Refraction Question

I have ghosting on lights that goes away when I place my hand in front of my eyebrows.  I guess my hand is creating a pinhole effect and leads me to believe that my problem is refractive.  I have been told that my problem is due to my tear film.  Can tear film cause such refractive errors?  Is the tear film a part of the refraction system of the eye?

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

Tear film problems can cause ghosting but they do not cause refractive errors. The cornea is the prinicple refracting surface of the eye. A bad tear film can disrupt clear vision but not by causing a need for glasses.

JCH MD

[MagicMadcap]

So ghosting that goes away with pinhole effect may be tear film problems and possibly not a refractive error?  The reason I ask is because the ghosting started after overusing visine for about two weeks and I just don't understand how that could cause a need for glasses.  It seems more likely that there is a tear film issue.  Artificial tears just make it worse and I've been on restasis for around three months + and I don't know if it's helping.  I'm thinking about going back to the ophthalmologist soon.  I don't know what to do and I really need advice.  It's making me so depressed.  My symptoms are basically burning, pain, itch and ghosting that all started after the visine.  What could this be?  I just don't see how two weeks of visine could cause a lifetime of restasis.  What else could this be?  Thanks so much for the help, I really need to get to the bottom of this. ;}

[MagicMadcap]

P.S.- I've been to a cornea specialist.

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

1. Two weeks of Vision will not cause permanent problem. If it did all we ophthalmologists would do is treat Visine problems.
2. Dryness on the surface of the cornea can blur vision but will not cause a need for glasses.
3. The pin hole could clear vision if it is refractive, and in some cases could make blurring by corneal diease, corneal drying and cataracts better (esp with posterior subcapsular cataracts)
4. I doubt seriously if your corneal specialist attributes your problem to two weeks of Visine.
5. Your symptoms are compatible with dry eye (tear dysfunction syndrome)
6. You can always get a second opinion

JCH MD

[MagicMadcap]

I really do appreciate your insight.  Thank you for taking the time to help me sort this out.  The only reason I blame the visine is because all of the symptoms started after the visine overuse.  Is it possible that something else happened around the same time that is causing this?  After overusing visine for two weeks I developed itch, burning, ghosting, sharp pains and no sleepies/eye crust.  In your honest opinion, what do you think happened?  If it's dry eye, then the visine must have caused it because I had perfect eyes and nothing like dry eye prior to the visine abuse.  What do you think?

p.s.- Sorry if I'm bothering you but I just really need someone to talk to about this.  Thanks again for your help. ;}

[MagicMadcap]

And every morning I wake up with a thick mucus in my eyes (no eye crust) that I can actually see sliding up my cornea with every blink.  It gets better after I'm up for a little while but it seems like it never fully goes away and could be whats causing my visual disturbances.  I'm just hoping the restasis will eventually fix all this but it's been 3+ months and I really don't know.