I need Help for Infrequent Dry/Fuzzy/Double Vision

I am currently 48, female, probably menopausal, large eyes.  I compete in equestrian show jumping and ride on a daily basis. Therefore, I am outside ALOT!  Anyhow, I've been experiencing this problem with my eyes for almost 6 years.  The first time I experienced it, I wore contacts.  It was in a competition and was somewhat windy.  I experienced fuzzy double vision when warming up my horse for the class and then when competing in the ring - Thank goodness I had a good horse!  I've been pretty much experiencing the same problem on and off from that time forward (it's inconsistant).  I tried OTC eye drops which gave me some relief from the dryness but not the disturbing occassional fuzzy double vision.  I tried wearing sunglasses & goggles - no help.  I also tried to ride/compete my perscription glasses - I still experienced the dry eye/double vision.  It was/is quite common to see me putting eye drops in my eyes before stepping into the show ring.  A couple of years ago, I had the Lasik surgery in hopes it would "cure" my ills - Lots of money later, I still had the problem.  Was treated for Blepharitis - no help.  Tried Restasis - no help.  I do seem to see better in the a.m. but by afternoon, my eyes have problems.  Unfortunately, the horse show class schedule doesn't accomodate my dry/fuzzy/double vision schedule.  Anyhow, after competing last week and experiencing the same problems, I'm going back to the doctor this week to talk about Punctal Plugs.  In the meantime, I have started on myself on Flaxseed Oil, Fish Oil and Currant Seed Oil.  I am quite concerned about my vision as I'm not quite ready to give up my equestrian lifestyle.  In the same token, I don't want to break my neck because I can't see what my horse and I am jumping.  Any other suggestions of what may help?

[John C Hagan III, MD, FACS, FAAO]

1. Be sure you ophthalmologist has done several Schirmer tear tests to gauge how dry your eyes are.
2. Use the search feature on this page and look at our extended discussions of dry eyes and blepharitis.
3. Be sure you used Restasis twice/day for a minimum of 10 weeks. Anything less is not a long enough trial.
4. Have plugs put in both your lower tear ducts. Don't use the type that disolve or the type that are completely in the tear duct and hard to remove (I've seen several complications with that type). You want the umbrella or parasol shaped ones that are easy to put in and easy to take out.
5. Eat a fatty fish meal 2-4 times/week   salmon, sardine, anchove, cod, salmon, salmon.
6. Consider taking Theratears Dry Eye Formula pills instead of flaxseed or currant seed oil.
7. Before and even maybe 20 minutes try a gel instead of a drop Genteal Gel or Refresh Liquigel.

John C. Hagan III MD Eye Physician & Surgeon