Suffering Dry eye post Lasik

[Jeannie]

And unfortunately, I have a very severe case of it. My right eye is fine, and doesn't bother me, as the dryness isn't as severe, but the left eye, on the other hand, is making me miserable.

I had ladarvision done 4 weeks ago. My problem with the left eye is that the dryness is right in my center of vision, so I'm seeing blurry through it all the time. its like wearing one good contact and one bad one.

So things got at their worst last week, and I saw both the surgeon and the post op doctor who had been doing my follow ups (I've been there twice a week since the surgery!). I've now had permanent plugs put in, and although things greatly improved after about 5 days, because I'm on some steriod drops, over the past 4 days, my vision has once again deteriorated. My lid on my left eye is swollen. The doctor said its because the eye is so dry that when I blink and the lid goes over it, it irritates the lid, causing it to swell.

This dry eye is consuming my life. I have humidifiers running at home and in my office at work. I put drops in every hour, steriod drops in four times a day, ointment on my lids at night and in the morning for mild blepharitis, and genteal gel at night for comfort.I do eye scrubs, warm compresses, etc. I'm also on thera tears nutrition. I feel like I've done EVERYTHING.

I've tried freshkote, etc. But I'm miserable. I just don't understand why this has happened to me.

Anyhow, hopefully I'll start seeing improvement in the next few weeks. I'm glad I found this website. If nothing else, misery loves company!

[Rebecca Petris]

Jeannie,

Welcome to Dry Eye Talk. Sorry to hear about what you're going through.

A couple of questions:

1) In terms of the symptoms you're experiencing in the left eye, is the vision the primary problem, or pain/discomfort from dryness? Or both equally?

2) Is the blur related exclusively to the dryness? Just asking because a lot of people have blur associated with slow healing or other problems after laser surgery, in one or both eyes.

What is the doctors' explanation for this excessive dryness in one eye? Do you have ABMD (loose epithelium) or any other conditions?

[prattstar]

Jeannie

Hi and welcome to DEZ, it is great that you found this resource but unfortunate that you found it through your laser surgery.

There are quite a few members here that have laser induced dry eye - I'm just one of many.

Your treatment list sounds very much like mine did in the early days. I found that my biggest improvement came with permanent plugs (temporary ones just didn't work for me). I see that you have taken this step, lets hope it is as positive for you as it was for me.

I have found that plugs can take a bit of trial and error to get the mix right. If you find that bottom plugs are not enough, ask for top as well, it may just be the difference that you need.

Don't worry about the number of times you have had follow up appointments, I have lost count of the number of times I have been back. Go as many times as you need to, they contributed to this problem so it is up to them to help you manage it also.

I have a post in the welcome centre (here) where many people have placed lots of suggestions to help me with my challenge along the way.

I found that warm compresses were helpful and on my really bad days, an Icepack was all that seemed to give me some comfort.

I guess my only comfort to you (and it may not sound comforting at this point in time) is that it is really early days for you, improvements will come slowly over the next few months, you will have some good days and not so good days. On the tougher ones, I found an icepack and my favourite music got me through.

It can be a really tough road but there are loads of people here to help you on your journey, keep your spirits high.

Regards

Ian

[Dotanne]

Hi Jeannie
I am so sorry about your dry eye problem after Lasik.
I have dry eye after Lasik 2 yrs ago.
I hope you are wearing some eye protection - wrap around glasses or even better - goggles that keep your eyes from drying out. I have found this reduces the need for such frequent use of drops.
I have also found that tranquil eyes worn at night have helped a lot. Or just use a damp (used boiled water) sleeping mask like those you can get when flying and keep it over your eyes at night when sleeping. I use gel type drops(Dwelle or Genteal Gel or Alcon poly gel) several times in the night which seems to give me better days. The DEZ drops (Dwelle and Dakrina) are worth a try. I feel they have helped my eyes feel a lot better. I have just started using Systane Free in between times especially when I am out and/or need clear vision instantly. They last better than all the thin type drops and feel good. However different drops suit different people!
I hope you come right very soon.
God bless
Dot

[heather g]

Hello Jeannie. Welcome to the site. I have found some wonderful information here. Most important I found I felt less alone in all this.
I am 7 months post lasik. I have had the dry eye since day one after the surgery. In the beginning it was my right eye that gave me the most trouble. Now after many different attempts to treat the dryness my left eye is the biggest problem.
I know it is hard to believe but most likely you will probably improve over the next few months. It will be slowly and may even take you time to notice.
At 6 months I came to a point that I just couldn't continue on with this discomfort and my doctor was out of ideas. I saw a "specialist" and was told I have blepharitis. So I have began the lid scrubs and am waiting for my doctor to get my records and begin antibiotics or steroids.
I found in the beginning that the refresh pm ointment saved me. However, after a time I realized it was too much and was causing me more problems.
Now I find refresh endura by day and systane liquidgel at night help. Plus a humidifier!
My problem is more severe by mid afternoon and evening. The compresses and eyelid scrubs help at night a bit.
I think it is good to remember you are still healing up to at least 6 months. So changes will come however great or small.
Hang in there and keep positive.
If it doesn't continue to improve especially at 6 months (I know this sounds like a lifetime to wait) Consult another doctor.
But keep the faith you are in early days ! It stinks but you have that chance that the healing will stop this for you keep hoping for that!
Good luck.
Heather

[Jeannie]

Jeannie,

Welcome to Dry Eye Talk. Sorry to hear about what you're going through.

A couple of questions:

1) In terms of the symptoms you're experiencing in the left eye, is the vision the primary problem, or pain/discomfort from dryness? Or both equally?

2) Is the blur related exclusively to the dryness? Just asking because a lot of people have blur associated with slow healing or other problems after laser surgery, in one or both eyes.

What is the doctors' explanation for this excessive dryness in one eye? Do you have ABMD (loose epithelium) or any other conditions?

Thanks for responding everyone. Rebecca, in response to your questions...

1. Yes, the vision is the primary problem. I'm really not having any pain or discomfort from that eye. However, the blurry vision gives me headaches. Sometimes the vision is worse than others.

2. According to all four doctors, the blur is associated with the dryness. My vision measures zero, but the dryness is causing an astigmatism. They keep telling me its like having a smudge on your glasses. If we could get the dryness to go away, my vision would be great. I've had "glimpses" of what my vision COULD be like. I have had a total of two days during the past month post op where the vision in that eye has been spectacular, but then for whatever reason, the vision deteriorates, even if I haven't changed the protocol.

And as far as having the dryness in one eye, they actually said that I had bad dryness in both eyes, although the reason the right eye doesn't bother me is because the dryness is not right in the center of my vision. I don't really have any discomfort with the dryness. The only time I even notice my eyes "feeling dry" is when I first wake up in the morning. But that darn blurriness in the left eye is what is practically dibilitating to me.


And thank you to all of you for the support. I know that I'm really early on in the healing process, and that alone gives me SOME hope. Its just been very difficult. I mostly get frustrated by having improvements, then only to be pulled back to where I was. Its like taking two steps forward and one step back. I suppose eventually I'll get to where I want, but its going to be very slow going.

I go back to the doctor yet again this morning (sigh). I'll keep everyone posted as things progress.

[prattstar]

Jeannie

I know exactly how you feel when you said you feel as though you are taking two steps forward and one back, let's hope that in a few months, you will be taking two forward and none back.

My doctors have also said that my minor astigmatism is caused by the dryness, my vision of a night is not as clear as during the day.

I just hope that your doctors can sort this out for you.

As I said in my previous post, don't feel bad about going back to the Dr as often as you need, after all that is what they are there for.

I found that keeping an eye journal helps document my eye health between visits and helps isolate what works and what doesn't.

The downside of the journal is that it sometimes makes me concentrate on my eyes more even more.

Take care

Ian

[Rebecca Petris]

Jeannie,

You're early on and have good odds for getting better.

I've seen so many parallels of your LASIK situation over the years that it is hard not to suspect a different explanation, notwithstanding 4 opinions on the dryness. As one example I am thinking of someone with a similar Ladarvision treatment who was told for many months that the very poor vision in her one eye was due to dryness. It wasn't. In her case, the doctors believed what they were saying, but they were wrong. The cause was some irregularity in the ablation itself (which, no doubt, in turn caused irregular lubrication, compounding the vision problem). Like you she had no pain associated with dryness, just bad vision.

The idea that your case may be similar to the many others I've known of like it is pure speculation on my part and I could be (and hopefully am) totally wrong. But if you do not start seeing improvement SOON, I would strongly suggest asking for corneal topography and wavefront aberrometry testing.
If you are not able to get these tests at your clinic, I'd recommend getting an independent second opinion who will do these tests. You could even post the results over in our sister forum, D'Eyealogues, to get some thoughts on whether they might explain the vision symptoms.

[Jeannie]

Jeannie,

You're early on and have good odds for getting better.

I've seen so many parallels of your LASIK situation over the years that it is hard not to suspect a different explanation, notwithstanding 4 opinions on the dryness. As one example I am thinking of someone with a similar Ladarvision treatment who was told for many months that the very poor vision in her one eye was due to dryness. It wasn't. In her case, the doctors believed what they were saying, but they were wrong. The cause was some irregularity in the ablation itself (which, no doubt, in turn caused irregular lubrication, compounding the vision problem). Like you she had no pain associated with dryness, just bad vision.

The idea that your case may be similar to the many others I've known of like it is pure speculation on my part and I could be (and hopefully am) totally wrong. But if you do not start seeing improvement SOON, I would strongly suggest asking for corneal topography and wavefront aberrometry testing.
If you are not able to get these tests at your clinic, I'd recommend getting an independent second opinion who will do these tests. You could even post the results over in our sister forum, D'Eyealogues, to get some thoughts on whether they might explain the vision symptoms.

Rebecca,
I'm curious to know more about the person you spoke about in your response above. If the problem was not dryness, what exactly was it, and was it able to be corrected? I would be very interested in hearing more about this.

I went in for another checkup today. First, they do the corneal topography test at every visit I've had since having problems. I'm not sure about the wavefront aberrometry testing though. I usually do two different tests on two different machines. I know that the one is the corneal topography, and don't know what the other does.

This visit showed that there was some improvement since last friday. My right eye is showing no dry patches at all now, and my left looks as though the dry patches are smaller, but there was not a huge improvement.

I am going back on friday to see how things go, and we aren't changing a thing in my protocol right now, for which I'm thankful. i don't care if the improvements are slow. Right now, we're waiting to see if my five day relapse is going to occur. In the past, I've always managed to show improvements over a couple of days after changing the protocol, but at around day 5 or 6, I start the severe regression back to where I was. So wednesday will be key. If I begin to regress again, she said that she has a "band aid" so to speak that they will put on the eye. She has been reluctant to do that because its more invasive, and they want to try as much as they can first to try to clear this up without going the invasive route, which I am totally in agreement.

anyhow, that's where I stand right now.

And Ian, thank you so much for your responses. Its encouraging to hear from someone who has been there. I've been reading your story and reading about the things you have tried. I appreciate all your advice and support!