Saw dr. today; feeling a little discouraged. Advice?

[LasikLady]

I'm certainly not an expert and really don't know half of what most people here do about this syndrome or disease or whatever it is. All I can tell you is that it is completely disruptive to one's life and happiness once you have real symptoms and experience daily pain. Dry eye pain is maddening and constant and really wears on you physically and emotionally. It has changed who I am as a person. I was not a high myope pre lasik so I don't know the challenges of having to wear thick glasses. But I do know the challenges of living in daily discomfort and I would venture to guess that pain is worse than not having the best vision in glasses or looking less than attractive in thick lenses. I'm worried for you after reading your posts. Before you are tipped over the edge into daily pain I would strongly suggest ditching your contacts. Trust me, living in discomfort sucks. Good luck in whatever you decide to do but be forwarned that you may get worse in time using the contacts. Being on this side of the fence I wouldn't do ANYTHING that would make this condition worse if it were me.

[Stanza]

So my eyes don't seem to be getting better, per se, but they're not really worse either. And on the days I wear glasses and don't put in my contacts at all, my eyes have the same degree of redness and dryness that they do with the contacts

Interesting, could be they need more time without to tell but I know my eye doc, thinks lenses are fine, which I think is strange.

[calli66]

I agree with Stanza--it does take more time OUT of lenses---for the eyes to heal. I used to think that my eyes felt better in contacts than in glasses, and they did. But that was because my corneas were "rough" and had dry spots (tears weren't wetting them properly). So when I took out my contacts at night--or sometimes for a day or two---those dry spots were exposed and my eyes felt awful. Cover them up with wet lenses, and they felt better. But they WEREN'T BETTER.

I was in this constant cycle of wearing contacts, and then having to use tons of drops in the evening when I took them out. Some lens brands were better than others, and I was just determined to keep going with the contacts. It wasn't until I quit wearing them for several months that I realized how much better overall my eyes were. And my eye doctor confirmed that the dry spots were gone.

Maenad1- I was interested to read that your doctor "lets" you use regular PF tears while wearing contacts. I never had the nerve to try that, but I think it's a better than using the preserved contact re-wetting drops like Blink and Acquify. Do you have trouble with the lenses getting coated with the drop ingredients? Do you wear soft or hard lenses? Thanks!

Calli

[Maenad1]

This just doesn't make any sense!

Thanks for the responses. It's helpful to hear different opinions and suggestions.

I swear, though, this isn't getting any easier. My DES doesn't seem to be unfolding in a logical way. Yesterday, for example, I took a day off from contacts -- wore glasses all day, spent little time on the computer. My eyes felt and looked good all day; I felt like I was making some tears, they were beautifully white (for me, anyway) when I went to bed. When I woke up this morning, they were as red as a stoplight! And there was even a little bit of gook in the corners. I don't get it. They looked *worse* the morning after a day without contacts. After a liberal application of Refresh Tears and Dwelle this morning, they looked normal again.

The only thing I did differently last night was I didn't coat my eyes with Genteal Gel before going to sleep, because the eyes felt so moist and "normal" it didn't seem necessary. Has anyone else ever experienced this -- dry eyes that are moister and clearer at night, regardless of whether contacts are worn, and red and dry in the A.M.?

Maybe I do have lagopthalamos. Hmmm.

[calli66]

Before I started using Genteal Gel at night, my eyes were always in pretty bad shape in the morning. Seems like if you have very few tears, you can still get by during the day because you're blinking and that produces tears. At night, tear production goes WAY down. Somebody posted here recently---Dr Holly maybe--and gave a number that I don't recall (sorry)--like we make maybe 1/10 the amount of tears at night.

If you tend to sleep deeply and don't wake up during the night----and if you're dreaming during REM sleep (eyes moving around a lot)---then your eyes can get pretty aggravated.

Calli

[Jade9923]

Welcome. I'm a -11. Severe dry eyes. Former contact lense wearer. No lasik.

I had to stop wearing contacts due to my dry eyes about 15 years ago. It wasn't even remotely an option my eyes were so dry. You are far from having severest type of dry eyes if you still are able to wear contacts at all.

Watch all these drops with preservatives. They can really make your eyes feel much worse. Systane is the best drop I've ever used. Not until I used a drop without preservatives did I realize how much the preservatives were irritating my eyes. You have dry eyes, you don't need anything else irritating your eyes. Try only the Systane for awhile (or any preverative free drop) and see if that doesn't get rid of some of this random irritation.

I can't believe how thin they got my lenses being a -11. I have small frames and they rolled and polished the edges. For the first time in my life, I don't feel like a coke bottle freak.

It sucks having to wear glasses but I really have no choice. You really want to be very careful with your eyes. Even though you are motivated to continue wearing lenses, I'm not so sure you won't end up like some of us with the type of severe dry eyes that won't allow you to wear them at all. The kind of severe dry eyes that make you not want to even open your eyes they are so painful.

Get another opinion. Go to a doctor someone here can suggest in Chicago. You don't want to waste your time with anyone that doesn't have an interest in dry eyes.

Be cautious...as someone else said, your eyes are putting up a big red flag right now with the dryness. Respect that and be very careful to not make things worse and irreversible.

[Terri]

Maybe I do have lagopthalamos. Hmmm.

Try taping your eyes shut with surgical tape before bed, after applying whatever gel or drops you are using. If your eyes are better after a few nights of this routine, you probably do have lagophthalmos. At that point, you can decide on a longer-term strategy, like Tranquileyes goggles.

[sazy123]

Thanks for the responses. It's helpful to hear different opinions and suggestions.

I swear, though, this isn't getting any easier. My DES doesn't seem to be unfolding in a logical way. Yesterday, for example, I took a day off from contacts -- wore glasses all day, spent little time on the computer. My eyes felt and looked good all day; I felt like I was making some tears, they were beautifully white (for me, anyway) when I went to bed. When I woke up this morning, they were as red as a stoplight! And there was even a little bit of gook in the corners. I don't get it. They looked *worse* the morning after a day without contacts. After a liberal application of Refresh Tears and Dwelle this morning, they looked normal again.

The only thing I did differently last night was I didn't coat my eyes with Genteal Gel before going to sleep, because the eyes felt so moist and "normal" it didn't seem necessary. Has anyone else ever experienced this -- dry eyes that are moister and clearer at night, regardless of whether contacts are worn, and red and dry in the A.M.?

Maybe I do have lagopthalamos. Hmmm.

It sounds like to me your doctor doesnt know what hes talking about.. sorry to be blunt. Im 22 and i have MGD and lots of young people on this site have MGD- its as common among young people as much as aqueous deficiency is- which is very common as you get older. I think you have a bigger problem than not being able to wear contacts, it sounds like you have 'border line' bad dry eye and contacts may be the thing that pushes it over the edge in to -daily discomfort, constant burning and pain like many of us here. I know because i was where you were 3 years ago, i tried to wear my contacts with dry eyes because of vanity and im sure its one of the causes of my severe dry eye now- amongst other things, now i my life is ruined and i have toi wear swimming goggles around the house. Just wear glasses, the risk of getting moderate/severe dry eye is not worth wearing contacts/ laser eye surgery or anything else. Signs and symptoms don't correlate in tests and tests are very unreliable, it sounds like atm your symptoms are quite mild, so you still have a chance to stop it getting worse or progressing, find a decent doctor and try to improve the dry eye before going back to contacts- thats my advise.

[sazy123]

Maenad,

You said that your Dr told you that you have lipid deficiency but not MGD?

I just wonder how that could be possible? Surely lipid deficiency...evaportative problems are a sign that the meibomiam glands are not working effectively...and therefore MGD..

I see that you have asked this to Dr Latkany..so I will let him answer that one!

Rory, lipids come from the MG's, therefore if there is a- lipid deficiency that is the same as mebiomian gland disorder (MGD). Another sign the doctor doesnt have a clue.

[Maenad1]

Had another appointment today

Here's an update on me, for anybody who is interested, or who is also struggling with contact lens issues.

I'm not sure these Oasys lenses are working out so well after all. Yes, they're comfortable. But I've been having problems with my eyes looking OK at night after removing the lenses, but dreadful in the morning when I wake up. One day last week my eyes were so bad in the morning, I wound up having to use a little TobraDex to get rid of the inflammation. It reminded me of the type of inflammation I used to get with non-disposables, all the trouble with lipid deposits and the resulting allergic reactions.

After that experience, I wore glasses for four days to give my eyes time to rest. When I put the Oasys lenses in again, I opened a new pair. With this pair, I did not use any solutions or drops containing preservatives, other than a few drops of Dwelle. I used ClearCare to clean them and only Refresh Tears Plus and Celluvisc. Well, who would have guessed it -- my eyes like this new regimen and have been looking much better! They don't look as bad in the mornings. I'm happy about this. However, they're still somewhat red and dry at the end of the day, and I'm concerned about the lipid deposits coming back. I'm tired of scrubbing the lenses and fiddling around with solutions. So I thought it might be worthwhile to inquire about daily disposables.

I don't know what it is with this OD but he doesn't seem to remember me from one visit to another. I am sure he sees hundreds of patients, but I'm there so often, and the former OD at this practice knew me and remembered my "issues" from one visit to the next without having to re-read my entire chart and start from scratch each time. This new OD (he's only been with the practice for a little over a month) was acting surprised my eyes were so dry. I was like, "Uhh, you were the one who diagnosed me last month, and I've been in at least three times since." Anyway, he did a thread test (he said my score was 8) and looked at me under a slit lamp and pronounced me to have a moderate amount of staining. He turned my eyelids inside out and pronounced me to have no blepharitis.

I had to do a lot of talking about my lipid deposit issues in order for him to agree to order me a set of Proclear trials -- he kept saying, "Well, Oasys are the lenses that are recommended for a dry eye patient." But dude, I have lipid deposits and inflammation too, that you mentioned at my last visit! We're talking lipid deposits on a three-day-old lens -- shouldn't that have told him something? He didn't even know the Proclears came in daily disposables. And yet he chided me for "self-medicating" one time with the TobraDex. Like I'm a "rogue" patient or something.

So the upshot is, he ordered me a set of the proclear one-day trials in -10 OU, which is a bit lower than my current CL prescription (-11, -10.5) but I'm willing to see if sacrificing a bit of the distance vision for the sake of a (potentially) more comfortable lens is worth it. I really like the idea of putting in a fresh lens every day, thus avoiding the lipid deposit problem, and I'm ready to try a non-Acuvue product. I've been wearing Acuvue lenses for over 5 years, and I haven't done well with them. That may not be the fault of the lenses, but I think it's worth a shot to just see if another brand is a better fit for me.

In the meantime, I will continue to wear the Oasys lenses on a limited basis, avoid preservatives and wear my glasses a lot. A lot more than I'd like to.

If you've made it this far, thanks for reading my epic!

[calli66]

Hey, I made it all the way through!

Your OD sounds like a real DUD!!! It's so discouraging and feels like such a waste of time to go to an OD like that. I'm SURE you'll be switching docs at the first opportunity. What's the point when you're the one educating him? Some docs are "quick on the up-take"---but not your guy.

Good luck with your trial lenses, but my intuition tells me those -10's are going to feel blurry.

Calli
(I had to give up on contacts)

[Zarla]

Hi Maenad,
Have just read through this post with great interest. I am the same age as you, a dry eye sufferer and, like you, am trying hard to stay a contact lenses wearer. My prescription in contacts is -9.50 in one eye and -6.50 in the other. With glasses I get wavy vision due to the discrepancy in my prescription and other tedious factors. Like you, my dry eye symptoms same if not worse with glasses. My left eye is the rogue one and regularly develops inflammation, quite sharp pin like pain behind the eyelid, strands and strands of mucus and all the other stuff. It's very bad tonight - just posted about the swelling under my eye and down my cheek. Have taken Nurofen Plus and am hoping it goes down. My right eye wears Zero 6 and seems ok; the left one has started to reject everything put in it after a few hours. Oasys seemed the most comfortable option, until today. My opticians tell me I should just wear glasses, even though my dry eye symptoms come and go and rarely affect my right eye. Let me know how you get on with the Proclear...the water content seems high?
Zarla