Extreme Dry Eyes

I had my upper and lower eyelids done about 3 years ago and the plastic surgeon never asked me if I suffered from dry eyes, nor was I aware that this could worsen the condition.  I am suffering with excruciating pain at night that wakes me up during/after REM.  My eyes are so dry that it feels like someone is scrubbing them with a steel brush.  I use Rystasis twice daily, my tear ducts have been plugged, I use Oasis contact lenses (I've been advised against lasic surgery), I lubricate my eyes with Genteal Gel at night, lubricant for contact lense user in the daytime, drink some water (never drank much anyway) and the problem persists.  I have been to many dry eye specialists including the Bascom Palmer Eye Institute and it seems that they do not have any more suggestions than what I'm presently doing.  What else can I do?  Am I running the risk of eye injury due to this? Eyesight loss?  

[James J Salz, M.D.]

You have an extremely severe case and you are doing everything you can so far but you can investigate a couple of more options.  At times the Restasis works better if you also use a mild cortisone drop like Lotemax for about 3 weeks, especially good to do this when you first start on the Restasis. You should also have your tear ducts plugged and perhaps even closed with cautery. If you live in Fl I would go back to Bascom Palmer and perhaps try to get a consult with Dr. Sonia Yoo.  You may also respond to oral medication containing Omega fatty acids availabel over the counter.  One is Hydroeyes and you need to take at least 4 per day and as with Restasis it takes a few weeks before you might notice any improvement. You are correct, you should not have LASIK.
JS

[Beile]

Thank you very much for your reply.  I will certainly ask my dr. (I see Dr. Kendall Donaldson at the Plantation Bascom Palmer Institute who is the dry eye specialist but I can request Dr. Sonia Yoo) regarding the Lotemax, as I assume I will need a prescription for that.  I have been on Restasis for about 8 months now and although it's about 20% better from where I started, I expected the problem to be much better than it is.  I have had my tear ducts plugged but not closed with cautery.  I will ask my dr. about that as well, thank you.  Do yo also suggest not wearing contact lenses for awhile?  Would that help?  

[Bevee]

A related discussion, Dry Eyes was started.