No , I have never tried the drops either. My appt is tomorrow, so I hope this guy is ready because for the first time, I have a LIST of stuff to go over with him .....all from this forum. hahaha. I will finally get my moneys worth out of a doctors appt. ha!

[DryLondoner]

Runner girl - love it! The last guy I saw said, try not to read to much stuff online! But as people on here say, we have to be our own advocates. Hope it goes well.

[steveyez]

Thanks everyone - this is great news - ive been on prp serum for about 15 months and i would be very interested to get the Confocal Microscopy done in England as I feel nerve growth may well have happened but i didnt even know we had access to this technology in England.

Some very interesting points - "I thought that It would be a good idea to bump up the serum percentage thinking I would heal quicker. I am currently taking about 20% serum. My doctor stated that if I went higher my nerves could grow back incorrectly and that I could cause a whole set of other problems. He said it's best to start with a low % and move up if there wasn't regrowth." - i never even thought of this wow !!

Is there any alternative to London for Confocal Microscopy - is it available on the NHS? and how much does it cost privately ?

Thanks
Steve

[Jovver]

Although I haven't been on this site for a while, I came across this thread about confocal microscopy and would wholeheartedly agree about its usefulness. I'm in similar position to you DryLondonder as I had Lasek 14 months ago, and have suffered dry eyes ever since. My eyes have improved a little in the intervening time, but they are still pretty bad in all honesty (TBUT varies but it's generally about 3 or 4 seconds in each eye, sometimes a little higher, sometimes a little lower).

After months of badgering, I finally persuaded the Laser clinic to send me for this test which I had yesterday. I had it done by Professor Dua at the Queens Medical Centre in Nottingham and it took about 10 minutes per eye. Not a painful experience, but it is fairly uncomfortable as the lens cover actually touches the surface of your (anaesthetised) eye during the test. Anyway, my results were possibly even worse than yours as I've only had 20% nerve regrowth in my right eye, and even less in my left.

Although it's bad news for me, I - like you - am glad I had it done as I know the root cause of my issues (although I long suspected it). The Professor is going to discuss treatment options and get back to me. I guess that serum (and time) are the only possible options for me now, but I guess I'll have to pay this myself as I can't imagine the laser clinic will (and I understand that the NHS won't prescribe it in the West Midlands area).

I would definitely urge anyone who had had Lasik or Lasek to insist on having this test as soon as possible (and I think it should be a mandatory requirement to have it done before surgery to see if there are any abnormalities) Fat chance of that though...

Anyway, I really hope you improve soon. Like I said, some of my symptoms have improved with time (I don't wake up with bloodshot eyes anymore for instance) so I hope yours will as well.