at wit's end

[jenna]

Hi, I am a 37 year old female, I have had PK (do to kerataconus) in both eyes and have severe dry eye. One was done in 96 the other in 98. Have both bottom ducts cauterized and the top are plugged. I currently wear softperm contacts, best vision with glasses is 20/100. I have tried semi-sclera RGP's but mucin was getting trapped inside so they were sent back for fenestration, then the outside was drying up in a matter of seconds, the doctor (from a teaching college) doesn't feel like he can help. I have already had rejection and now neovascularization is starting toward the button. I take thera tears (vitamin), pred forte, refresh drops (have tried all different kinds) and genteal at night. I am in such pain when putting in my contact and can't keep my eyes open to drive sometimes. I feel like someone is jabbing an ice pick in my eye sometimes. I do not have any other medical problems as a contributing factor. Is there ANYTHING else I can try. My doctor today suggested the moisture chambers and possibly autalogus serum drops. This is effecting my life and need to find some help somewhere. Sorry, this is long, just wanted to try and touch all bases so you can help. Thanks :

[Robert Latkany MD]

It sounds as though you still have a high astigmatism despite the transplants. There are procedures that one could do to reduce the astigmatism called AKs which are cuts in the cornea that are real simple to do. The reason why I bring this up and you should talk to your corneal specialist about is if they reduce your astigmatism enough you may be able to convert to just eyeglasses and rid yourself of the contacts and get good vision and comfort because I assure you the contacts are the major source of your problem. Also ask your doctor if you have allergies because I have never met a keratoconuc patient that does not have a bunch of allergies.