Can Dry Eye do all this?

[frwbeach]

   Simple question ( not really )

Can Dry eye casue poor visual acuity ( 20-50 corrected ) -- light sensativity--pain- unbearable pain if I take sunglasses off on sunny day ( immediately -like two knives in the eye )-  cannot be on comp ( large monitor-large fonts ) --outside ( even with sunglasses ) or read large print articles - work with low vision glasses ( mag ) for more than an hour ??

I know it cause the burning and after trying about everything else at the Pharmacy- My new Doc has me using Celluvisc--can't see much at all when I use it but it really does work on the burning and pain . Tryed putting them in and went outside and didn't help there .

Can Dry Eye be that disabling ??????  I can't drive - can't read small print--can't even stand going to well lit stores for over an hour even with surgery sunglasses .

I have had  Capsolotomy both eyes--Catarct surgery both eyes -- torn, detached retina Rt eye ( buckle ) - Vitrectomy RT eye-- Laser surgery for suspect spots small tears and lattice degeneration
and Open angle Glaucoma . current Doc said they all combined- make dry eye worse--Do you concur???  ( all in last 14 months )

PS Tryed Restasis - a dozen or so drops ( Celluvisc only one that works )  test strips had to be peeled off resulting in a tear--oil film evaported in less than a second.  Oh almost forgot my new Doc found Occular Rosecea and treatments ( pills ) have improved red eye-red nose-red forehead after exercise-being outside- and at days end  . Still need Celluvisc.

Your thoughts please

Thanks

[John C Hagan III, MD, FACS]

Well you are quite a challenge. These are my thoughts.

1. You have glaucoma but you don't specify which drops you are taking for it. If you are on brand name or generic ALPHAGAN-P, LUMIGAN OR TRAVATAN these three medications can cause all the symptoms you are describing. If you are taking any of these three medicines you need to talk to the Eye MD that takes care of your glaucoma and get permission to stop them and see if over 2-4 weeks your eye gets better. If it does then you will need to try Trusopt, Azopt, timiolol, Xalatan or have a selective laser trabeculoplasty.

2. A severe dry eyes coupled with Rosecea could cause these. Be sure you are seeing a dermatologist and on a cream and oral tetracyclines.

3. Have your physicians test you for Sjorgren's Syndrome especially if you have a very dry mouth.

4. A dozen drops of Restasis is not even remotely close to being a trial. The modern trial of Restasis is minimum of 3-4 MONTHS on the medication and often it keeps getting better for 6 months then you need to STAY ON IT.  If often stings when you start and if it does ask your eye MD to prescribe a mild steroid such as FML, HMS or Vexol.

5. Use the search feature on this page, read archives and health topics about dry eyes. Lots of other information is present there. Humidify your home. Start Theratears Dry Eye Formula pills (over the counter).

6. Make sure from your retina surgery that none of the hardware is exposed (sutures, buckle, sleeves, exoplants). If so they may need to be removed.

7. Discuss with your eye MD putting in tear duct plugs in both lower puncta.

8. See a Corneal-External Disease eye MD physician for a review of all the above. Print this out and take it in with you. Ask about each point.

JCH III MD

[frwbeach]

The points listed were all valid and covered by my new Doctor--however they were not covered by previous doctors who wanted to blame everything on Glaucoma and treated it over aggressively. The reply gives me peace of mind with my current doctor--I guess my point is--if you aren't getting better or have problems--Get a second opinion--or in my case it took a few more than a second opinion.

[John C Hagan III, MD, FACS]

-----------------------------

[frwbeach]

Yes --
Reply to
1. Was  on a combination of  Travatan / Kosopt and Alphangan by Glaucoma specialist that I no longer see. New Doc took me off and  all is well with op"s now. Acuity improved also.
2. Doc put me on tetracyclines and  X treme red eye red nose and red forehead much improved  ( found out my sister has  been treated for it for years and never knew )
3. No dry mouth-took extra blood tests and Sjorgrens ruled out
4.  Was on Restasis for 9 months and no improvement.  ( I was on a dozen or so assorted drops for dry eye during that time in addition sorry )
5.Humidity is kept on  Moist at all times.  ( despite this when heat is on or AC on its nearly unbearable and drops less effective.
6.  My Retina and buckle is checked regularly and holes and tears around buckle have been repaired a few times. ( has looked good past 6 months )
7.  Seeing my new Doc in a week and will revisit plugs ( seems to be all thats left ) we discussed it in the past-- The strip test was bone dry and had to be peeled off resulting in a small tear it was so dry. My eye film evaporated in about a second- could actually see the film evaporate from outside in with the drops. Several Docs didn't know how effective the plugs would be--but will revisit .
8. Outside of some small abrasions and irratation ( from dry eye ) Corneas look fine and doc says to take drops as often as needed to keep from dfamaging the cornea ( first Doc to explain that- I used to let the burning go till I couldn't stand it anymore to take drops--now I do often .

  The post was very helpful and gave me peace of mind and reminded me to at least try the plugs as a last effort ( actually Serum drops were mentioned but he said if we could keep the pain and burning down with Celluvisc it would be much less exspensive than Serum ) maybe your input on that????

You have mentioned about everything  about a dozen doctors didn't do and should have- I would encourage people to use this forum as well as seek second opinions before surgery and if the results are not
positive to your treatment.
    
     Thanks so much!!

PS I just got back from my wifes Christmas party and it was unbearable- between the heat and then AC and all the fumes
I put in drops about every 15 min and was in agony most of the evening--If any Doctor ever says Dry eye is not a problem I am afraid I may get violent- I am home now in my moderately lit ( moist )  room -- put in Celluvisc drops about 10 min ago and my eyes feel heavy but
pain and burning free for the first time in hours.  I sure hope the plugs work and I can go out and enjoy things again.

[John C Hagan III, MD, FACS]

When you see you corneal next time you should consider having all four tear duct openings plugged and if it helps some you should consider having all permanently closed with cautery. This is an important therapeutic effort and I've seen it help greatly for dry eyes that were getting desperate.

Also consider Fish Oil roughly 1000 mgm three times/day. If it upsets your stomach use the enteric coated and start out with one a day for 2 weeks then add another with your morning meal. Work up to 3 pills/day. Consider also the TheraTears Dry Eye formula pills.
You can also use Genteal Gel or TherTears Liquigel during the day. It will film your eye up for a couple of minutes but worth it. Eat a fatty fish meal three times/week (salmon-it will also reduce the risk of Alzheimer's).

Good luck.

JCH III MD

[frwbeach]

Thanks so much for your quick and  detailed response. You obviously have taken your oath very seriously !!!  You have brought up a very interesting point   -Diet-  I had a consult with an assistant and she went over many things-- I take Omega 3 fish oil  1000 MG ( 4 a day ) and have done very well following her instructions ( vitamin supplements also )  I do not know if it has helped my eyes, I would imagine so--however my blood work was the best its been in a long time .( 10 years )

You have virtually covered points that it has taken several specialists and Doctors and over a year to address.  Your patients are very lucky
to have this knowledge and concern available.  

God Bless

PS the fish oil did cause a queezy feeling in my stomach so I started taking them with a tiny bit of bread and milk and have no problem.
Also the Genteal Gel has more of a cooling effect on my eyes but for me I think the Celluvisc has worked the best so far--I use the Gel at night because of the cool soothing feeling and Celluvisc during the day. Last evening  I took Celluvisc--Genteal Gel--Systane - Thera tears and nothing worked ( when I was at a  party ) once I got home the drops worked well.

[John C Hagan III, MD, FACS]

Well thanks. God bless you and good luck. I believe that plugging all four puncta will be a big help. Plus keep trying the new drops for dry eyes that are coming out all the time: Soothe, Systane, Optive.

JCH III MD