Questions about dry eye...

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Questions about dry eye...

Postby etess » Sat Mar 17, 2007 3:41 am

Hello...I've posted under the topic of dry eyes after lasik, but wanted to start a new post. I have some questions for those people who are experiencing dry eye.

1. Do your eyes show any indication of being dry. Meaning...would a person talking to you think you had a problem with you eyes? Do the look red? Puffy? My eyes LOOK healthy. I was just wondering if maybe I am overreacting!

2. How long after you wake up does it take to get your eyes feeling better? I take a shower immediately after waking up. This helps! In fact...the only time my eyes feel good is when I'm in the shower!

3. Does your dry eye feel like you have contacts in? Do you ever have pain? At times, my eyes feel like I have contacts in. Then in the afternoon/evening I can experience pain. Typically, the pain is in my right eye. There is a definate difference between my right and left eye with respect to dryness. Anyway..by pain I mean that it feels like something is pushing in the corner.

4. And for those using restasis....when did you start to feel a difference? I've only been using it for 2 weeks...so I know I have a while before I'll feel an improvement. I just hope that I eventually DO feel an improvement.

5. Is there any way for doctors to SEE if the nerves have regenerated? And if so, to what extent?

Thanks!!!
etess
 
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Postby etess » Sat Mar 17, 2007 3:44 am

Also...one more thing.....

6. For those of you with all 4 tear ducts plugged....do tears drip down your cheek ever??? When I had the ducts plugged a week before surgery...my eyes were tearing terribly. I would expect that my tears wouldn't drip down my cheek now that I have dry eyes....well...I had moderately dry eyes before. Anyway...the doctor wants me to keep the plugs at least until the one month mark....and I'm at 3 weeks post. I was just wondering if it's a POSITIVE sign that I do drip...even if only a little? Does that mean my nerves are regenerating?
etess
 
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Postby Betty39 » Sat Mar 17, 2007 5:02 am

Hi etess,

My eyes look fine, not red or anything. Occassionally they will look slightly irritated. Not as much now as in previous months. No one looking at me can tell they are dry. My eyes look healthy and even the doctor said they don't look as dry as they feel to me.
My right eye is drier than my left.
I sleep with Genteal Gel in my eyes and usually put some more in in the middle of the night so when I wake up they don't feel too dry. My best hours are in the morning. If I don't wake up to put more gel in my eyes then yes, they feel very dry. But as soon as I lubricate them they are better.
I wouldn't say they feel like I am wearing my contacts, but I get that feeling of something bugging me like something is in my eye. The pain I feel is a burning/stinging sensation. I'm not sure why yours feels like pressure pain in the corner, I would mention that to your doctor.
I have been on Restasis I think a month now. I feel it working and started to after about 2 weeks or so but this week I am really feeling it working. My doctor also put me on Lotemax with the Restasis to help it work faster. I think you will feel an improvement as time goes on but you are still really early in the healing period. This whole condition seems to improve VERY SLOWLY. I know it's maddening.
I don't know if doctors can see the nerves regenerate. Glenn will answer this better. It's more about corneal sensitivity returning than the nerves fully regenerating. And as Glenn will tell you corneal sensitivity usually returns in the 6 month healing period.
I have had all my ducts pluged and tears have never dripped down my cheeks. I think having the tears drip down your face probably means that the plugs are doing their job and the quantity of your tears is relatively good. Maybe it's the quality of your tears. Again a question for Glenn.
I wouldn't be so concerned about the nerves regenerating. It's the corneal sensitivity that tells your glands to make more tears and again, that takes about 6 months.
The restasis is really helping me now and I feel very relieved. I still have dryness but now it is something I can cope with. Before I literally felt like I was going nuts. They were constantly dry. I know what you are going through. I know it's hard (believe me I know) but we have to be patient.
You are not alone :)
Betty
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Postby peakaboo » Sun Mar 18, 2007 4:14 am

I had lasik about 7 months ago and had some pretty severe dry eye, similar to what Betty has experienced.

i'm in my 4th month on Restasis and am really starting to see the effects of this medication kick in, although I did experneice noticeable improvement after the first month, my eyes are finally starting to feel normal again. Some days are worse than others, but just recently I've not even thought about needing drops other than the twice daily Restasis.

Dry eyes, in my opinion, is similar to when you're wearing contacts that are dry and irritating. I've had some minor pain, but it is infrequent and is more like a slight throbbing than acute pain. I had some swelling/puffiness around the eye for the first few months after surgery, but it seems to have subsided now. I'm guessing it is more from the suction ring and the clamp to keep the eyes open than from the actual flap creation or effects of ablation.

My eyes feel dry when I wake up in the morning, but nothing like they used to be. In the first few months after surgery, I found myself waking up a few times a night due to extreme dry eye. Now I sleep right through the night and it takes about 10 minutes until my tear film gets going in the AM. The shower always helps, and once I put the Restasis in, I'm good to go for the rest of the day.

To sum up my dry eye experience to date:

1. First few weeks post op - not bad due to frequent use of drops.
2. 2-3 months post op - extreme dry eye, especially at night.
3. 4-5 months - Started Restasis...noticeable improvement, but still dry episodes.
4. 6-7 months - Restasis really kicking in...much better. Still a little dry, but don't need drops during the day and don't wake up in the middle of the night.

Keep in mind I take 3 1000mg flaxseed oil pills each day and have a humidifier going at night. Also, at 7 months post op, my corneas seem to be healing naturally, so the improvements are probably a combination of the Restasis, the natural healing, the flaxseed, the humidifier, etc. Can't say which one is causing the biggest impact on resolving the dry eye, but I wouldn't be surprised if it's simply the natural healing process at work...maybe the corneal nerves are beginning to regenerate and everything else is just a fluke. Who knows for sure.

I'm glad I had the operation...much better than dealing with contacts every day. =)
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question

Postby mowchowch » Sun Mar 18, 2007 4:47 pm

peakaboo,
With the dry eyes that you have experienced, has it just been uncomfortable or has it also made your vision difficult also? I had my surgery Jan 18, lasik with flap. I have dry eyes and was started on Restasis at my one month visit. I dont feel so uncomfortable with the dry eyes...but my vision been very poor b/c of it. Now I've been on the Restasis about 5 weeks....I have noticed improvement in my vision...but still having difficulties. You mentioned that you are feeling better in your post. I was wondering if your vision has also improved?
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Postby peakaboo » Mon Mar 19, 2007 2:53 am

My vision is not perfect by any stretch of the imagination, but it is not bad either. I think I have regressed a little bit since the week after surgery, but I'd put my vision at about the 20/25 line. Prior to putting me on Restasis, my doctor tried the standard vision test with lenses ("which is better one or two") to see if he could correct my vision post-surgery but nothing he did improved what I could see on the eye chart, so I definitely lost BCVA vs what was achievable with contacts or glasses before the surgery. I'm pretty sure he attributed this to corneal swelling in addition to dry eye, which is why he has me coming back avery 2 months to check my progress.

I see pretty well but not perfect. Maybe some of it is due to dry eye, some may be due to regression, and some maybe attributable to the ablation settings - undercorrection (I had customvue intralasik - no blade). I still see starbursts at night, but not quite so bad as right after the surgery. I attribute my night vision problems to extremely large pupils, in addition to a small amount of residual myopia. It might get better after another 6-12 months of healing, but then again, this may be as good as it gets for me. If it doesn't get better, I'm still happy with the results. I was -6.5 in both eyes originally, so this is pretty miraculous in my opinion. It's possible an enhancement could improve my vision a little more, but I'm not sure messing with the flaps is worth the risk at this point, considering I've had such a rough time with the dry eyes. We'll see what the next few months bring...
peakaboo
 
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Postby mowchowch » Mon Mar 19, 2007 9:26 am

THanks for the response. My eyes are better than they were also. But often my vision at 10-40ft in a room is difficult. Oddly however further distances when driving is fine. I am hoping that it continues to improve. I really hesitate on enhancement also b/c of the flap and dry eyes. If there is any healing that is happening with the nerves..I hate to start all over again. The Restasis has helping...thankgoodness this med exists.
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Postby etess » Sat Mar 24, 2007 3:41 am

Thank you everyone for your posts! I do appreciate your input. I haven't logged on all week as I've been sick. Pretty interesting, actually. On Monday, my eyes felt great! I realized that they didn't feel dry! Then by the end of the day...I realized why. I had come down with a cold and was just draining...my eyes AND nose. So, I was sick with a bad cold all week, but my eyes felt better. I guess because they were tearing so much from being sick.

I am feeling better now...and happy to say that my left eye feels GREAT! My vision is wonderful (in my left eye) and it doesn't feel dry at all! My right eye is another story!

My right eye is still dry....but not like last week. Also, my vision in my right eye is not as sharp as in my left. It's noticably different. I don't know if my left eye got better...or my right eye got worse. Or, because my left eye isn't dry anymore, the vision got better. My right eye still being dry may be causing my vision to be less sharp.

I go for my one month check up on Monday. I'm anxious to hear what they say.

I still haven't worn makeup...but since I do feel better than a week ago...I hope that I will be back to myself soon. I have to say that I DO feel better seeing some improvement. Gives me hope.
etess
 
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Postby mowchowch » Sat Mar 24, 2007 3:24 pm

This morning I was at the grocery store and couldnt believe how clear my vision was. I suspect my vision will slowly worsen as the day goes on and my eyes become more dry. I also feel some hope that eventually..even if it's not for months...my vision will improve. These few hours of clear vision is what I need to feel encouraged.
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Postby tiggy » Sat Mar 24, 2007 3:40 pm

http://www.dryeyezone.com/index.html

There is a great site devoted to dry eyes. They have a forum also.
Hope this helps!

Tigs :D
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Postby Betty39 » Sat Mar 24, 2007 6:57 pm

Thankyou for that website! It was very interesting. And I was happy to see that of all the posts I read only one person there mentioned their long term dryness from Lasik. That was encouraging.
As for me, I feel continual improvement. Restasis for me was a life saver. I never feel/felt any burning from using it which I am very happy about. It feels like I'm just putting in regular eye drops. And speaking of them, I am down to only 2 times a day, maybe 3 if it's a dry day. I can't tell you how much of an improvement that is! The corneal specialist gave me a year prescription. I don't know how long he will have me on it but I really don't care. Putting in the drops is no more of an inconvienience than hassling with contacts every day, in fact less so. And the vision I now have is sooo much better than I ever saw in my contacts.
Dare I say.....I am beginning to be glad I got Lasik! Hopefully now things only get better.
Betty39
 
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Postby etess » Sun Mar 25, 2007 3:07 am

Betty - I am SO glad to hear that the Restasis is working well for you. It's nice to hear some POSITIVE! :-) I have to say...that your posts over the past month have really helped me. From the week before I had Lasik...until now. I appreciate your input/thoughts. Best if luck to you!
etess
 
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Location: PA

Postby Betty39 » Sun Mar 25, 2007 3:43 am

Thankyou Etess! This is an amazing forum and as I have expressed before, I don't know where I would be if I hadn't found it. I am sure it has helped countless others get the relief they need. Literally, every helpful thing I have found has been from here.
Good luck on your continued improvement!
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