I made the print!!

[Guest]

Caroline

I totally agree with you on the lack of screening process.

There are a few of us on this board that live in the UK that have laser induced dry eye.

Fortunately after 2 years of almost hell, things are starting to improve. I work as a consultant so have been very lucky that I can do some of my work on the end of a phone at home and I tend to work the hours that suit. I am extremely fortunate that I have had this flexibility otherwise, I would be in extreme financial difficulty.

Disability is not an option for me given my employment status.

Fortunately I had some money saved prior to my surgery that has managed to scrape me through. This is why I always advise people to have a backup plan when they are contemplating this surgery as there is no guarantee that you will get the outcome you desire.

As far as your morning dryness goes, I went through a stage where I had a steripod - non preserved saline solution (you can get them on prescription), I used to keep it by the bed and crack it open before I open my eyes and pour it over them. I found that this really helped with the morning dryness.

Take care and I hope things settle for you soon.

Warm regards

Ian

[Caroline]

Hi

Ian,

Thank you for that, I will ask my doctor about the saline solution (it sounds better than eye drops that contain all sorts). I am glad to hear you can still work and that things have improved for you.

All the best
Caroline

[Guest]

Caroline

The saline solution is great for rinising and flushing. I used to use it first up of a morning to wet my eyes before I opened them (after I removed the tape) so that they at least had a little bit of moisture in them before the scratching started.

It is certainly not a substitute for a good artificial tear. It is mearly a good rinising product.

I used to pop one in the fridge/freezer and pour it over my eyes in the shower for a refreshing rinse.

They can be purchase without prescription but are very expensive. If you can convince your dr that you use 1 a day, you will get about 30 on prescription for the standard prescription charge, rather than about 70p each OTC.

Good luck with it.

Cheers

Ian

[Caroline]

Hi

Hi

Thanks for that info. I was going to ask what the Saline solution is called to be able to ask my doctor for it. I guess its just called "Saline solution" and comes in little vials like eye drops.

I tried making my own saline solution the other night with cooled boiled water and salt. I was using it for my eyes and nose (my nose gets dry and stuffy/ blocked one side- this happens with the dry eye, not sure if the dry eye causes it or if the other way round). It gave probably as much relief as an eye drop which for me lasts about 20 minutes at best. I'd rather use saline solution if it works just as well long term because I find that eye drops leave a residue in my eyes, espically if I use them in the night. I wake up with crusty eyes and eyes are more itchy ( i think it creates a blepharitus like reaction in me). I doubt saline would do this. Also i don't like the fact most eye drops contain some sort of acid in them to keep them sterile.

Hope you are doing ok
Caroline

[Guest]

Caroline

In the UK we have two versions of non preserved saline solution that I am aware of, 1 is a proprietory brand called Steripods and the other is in a little packet. The packet is next to useless as you have no control over it.

The Steripods are about 25mls of non preserved saline solution in a harder plastic vial that you simply snap the top off and pour it on your eyes.

The steripod are designed for eye rinses (foreign body) and wound care.

The come in a box of about 20 but can be purchased separately OTC at a good pharmacy.

Ask your DR for 30 vials (1 x day for 30 days (as your prescription will only cover 30 days). My GP didn't have a problem with this amount (they are quite expensive though at 70p each OTC so your GP may question it simply due to the cost £21.00 OTC but your standard prescription charge will apply).

Simply ask your GP for Steripods (non preserved saline solution) X 30, they should know exactly what it is or otherwise they shouldn't be in the business.

I think you are taking huge risk making attempting to make your own, normal tap water contains all sorts of "rubbish". If you don't want a full prescription supply, grab a couple from your pharmacy again, ask for Steripod - Non preserved noraml saline solution - should cost you no more than £1.50 for 2.

As I said previously, they are not a substitute for a good lubricating eye drop, their purpose is for rinising.

As I am rennovating my house at the moment I have loads of dust from sanding etc so I find they are good to rinse my eyes at the end of the day to get rid of the "crap".

If you have any further questions on it, please PM me as I am a little concerned that we may have redirected this post a little but I am more than happy to help.

cheers

Ian

[Rory]

I have to say that i was astonished by the lasik surgeons here and in europe and asia. I have had very dry eyes since i was 20 and not from lasik. However 4 out of 5 lasik surgeons who i have consulted over the past 5 years were happy to perform the procedure on me. I have schirmers of 1 and 2mm!!! Only one of the surgeons refused me and said that i most certainly should not have lasik

I believe it is purely the fact that eye Drs throughout the world are ignorant of dry eye and certainly do not understand the massive affect that is has on people's lives.

I do not believe that Lasik should be banned..but the risk of dry eye AND a clear explanation of what real dry eye really means should be made clear to all prospective patients. As most of you know by now, dry eye is considered a minor ailment to those who have never experienced it.....and i believe that this attitude is shared by the majority of eye surgeons today

[YGB]

I have to say that i was astonished by the lasik surgeons here and in europe and asia. I have had very dry eyes since i was 20 and not from lasik. However 4 out of 5 lasik surgeons who i have consulted over the past 5 years were happy to perform the procedure on me. I have schirmers of 1 and 2mm!!! Only one of the surgeons refused me and said that i most certainly should not have lasik

I do not believe that Lasik should be banned..but the risk of dry eye AND a clear explanation of what real dry eye really means should be made clear to all prospective patients.

Hi Rory - you bring up an interesting paradox in your post. You state that 4 out of 5 LASIK MD's were willing to do LASIK on you despite you very low schirmer score and pre-existing dry eye. You then state that you do not believe LASIK should be banned.

My thought is that if LASIK MD's as a collective group cannot establish standards of care that protect the patient population as a collective group, then aside from pure financial reasons, why should it be an accepted elective procedure?

[Caroline]

Hear hear!

I couldn't agree more. 1 in 20 get this from LASIK, at least! Thats 50,000 a year if there are a million ops. The pain and suffering of the minority outways the joy of not wearing glasses for the majority. Most large money making companies/ surgeons only care about money. Pressure needs to be put on organisations that are responsible for protecting the public and them made aware how disabling and painful the condition is. I can't believe this has be allowed to happen to me. I accepted a very tiny risk of dry eye, like 1 in 5000 chance, the same chance of loss of corneal flap (as the warning was written next to that in the small print). But i would not have acccepted 1 in 20 chance, no way. Everyone is saying the same thing, that they were not told their true risks or how problematic dry eye actually is. My friend who had a good LASIK result and recommended it to me said, after i developed dry eye, that she would still have LASIK done if she knew it would give her dry eyes. She clearly has no idea what dry eye is like, no one wants headaches, burning eyes, feeling like you've been punched in the eyes or have sawdust in your eye on a daily basis. Its my belief that she will likely know just how horrible dry eye is when she ages and her eyes get dryer. We must tell those in power who can do something! The NHS has rejected LASIK because it says it is unsafe. So how can those in power allow the procedure to carry on?

[Rebecca Petris]

We must tell those in power who can do something!

Caroline,
I'd encourage you to contact your MP. When I lived in the UK I lobbied for much stricter regulation of laser eye surgery because of just such problems as these, and testified to a parliamentary panel which was put together to investigate widespread problems such as misleading advertising, inadequate informed consent and poor care of patients with complications.

Google "Regulation of laser eye surgery bill" and you'll learn more about this. Last I heard the bill was on its third reading and then I lost track of it.

[Caroline]

Thanks Rebecca

I think its great you did this. Thanks for the idea to contact my MP.

I've had a quick look at the publication on the internet. I find its not easy reading, written in very old fashioned court lengthy type writing, typical court stuff. From a quick glance it looks like they have written a lot about what surgeons should do. This is important, but how do they ensure it? I warned my surgeon I had dry eyes (as couldn't wear contacts) and mentioned my concerns about the consent form mentioning dry eye and he played down the risk, saying that did not mean i had dry eyes and my eyes looked ok. Another surgeon has said he was in the wrong for not cautioning me against LASIK but that its still my surgeons word against mine. My point is that creating all these rules is a start but if they are not adhered to, in respect of warning people of risks and carrying out ALL eyes tests etc, then the surgeons just get away with it. It then comes down to the poor individual battling depression etc to risk huge financial loss to seek justice. Thats why i feel that LASIK surgery should not be allowed full stop. Its too risky and side affects are near impossible to correct.

I appreciate that regulation is vital and this bill has most likely made many surgeons sit up and think, so it is really important and admire you for doing this. I have not read it all so I apologise if I repeat whats in the publication but I would ask my MP to see that if LASIK can not be banned that all consultations and consent forms are standardised across companies to properly inform people of the risks, with actual % figures of risks. Listing the most common to the most rare. This of course may not be exact but people need to have an idea that dry eye is not rare with LASIK, and that you have a real chance of getting it (i've read 28% of patients have dry eye 6 months post LASIK). With respect to dry eye then list of pre surgery dry eye symptoms should be listed, including difficultly with contacts (as I have read dry eye is on the increase as many who hate wearing contacts are going for the surgery) and that the more dry your eyes are pre surgery the more dry post surgery. I did some research and looked at several consent forms on google and out of about 10 only found 1 that warned if you have warn contact lenses for many years then you might not be a good candidate. In addition to this all dry eye test results should be carried out AND recorded. AND all consultations should be recorded and a copy of it given to the patient. This would protect the patient from sly surgeons more interested in money than care.

The fact that with most other surgeries, such as a back operation, patients are given % chance of it going wrong then it makes me wander why LASIK risk figures are not disclosed for all the possible complications. I don't believe its because it has not being going long enough, they have at least 10 years. I doubt they are collecting the data. Obviously if you added up all the risks including poor myopia correction then its just not worth the risk which is what the industry doesn't want people to know. I would also ask my MP that patient satification should be recorded always, upto one year post surgery, and companies should be made to report this back and to authorities. Spot checks should be carried out to make sure LASIK companies are giving truthful figures. There should be a law to say patients can not receive elective surgery without being given actual % risks from previously carried out operations.

I would appreciate any extra comments from people on this which can be added to help.

[YGB]

Spot checks should be carried out to make sure LASIK companies are giving truthful figures. There should be a law to say patients can not receive elective surgery without being given actual % risks from previously carried out operations.

I totally agree but as I've come to learn, there are no agencies in charge of checking MD's as a group. In the U.S., there is the FDA but they are the food and drug administration and not the food and doctor administration.

In the U.S., we learn to trust MD's in part due to the Hippocratic Oath that MD's take that states "Do No Harm".

I still believe the overwhelming majority of doctors do still believe in doing no harm but with LASIK, greed combined with an informed consent form to protect the MD and an unregulated MD industry creates a recipe for disaster for too many patients.

[Rojzen]

what amazes me

...is that so many LASIK practitioners also hold themselves out as dry eye specialists. . .Sure, it's all about the "anterior segment," but it is so troubling that docs who witness the sometime ravages of ocular surface abnormality still have the stomach for cutting in to that surface. . .I can't think of any other medical specialty in which this paradox exists, but there are probably parallels. . .

[Caroline]

..I think "You gotta believe" has put this well. I think most surgeons do believe in not harming and think of themselves as caring and doing best for their patients. Also I think it is too easy for surgeons to believe what the LASIK industry says of safety because of lack of statistics and clear guidelines on pre surgery dry eye detection. My LASIK company's policy was for the surgeons not to do follow up care on their patients so how would they get to know of all the dry eye cases? Also most of them don't have dry eye and its all too easy for them to think its a minor price to pay for 20:20 vision.
I would believe by now, in addition to surgeon regulation, accurate statistics should be given on surgery outcome. I find it very difficult to accept in this day and age with our technology that post surgery patient satisifaction is not being collected and submitted to a central database/ regulation body. I thought it would have to be the law with a new procedure like this. How can the industry/ government get away with saying 10 years after this surgery has started that its still a new procedure and they can't give actual recorded risk figures. But i guess even this could be misleading as saying your risk of dry eye is 1 in 20 would not be true if you have dryer than average eyes! Your risk would increase much more than this. Also people who hate wearing glasses are vunerable people who may be willing to take such high risks. I don't think i would have taken that risk if i knew there was a (apparently so i've heard) 5 % risk of dry eye as to me that is quite high and knew dry eye was horrible when wearing contacts. I was given the impression the risk was like 1 in 5000 and LASIK hardly made the eyes dryer. I don't know if there is a full proof way of protecting all people from this miserable condition and just know the convenience for the majority is far outwayed by the suffering of a few. I say this when i can see both sides as my vision is pretty good and i have days with very little dry eye. But other days i'm in constant discomfort and have to wear wrap around glasses. Give me my glasses back anyday. Perhaps publicity and word of mouth is a better way to make people realise LASIK isn't safe, and not worth the risk to your happiness, career, family, life etc. Also what with more people being able to use the internet these days they can read what bad outcomes are like (I didn't even know how to use google when i had my eyes done, how i regret that). I just hope people can get an idea on what grand scale this is happening. I don't expect many surgeons tell their patients that 5% of people get torturous dry eye (i.e. 50,000 in every million). I wander how much of the LASIK industry profit goes toward finding a cure for dry eyes? Sorry i've rambled on.....

[m_cncl]

Its all about making money to become wealthy. The ophthalmology sector has abandoned what their trade is about - maintain wellness to the eyes. Instead, some have taken the evil route (lasik) to profit from it while the craze(lasik) is still in demand. I do not believe gov't interaction will improve because lasik provides jobs, pays taxes (federal,state,etc), cook the books(give impression everything is well) , and give money to politician for their campaign. The only way to discourage this is by discouraging others not to do it, which I have been doing. Mario

[Caroline]

I agree the government may think that but I was wandering if they realised 100s of thousands of people a year are developing dry eye from LASIK and losing their jobs or being demoted then thats less tax they can take off of their wages. In my case I nearly lost my job until I fought disability rights, now my employer has to make special arrangments for me to work in a humidified small office and I am stuck at my level because it would be very difficult to leave and go for a promotion (who wants to employee someone with this disability). Therefore the government is losing out on a lot of income tax for the rest of my life time (as i would have been on a higher salary by now). Some LASIKed people may be able to claim disability benefits which is more of a burden on the economy. Also if more and more people develop dry eye years after their LASIK as they age then the 5% getting dry eye will rise and goverment will pay an even higher price eventually.