Ups on Downs with Dry Eye during recovery

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Ups on Downs with Dry Eye during recovery

Postby johnny_F » Mon Aug 11, 2008 5:24 pm

This has probably been posted a thousand times on these boards, but I was hoping to get some opinions from people about this.

I am now about a week and a half shy of 3 months post op (wavefront Lasik) and my dry eye symptoms have been all over the map. For the first few weeks I had very mild to no symptoms and thought I was in the clear. At about the 3 week mark, they began to sting and burn and feel very dry and the artificial tears did little to help. This only lasted a couple weeks, then it was more of a mild tolerable dry eye feeling. They slowly felt better and better over the next few weeks until about the 9 week mark when they started to get worse again. Now for the past couple of weeks they are again dry and burning quite often (every day) and can get really itchy. I am also noticing that in the mornings they are dry like they were in the mornings during the first few weeks. Obviously I am getting concerned over this and don't expect to get much information (the usual this is normal routine) during my 3 month follow up next week.

I've heard people talk about bad days and bad hours, but has anyone had an experience like this.

Hope to hear your thoughts.
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Postby LasikExpert » Tue Aug 12, 2008 3:28 am

Many have had experiences like you describe. The tear film is a gentle balance of three layers of lubricants. A bit of inflammation and the flow can be limited or even turned off. Confused nerve signals can send the wrong message.

There are also all the other environmental and other issues that have nothing to do with Lasik. Air conditioning is a dehumidifier and can contribute to the problem. Long hours at a computer can be problematic. Allergies come and go. Different medicines over the counter and prescribed can affect dry eyes. Don't look just at Lasik as the cause - it may only be contributing.

Be sure to read our article about dry eyes after Lasik.
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ups and downs with dry eyes

Postby dinoparker » Thu Aug 21, 2008 6:37 pm

I have experienced the same thing. I had Lasik on May 6, 2008 and the first month was very smooth. I used my drops, but no real bad dry eye symptoms. Then around the middle of June, the dry eye problems began, even my eyes getting sore. This gradually improved, but I still have to use the drops often (I work on a computer) to prevent the stinging and burning. My doctor has prescribed Restasis which I have just begun to use. My only fear is that this will be a permanent condition after I have read some of the horror stories. I would like reassurance that this will eventually resolve. Does the fact that the first month post op was so smooth give me any encouragement??
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Postby LasikExpert » Thu Aug 21, 2008 7:36 pm

Transient or temporary dry eyes is a relatively common complaint during the first few months after laser vision correction. In the vast majority of cases, the problem resolves.

To give you some perspective, I referenced the USAEyes Competence Opinion Relative to Expectation refractive surgey patient survey. Looking only at those patients more than six months postop who replied that their dry eyes were "Worse than expected" or "Much worse than expected", 88% would definately have surgery again knowing what they know now, 22% would probably have surgery again knowing what they know now, 12% are not sure, 2% would probably not have surgery again, and 3% would definately not have surgery again.

This may give you an idea of the odds you would have long-term dry eyes that would wish you had not had Lasik.
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3 month follow up today

Postby johnny_F » Fri Aug 22, 2008 1:14 am

I had my 3 month follow up today and I was told there were absolutely no dry spots and everything looked good. This was encouraging and helps make staying patient a little easier. I find it a little strange though, as they feel dry, but aren't dry? Perhaps this is a good example of the confused nerve signals.

I also think that working in the office makes it much worse. I spent 4 days on the lake this past weekend with the sun, wind, swimming and all, and they didn't bother me. I also notice in the office they are more red then normal. Using drops keeps it in check, so I will stay optimistic for now.
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Postby LasikExpert » Fri Aug 22, 2008 1:59 am

Let me guess, you use a computer all the time in your office. Computer work is notorious for causing dry eye problems, along with air conditioning.
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Postby johnny_F » Fri Aug 22, 2008 2:08 am

That is true, and is no doubt the worst factor, however I never had any problems working on the computer in the office before. Hopefully with time they will be more tolerable, as I won't be retiring any time soon!
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dry eyes, plugs and starburst

Postby eyebright » Mon Sep 01, 2008 2:08 pm

hi i would like to offer you some reassurance. i had wavefront just over a year ago. i suffered terribly with dry eyes and medium starbursts around some lights. the whole thing made me feel very depressed and frightened that i had done the wrong thing. i was back and forth to my surgeon trying different drops and had plugs fitted. they popped out and i just thought things would never get better. but then one day at about 6 months i started to notice an improvement i managed to move off preservative free drops( very expensive) on to their equivelent with preservative. now i never use drops my eyes are good, i still have some starburst but not enough to ruin my life. things do improve but the percieved expectations of lasor eye surgery make us expect instant perfect results with no problems. certainly the friends who'd had it told me it was great only to remember later when i was asking about my problems that infact they'd had some problems too. keep in mind youve had your eye cut open, burned with a lasor and the flap replaced. hardly the stroll in the park its painted as in tv adverts. i would also like to comment that here in england we are given a 2 week course of anti biotic eyedrops and preservative free eyedrops. at no time was i ever offered steroid drops. is there a reason for this? what benefits do they offer. good luck to everyone who is struggling it can get better just dont lose hope.
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Postby johnny_F » Tue Sep 02, 2008 6:44 pm

Hi eyebright. Thank you for your reply. This kind of reassurance goes a long way. My situation actually sounds a lot like yours. I also have medium starbusts around lights at night, but nothing debilitating. I can drive a night with no problems, and otherwise they are more of a nuisance then anything else. The more I forget about them, the less of an issue it is, so hopefully they don't get any worse. My dim light pupils were measured at 8.3mm and my ablation zone was 6.6mm, so this seems to be what's causing my problems. I asked the tech about the blend zone and she didn't see anything in my file about it. I had the B&L zyoptix, so I assume there was a blend zone created given my pupil size and corneal thickness. I also have a mild ghosting effect in my left eye, but that is only noticeable when close my right eye and focus on something like a digital clock. All in all, them more I put these issues out of my mind, the less noticeable they are.

I have since moved to a new office and have found it much more comfortable. Maybe it isn't as dry, or there isn't as much air circulation. The past few weeks have been encouraging. I am to the point now where I am only using drops at night and first thing in the morning. Other then that, I may use them occasionally if they feel dry, but its been rare, so all in all, i've been happy with that progress, and feel certain that it won't be a long term issue.

My only other complaint are the floaters, which I noticed a few days after the surgery and have stayed around. There are quite a few of them, but only noticeable outdoors in bright daylight. I can live with them. However, reading about how they possibly occur from the suction ring, it makes me wish i took the PRK option more seriously. The doctor practically dismissed PRK, since I was a candidate for LASIK.

You are definitely right about the perceived expectations of laser eye surgery and how we expect instant perfect results with no problems. This is what makes the aftermath so difficult. sure I can see 20/20, but it is not the miracle I expected. I too had spoken with about a half dozen friends / colleagues who were thrilled with their results and didn't have any complaints, only to find out after the fact that they did have a few side effects. In the end, after reading other people's stories, I actually feel quite lucky with my results. Things could be a lot worse.
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Postby LasikExpert » Tue Sep 02, 2008 7:55 pm

johnny_F wrote:However, reading about how (floaters) possibly occur from the suction ring, it makes me wish i took the PRK option more seriously.


Patients with PRK remark about floaters also. In addition to the pressure releasing or stirring up floaters, there is an argument that the change in the optics can make them visible when with your old error they were not noticed.
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Postby eyebright » Wed Sep 03, 2008 5:02 pm

LasikExpert wrote:
johnny_F wrote:However, reading about how (floaters) possibly occur from the suction ring, it makes me wish i took the PRK option more seriously.


Patients with PRK remark about floaters also. In addition to the pressure releasing or stirring up floaters, there is an argument that the change in the optics can make them visible when with your old error they were not noticed.

hi johnny f glad things are improving your right about not dwelling on stuff too much and i definately think your brain makes adjustments as any mild staburst i see now i tend to notice after about ten other things, like the lights on red or what i'm having for dinner! as for floaters i didnt notice them for a couple of months and i do get them but they come and go. I do remember getting a few before surgery but like the starburst they are a minor event now good luck mate take care x
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Postby boston » Fri Sep 12, 2008 5:26 am

Hi, I would DEFINITELY use Genteal Gel EVERY NIGHT before bed. It helps keep the eyes hydrated, heal well, and dry eye symptoms stay away. When this happens the eyes can heal better.
This is something that is hardly ever mentioned here, but is really important!! Especially while your eyes are trying to heal. Dry eyes do not heal well, but well hydrated eyes are healthy, hydrated, feeling good, and have a higher capacity to heal.

Peace, and good luck!

ps. Also, there are masks or goggles that people can wear at night to help even more if you still wake up with dryness.
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