Question About Tear Production

[dnew85]

Just finished opthalmologist appointment this morning and he says that I have no MGD/Blepharitis etc. My Schirmers were 4mm. He stated that my problem is that I just don't make enought tears. I asked him about the LASIK connection and he said this was probabley inevitable and systemic.

Here is my question: I make plenty of tears when I yawn or get emotional. I just don't have many basal tears. It sounds to me that my lacrimal glands have the capacity to make tears (not a systemic problem), they just are not receiving the signal from my eyes to produce them (LASIK problem). Am I right or not?

thanks,

dnew

[LasikLady]

If the doctor said that it was inevitable that you would get dry eyes due to a systemic reason and discounted the fact that lasik caused the dry eye I say grrr.... These doctors have nerve. You may have developed dry eye for other reasons but I would bet you a billion dollars that if you didn't have the lasik your symptoms would have been MUCH, MUCH, easier to manage and you may have not developed symptoms at all.
I am a newby to all this too but since no one has yet to answer your question I will take a stab at it. The tears you make from crying and yawning are reflex tears and they are different than the tears that continually wet your eyes (or don't as in our case) They come from different glands (I think) or something like that. Hopefully someone more knowledgable will come along to answer that. Of course your eyes have a nerve problem and you are right the lasik interupts the nerve signals to your brain to lubricate your eyes. I think everyone who has lasik compromises their tear production. But there is a certain threshold where someone will have symptoms. Lasik pushed you and me and many others below that threshold and into symptoms.

[Lucy]

Hi dnew:
Lasiklady's answers are pretty much on target. Reflex tears don't do anything to really help your eyes. In fact, sometimes mine burn extra hot.

If your doc said dry eyes were "inevitable" he should have put this in the informed consent.

Have you been checked for Sjogrens Syndrome? Or have other symptoms ie. dry mouth?

Lasiklady said:

These doctors have nerve. You may have developed dry eye for other reasons but I would bet you a billion dollars that if you didn't have the lasik your symptoms would have been MUCH, MUCH, easier to manage and you may have not developed symptoms at all.

Here, here.

I'm a perfect example of this, being diagnosed with Sjogrens 6 1/2 years post lasik. My misery started between one and two months post-lasik. If I'd not had lasik, my eyes would no doubt be dry now, but nothing like the past 8 years of agony, and the s***ty vision that seems to be permanent. I'd have dry eyes, not butchered and dry eyes.

Good luck, and come to this board when you need answers, support. There's lots of it here. Lucy

[Natalie06]

dnew85

I got the "you were heading for dry eye anyway" excuse too. It's a load of BS and just an excuse to put the responsibility on the patient. Your instincts seem right on to me.

It would be very difficult to "accidentally" or naturally sever your corneal nerves without Lasik.

I too have a lot of reflex tearing with yawning, laughing, etc. Or when my eyes get so dry that an "emergency" tear production is called for. As Lucy noted, these are not "good" tears and actually make my eyes burn and sting too.

What's strange to me is that when I peel an onion or am in the presence of other strong odors, my eyes no longer "tear"...they just burn and hurt and I need eyedrops to stop the burning.

But my day to day basal tear production is about zero. As I understand it, your corneal nerves send the signal to the lacrimal glands to produce the tears when the corneal surface is dry. Compromised nerves=compromised tear production. And that is a Lasik induced phenonmenon. As Lasik Lady said, you would not likely be experiencing the severity of dry eye that you are now if you just developed dry eye due to other causes. And if you were predisposed to dry eye, you should have been told that and warned of the risk for permanent/chronic dry eye post Lasik.

Okay then...I'll get off my soapbox this morning.

Natalie
Lasik induced severe dry eye 7/14/06

PS: I'd give my right arm to be dealing with the annoying/episodic DES symptoms I had before lasik than deal with what I am now. With appropriate treatment, I might even have been able to tolerate contact lenses which was my first choice over Lasik.

[IanJ]

Hi all,

My right eye only is in this scenario. I can make some tears when I yawn/cry, but not as much as my left eye. I have very, very little basal tears. My left eye is perfect (apart from Bleph in both eyes).

I was at the eye doc just last Friday and we talked about this. I reckoned that because my eye developed this very, very suddenly (5 minutes!) whilst sat at work one day, and has been this way since........then perhaps it was caused by a blockage in my lacrimal area. And, because I can tear when I yawn then it was as if I was able to force tears passed some kind of restriction.

I still think this article is great food for thought:-
http://www.dryeyezone.com/talk/showthread.php?t=4915

PS. I've never had lasik, no eye infection to notice of etc etc etc....i.e no rhyme or reason.