Hazy Vision/Light Sensitivity/Dry Eyes?

[Laura__0__0]

Posted by Laura on August 02, 1999 at 14:12:35
Dear Doctor.  I am in such a mess here.  I posted here prior describing my symptoms that started in April, 1999.   Sunlight first, hazy vision and then Dry eyes. I started having pains in my left temple first so the doc put me on celebrex/baclofen combination.   Have no idea if these meds were the culprit but i soon got off them.  had lots of blood work , Sed, ANA, SSA-SSB, Glucose, thyroid, B12.  All negative except the TSH was 13. Hypo, I guess as the T3/T4 were normal. B12 was a lil low.
I saw my regular eye doc and he gave me cyclos a new waiting for FDA approval med.  No help. My GP sent me to his friend.  The OD does everything (not the MD) and looks into your eyes and declares if the nerves are OK or not.  This OD put temp. plugs in the bottom lids only.  Got no better.  I e-mailed you and saw a cornea specialist as you suggested.  The Baylor doc I saw did not do another eye exam.  She did a shirmer's and it was 6 in one eye and 5 in the other. An OD did an eye glass exam and changed the glasses.  She put me on Acular and told me to wash my eyes out with diluted warm babyshampoo.  No help and this burned like &^$%#&!!!!  I called her office and the OD Rx'd. tetracycline pills over a months span.  Still no help.  Went back and saw her and she has no clue what is happening. Still no dialated eye exam. The OD did do a glaucoma test which was 19 and 20.  Now, she wants me to see another Cornea specialist with this group.  I am beside myself as lots of valuable time has passed and I feel I am getting nowhere.
Should I just throw in the towel and say this is normal for my age (56) and suffer with this..or should I call another Cornea Specialist.(not Baylor)  I feel I will not get the care I need from another Baylor eye doctor as he will not certainly go against her.
They did change the stigmatism reading again in my glasses from the one they put in a month earlier.  Another 50.00 for this mistake. Not happy here and scard to death.  
What questions should I ask?  Am I too nice to these people that they do not take me serious?  Please advise my next step.  Do you know anything about Herman UT eye center? Can they plug all eyes..meaning top and bottom?  Can a eye doc see diseases in an eye if they just look in them? My insurance can take me anywhere and I wish she had dilated my eyes last month and looked. I have not had visual field testing done as the Baylor OD said you have to have high pressure readings for this. Can Visual testings yield more?
I am so tired of this.  
Thanks you for listening to this frightened hazy vision female.

Posted by hfhs md ke on August 02, 1999 at 15:13:12
laura-
i have to say your comments are "all over the board". what i mean is that u seem to be addressing dry eyes, yet you wonder why u have not had a visual field test for glaucoma. i really believe that at this point, after all the people u have seen, that it would not do u much good for me to randomly suggest u see another "eye doctor". what i would advise u to do is to ask around with friends and family and find out who sees an ophthalmologist that they consider caring and patient and see them.  u obviously need someone who is willing to take alot of time and energy with you. if u were in cincinnati, ohio i would have just the doctor for u. and of course, If you are interested we would love to see you here at Henry Ford Eye Care Services.  Simply call 1-800-363-7575 for an appointment.  good luck with everything.

Posted by Laura on August 02, 1999 at 16:18:10
Dear Doctor.   thank you for your input.  Unfortinaltey I do not live near Cincinatti.  
I will not subject myself to another eye doc here and I quess I should be thankful that I can see whether blurry or not. Some folks have no sight at all.
Again, my thanks.
Laura

Posted by John on August 03, 1999 at 18:40:40
First of all, DO NOT GIVE UP !!! There is obviously something wrong, and you certainly are right in wanting to find out what it is. Sometimes this can be difficult, but at the very least, you need treatment to alleviate the symptoms. I also have dry eyes, and often this condition can cause a range of other symptoms.
Dry eye can be made worse by a condition called Blepharitis, which basically means an infection of the eyelids through the eyelash follicles. Treatment for this is generally antibiotics and washing the eyelids and eyelashes with baby shampoo. Sound familiar ? You should ask your doctors if they think you have Blepharitis. Generally indicators of this condition are slightly red eyes in the morning (which improve as the day goes on)and some form of matter developing on your eyelashes - especially evident when you wake up. If you don't have these conditions, it's unlikely you have Blepharitis (at least in any form that would be causing you trouble).
It is possible to get all four puncta (eyelid drains) closed. Best method is generally by the use of silicone plugs. These are removable later on if need be, but - if properly fitted - are considered a permanent closure of the ducts. This may still not put an end to your dry eyes. Even with the puncta closed, you may also need to use artificial tears. The best tears are those that do not contain preservative (which can be toxic to the eye if used for a long time). Try Theratears, Cellufresh or Biontears.
If the eyes get too dry, the cornea can start to change shape a little as it dries out. This could explain the slightly hazy vision (but there may also be many other, unrelated reasons for this). If the pressure test shows normal pressures, it means you probably don't have glaucoma, although there are some types of glaucoma that cause the pressure to fluctuate. This can be difficult to diagnose with a pressure test unless you happen to be tested at one of the times when the pressure is up. Certainly, your specialist is able to check your optic nerve visually, to see if there is any damage to it. But if you want a field test, or a dilated retinal exam, then tell your doctor that is what you want. YOU are your primary health care provider, not your doctor !!
Light sensitivity can be caused by a numner of things, too. Iritis is one cause.

One final comment - it is apparently not uncommon for women in their 50's to get dry eyes - it is a part of the ageing (aging) process, and for hormonal reasons, it appears to be more prevalent in women than in men. But that doesn't mean you have to put up with it. I hope this has been of help. Good luck in finding a doctor who will be able to work through this with you.


Posted by Lena        To: John and Clara...Thank You on August 04, 1999 at 00:22:31
Thank You very much for the most encouraging words.  yes, my eyes have so much matter in them. I have great difficulty closing them as it stings and scratches to to put the lids down.  There is reddness on the whites of the eyes also.  i cannot read the paper and can barely make out TV so I sit with a cloth over my eyes.
I was tested for Sjogrens but came back negative. Two of the eye docs (MD's) I saw in the past few months did not look into my eyes.  They have OD's to do this and the Od's make the call and then the MD comes in the room to tell you.
I feel I have been slighted in this respect when an MD should of been the Captain of the Team and not an OD.  
My husband (bless him) called another Eye Center and tomorrow I see them.  They called me and I did tell them that if I cannot be dilated and seen by an MD, I will not come there.  They assured me I would be there for at least 2 hours.
John, I feel there is infection/inflammation. Was on Cylosporin for 2 months.  No help.  I am getting worse and this is frightening.  God Bless You and Clara for the wonderful support you have given me.   I will post again.


Posted by John on August 04, 1999 at 03:58:07
From what you say about the mattering and the redness of the conjunctiva, you definitely have an infection. It is most probably Blepharitis and it may have spread to the conjunctiva as chronic conjunctivitis. Add to that your dry eye problems, and that may be the cause of your discomfort and visual problems.
If you have constant mattering being produced and flowing around on the surface of the eye, then this will certainly give you hazy vision.
If I was you, I would have all four puncta closed with silicone plugs, go onto a strict regime of using artificial tears as frequently as needed (even if that means one drop every hour)and use antibiotic EYEDROPS for the conjunctivitis/blepharitis - drops will work much better than pills for this type of infection.
By all means, have your dilated exam, field test and pressure test - but I strongly doubt that you have glaucoma.
Please let me know how you get on.
Posted by LauraL. TO: Henry Ford Cornea Doctor and John on August 04, 1999 at 15:52:26
Today, I saw another Cornea Specialist. Both corneas are  damaged by the severe dry eyes. Not a happy Camper here as I have tried very hard to get good help in the past 4 months.
he said I had Meibomianitis (sp)and RX'd Microcycline 100mg. and Erythromycine Opth.in a tube for night time.  Must not use the baby Shampoo that the other cornea doc told me as it is too harsh on my eyes.  I have to us 1.2tsp. to a qt. of warm water and use several time per day gently on the eyes and he told me that I must follow these instructions to a tee.  Surpiringly, the shirnmer's test was down to a one on the left eye but was up to 8 in the right eye from one month ago.  Previous it was a 5 in the left and a 6 in the right.  
I have to return in 3 weeks and he wants to do a permanent punctual occlusion in both the lower lids. This he will do via surgery with his hands and no plugs of any sorts.  He is doing this himself.  He said the damage is there now but he has seen his patients improve by this method.  I am a bit frightened as I hope thre is no underlying correctable probelm causing all this.  This doc seems very sure of himself. No nonsense type. he did ask me if I had ever had a lip biopsy for Sjogrens.  I had blood work for Sjogrens.  My mouth is not dry. Just the eyes. He also asked if I had been worked up for Rheumatoid Artheritis.
Had most of this also.
Question:  please tell me about this permanent punctal occlusion vs. the silicone put in plugs? He is not using plugs as he will do this himself.  Any residuals, I should be concerend about?  I do have time to ask questions. (3 weeks)  I wonder since the left eye is the worse if not an MRI/CT scan would be in order for that area.
i Thank You.   LauraL.  Pls. excuse grammer errors. Cannot see!
i thank you both.  

Posted by John on August 04, 1999 at 19:42:29
I'm pleased that you have finally found a doctor who seems to know what he is doing !!
I presume the 'surgical' method of punctal occlusion he is talking about is cautery - basically this means (painlessly, I'm told) searing the opening of the puncta, so the skin there actually 'melts' a little and closes the opening. This if often very effective. However, I do know of people who have had to have this procedure several times, because the puncta have opened up again. This may have been because the doctor doing it didn't do it correctly, I don't know.
My personal preference is for the silicone plugs, which work well for me.
You really have two problems - the infection, and the dry eyes. Once the dryness is fixed, then hopefully your corneas will repair themselves, and your vision will no longer be hazy.
Do bear in mind that, even after the punctal occlusion, you will most probably still need to use artificial tears.
I hope it all works out for you.

  

Posted by LauraL. ...Thanks John on August 04, 1999 at 20:49:25
Wanted to metnion one more thing.  This Cornea doc wrote down Thera tears for me also.....just like you mentioned last night.  you need to hang your shingle out.   We are going to ask this Cornea doc about the silicone plugs.  I am really leaning toward this instead of the other...but this eye doc is firm in his convictions. Hate to mess too much with him..Hubby will have to do this and I will hide.
Thanks again.   We are hoepful now.
Posted by hfhs md ke on August 04, 1999 at 22:48:55
laura-
is john an MD??? sure seems to know alot- but as an MD i must warn u-  be careful taking advice-  for instance u do not have to havean infection just because your eyes are red and matter alot-  those are also signs of dry eyes. in regards to the permanent closure- this can be done easily in the office and if your dryness is severe enough it is really the method of choice   remember u have puncta in your upper lids that will remain open and they can be closed later if need be-   the plugs are also an option but trust your doctor if u like him  sounds like he is on the right track.