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  1. #1

    Question for Dr. Latkany

    Do you know of any dry eye specialists in the Chicago area? I have an appointment with Robert Feder, who is the chief of Corneal and External Disease Services at Northwestern University Medical School, but would like to know whether someone else comes to mind. I have been contemplating flying to New York to see you, but given the need for follow-up visits, it would be helpful to speak with someone in the area first.

    I would also appreciate any insight you have on my condition:
    27/M
    Healthy
    No contacts
    Diagnosed aqeuous tear deficiency (schirmer scores of less than 2 with plugs in) but likely have mild MGD as well. Have punctal plugs in lower two tear ducts. Trieds four plugs, but they make me weep within 30 minutes and irritate my eyes. As a result, my eye doctor partially lasered my upper two ducts in order to shrink them.

    Have been on Lotemax qid for two weeks and restasis bid for two weeks (understand this is not long enough). I am having trouble with the regimen because it seems my eyes burn worse halfway through the day when I take the restasis and lotemax. I am not sure whether it is a reaction or not. The burning is localized to the outside portion of my conjunctiva (any reason for this -- conjunctivachalasis??).

    Would a drop like optivar in addition to restasis and lotemax be helpful?

    I am having difficulty tracing any cause to decreased lacrimal function -- i don't have sjogrens, have not had lasik or contacts, have never had eye trauma and I am otherwise healthy. I have stumped 7 opthamologists....any suggestions??


    Thanks

  2. #2
    Join Date
    Mar 2007
    Location
    Fort Worth TX
    Posts
    185
    dryasadesert

    I dont think Dr Latkany has time to read this Open Forum, so you'd probably get a faster response posting it in the forum with his name.

    I cant say anything about Chicago but I can about Dr Latkany. I went to him once, Im about 5 hours away from his White Plains office. I got a lot out of the visit and have followed up with him a few times. He has spent at least 20 minutes on the phone with me knowing I probably wouldn't come back to see him. That said, I have an appt with him at the end of the month again. Anyways, if you aren't completely satisfied with your local docs (I sure wasn't) then by all means make a single trip to see him. I even paid cash because the stupid HMO wont cover him, which sucks...but I can't keep living like this so its worth it. Also if you haven't read his book, check it out too.

    bassfan

  3. #3
    Join Date
    Oct 2006
    Location
    Portland
    Posts
    192

    Lightbulb

    Hi,

    Your problem is similar with mine. I have zero Schimer scores in both eyes, but TBUT is 10 sec. I use upper and lower plugs -flow controllers. I have MGD/ocular rosacea. It's very difficult, and now I am looking into moisture chamber glasses. I also had many failures with restatis.
    Could you tolerate restatis?
    BTW, you'll find a few good doctors on the forum.

    All best,

    George

  4. #4
    Join Date
    Jan 2005
    Location
    Poulsbo, WA
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    Hello dryasadesert and welcome.

    This forum (and all of the others except the Q&A) are patient discussion forums. If you would like a response from Dr. Latkany please post in his Q&A forum after reading the guidelines.

    Glad you found us, and hope you find all the info you need here!
    Rebecca Petris
    The Dry Eye Zone

  5. #5
    Join Date
    Jan 2005
    Location
    Poulsbo, WA
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    ...By the way...

    How long have you had this condition? Was it sudden onset or gradual?

    Any medications (ocular or systemic)?

    Any environmental changes around the time of onset? New home, new job, new office, new car, anything like that?
    Rebecca Petris
    The Dry Eye Zone

  6. #6
    It has been a problem for close to 7 years, but it is clearly getting worse. I am not on any medications other than the Lotemax and Restasis, which I don't appear to be tolerating well. I was on restasis for 3 months at one point and it didn't help much...it was pretty strange in that my eyes wouldn't hurt after putting it in but would sting really bad midday so I assume I am reacting to it.

    Other than that:
    No systemic medications
    No allergies
    No eye trauma
    Eat healthy
    Drink a ton of water
    Exercise

    That is why it is somewhat perplexing to most doctors I see.
    I reposted my initial post. Thanks, I didn't see that forum when I first signed up.

  7. #7
    Join Date
    May 2007
    Location
    Deerfield, IL
    Posts
    16

    From Chicago also and unresolved problems

    Hi I am in the midst of figuring out what is causing my inflammation / dry eye but I have a very complicated case. I see my rosacea has spread to my eyes but because I had episclertits that turned into sclertits after giving me Vigamox my doctor put me on Pred Forte and I have been going on and off it mostly on unfortunately. Trying to just do one dose today.

    I am also on Restasis. The doctor who is helping me saved my eyes 19 years ago when I had Stevens Johnsons syndrome which really complicates dry eye syndrome as my cornea is full of scarring from that awful allergic rection and I already had some but not inflammatory dry eye or episcleritis before this year.

    I have gone through autoimmune testing and fortunately everything came out negative but not being able to get completely off of Pred Forte worries me; I have been on it since May which is also allergy season. I am pursuing allergy, dermatology, and opthamology solutions as with rosacea and allergy they don't know what is causing thei inflammation which started so suddenly as episcleritis is usually a symptom of an autoimmune disease.

    The dry eye remedy book and this site reallly helped me and especially the Panoptyx which I got through my eye doctor. Through my eye doctor I was able to get them to order special high index ones. They don't fit perfectly as I was limited to 1 or 2 styles but I can be outside. My dry eye was so bad and scary with the episclertits any breeze was a threat to my eyes. Thank goodness they make Panoptyx.

    However, I am seeking another opinion on Wednesday with Dr. Macsai who is in the dry eye yellow pages. I see the rosacea bumps have spread to my eye lids and I am the one who mentioned rosacea to all the optometrists and opthamologists. I can't help feeling my tear ducts are really plugged from it. They are so much better after doing the rice bag heat treatments followed by massage and cold nonpreservative drops, but it doesn't last long. I need to have a doctor who looks at everything and really takes their time.

    I learned more from this site and the Dry Eye Remedy book plus my own research than from the physicians.

    Let me know how your doctor is.

  8. #8
    dryasadesert, it seem like I have very similar problems to you. I have been on Restasis for a couple days, and i can't get past the burning in the afternoon. Plus my eyes are all red and irritated. My eye doctor did the AMT surgery on me a year ago, thinking cinjunctivo chalasis was the proplem, well it wasn't. I know this because my eyes still bother me and are red. So now he is thinking it's MGD. i don't know if I agree with him. He seems to always be changing his mind.

  9. #9
    The doctor I saw was not too sympathetic. He plugged my uppers because my Sch. tests were 1 and 2, which I already know. I have had these plugs before and they have not offered any help, but he wanted to do it anyway. I have pure aqeauous deficiency (which I knew) but he couldn't attribute it to any root cause. He said typically they don't "go on fishing expeditions" to find the root cause.

    He offered no suggestion as to why restasis hurts several hours after instillation for me. Looks like I am off to NYC to see Dr Latkany.

  10. #10
    Join Date
    Jan 2005
    Location
    Poulsbo, WA
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    If you (and Dr. Latkany) will forgive my facetiousness, whaddya suppose the odds are he'll agree that you have "pure" aqueous deficiency with no traceable cause....!
    Rebecca Petris
    The Dry Eye Zone

  11. #11
    I agree...I felt like jumping out of my chair and punching him.

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