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Severe Dry Eye Causing Ghosting&Streaks?
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Severe Dry Eye Causing Ghosting&Streaks?

I recently posted regarding severe ghosting images and believe I have the cause pinned down to dry eye but I would like further input. I am a 20 year old female who started having really severe distortions to my vision about 10 months ago, around the same time that my dry eye got REALLY painfully noticeable. My two main symptoms are very intense ghosting of objects (usually creating 2 distinct copies right above the original image, or if it is closer up just an extra 'border' around the object as well as a light streak similar to those of a starburst below the image) and very severe light sensitivity (it just feels like something is 'off' with my vision, like my eyes are stuck in that 'just came inside from bright light and can't see well/blotchy' stage, even in conditions with less light). Here is a list of the chronology in which things happened for me (roughly)
    1-complained maybe once a month about eyes feeling a tad bit dry
    2-got a job working 6 hours in front of a computer with little to no breaks
    3-after about 9 months at said job, dry eye was bad enough for me to purchase over the counter artificial tears which didn't help
    4-2 months after buying drops, very bad ghosting in both eyes (together and individually) started and has gotten slightly worse since
    5- currently: ghosting is very, very severe. VERY sensitive to light and eyes are constantly in incredible amounts of pain due to dryness/upper eye lids feel like they 'stick' to my eyeball

    I don't know if dry eye can creep up on you quite this fast but perhaps it was building slowly like many things you don't notice until it's too late. From what I have read it can sometimes be bad enough to cause ghost images.Because the ghosting started so suddenly, I have been to many, many doctors to rule out condition after condition. At first they believed it might be linked to my migraines (I get very frightening hemi-plegic migraines that resemble a stroke identically, about 5 to 6 times a year) but I am now about 95% sure that this almost HAS to be a tear production/quality issue after all of the testing I've had done the past year and everything that's been ruled out already.
    Here is what I have tried and all of the tests I have had:
    -5 dilated eye exams by various opthamologists
    -Examined by Neuro-Opthamologist
    -CT scan of orb, amsler grid test, intense testing of retina & back of the eye/optic nerve
    -2 different prescriptions in eye glasses
    -Cycloplegic refraction for even more accurate prescription (had a HORRID reaction to the drops used and went into cardiac arrest...apparently this is one in a million that it happens to..?)
    -Corneal topography to rule out keratoconus (sp?) no significant abnormalities were found
    -Hard and soft contact lenses (soft contacts were very very painful and suctioned to my eye by the end of 4 hours probably b/c of the dry eye) (hard contacts caused constant involuntary muscles spasms so I couldn't tell if they helped)
    -Examined by Neurologist for migraine-aura related stuffs
    - 2 MRIs of the brain/head/neck with contrast, only thing found was a small cyst the size of a grain of salt & shrinking in the corpus callosum
    -Tried both Topamax (yuck!) and Depakote in attempt to see if it was migraine-related
    -Pilocarpine drops to see if constricting the pupil would change the ghosting in any way
    -5+ blood tests for everything under the sun... (lyme, thyroid, vitamin/mineral shortages, etc. )

    Blood tests show very very low iron levels (for which I'm now taking supplements), mildly low potassium (I'm eating 2 bananas every day, haha) , and slightly high blood sugar.
    My TBUT test was less than 4

    I am having additional testing on blood this friday to check for diabetes as I know this can be a cause for dry eye, as well as more intense thyroid testing.
    Neurologically I seem to be quite fine, and no eye doctor has found anything mechanically wrong with my eyes AT ALL. I have very very mild astigmatism in my left eye, but it has better than perfect vision and all 3 opthamologists said that the amount of astigmatism was so slight it didn't even need any correction. I know astigmatism can cause ghost images, but I only have it in one eye and it is "not even worth mentioning" according to the Drs, so I don't believe that's the cause for my symptoms. I have never had anything wrong with my vision prior to this, never worn glasses or contacts before (except for the few week trials I gave listed above) and have never had any injuries/surgeries to my eyes. No cataracts, glaucoma, etc.
    Since I now am assuming this is a tear film problem, the past 3 weeks or so I have added mega doses of Omega-3 and Vitamin B supplements into my diet as well as cut sugars A LOT as I understand they can be a contributor to dry eye (and it would be bad if I do end up with diabetes anyway). I have been drinking much more water than usual, put a humidifier in my room, use Systane PM lubricant gel before bed, and started Restasis again (tried it for a bit, but didn't give it enough time I don't think). The OTC drops don't seem to help, and in fact seem to make my issue worse so I am not using them except on rare occasions. I use a warm compress for about 5 min in the morning or throughout the day if I can and have an apt scheduled to get punctal plugs fit to test out.
    Lastly (I promise) in addition to the dry eye I have had slightly "droopy" eyelids my whole life, and although it has never affected my vision, I am wondering if this could be contributing to my ghosting? Below is a link to roughly what my eye looks like:

    http://s229.beta.photobucket.com/use...121e5.jpg.html

    The top lid covers the tip top of the pupil ever so slightly, rather than the top lid "resting" on the very top of the pupil. I know a few people with this appearance to the same degree as myself or even worse and it does not affect their vision, so perhaps I'm just obsessing. Again, I've had this issue my whole life and it has never been a problem, but I'm wondering if maybe the sudden combo of severe dry eye AND droopy lids could be causing it.
    Has anyone else here experienced ghosting as a result of dry eye? My online searching has told me that dry eye is often listed as a cause, though more common is astigmatism, cataracts, retina membrane, etc (but those are all already ruled out). My ghosting is constant, worse in dark conditions than in light, and has worsened ever so slightly over the past 6 months as the dry eye got worse (which is why I connect them). I get 2 copies of an image directly above the original, or at a closer range get an extra outline/border of images. These ghosts move up and down when I open my eyes wide and disappear with the pinhole test at the eye doctor's. They are there ALL the time regardless of if I put in eye drops, however SOMEtimes in the morning when my vision is a wee bit blurry waking up, they will be gone and replaced by a filmy circle.
Sorry this was so ungodly long. Any help is appreciated more than you know, this thing has totally destroyed my life I've lost my job, the ability to drive, watch TV, read, etc.

5 Comments Post a Comment
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711220_tn?1251894727
I would suggest you see a corneal and retinal specialist at a University center.


Dr. O.
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Avatar_m_tn
I have already seen a corneal specialist associated with our university (he was the one that looked at the corneal topography and said there were no abnormalities) and have had a very extensive exam of the retina. Would a retina specialist be better? would a wave front test be good in this case? It is the only test I can think of that I have not had and I know it is very specialized for seeing how the light goes through the eye. thank you
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Avatar_m_tn
My apologies for posting twice. If it gives any more information I have already had an OCT scan of the retina that came back normal. Should I still seek a retinal 'specialist'? Thank you again
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Avatar_n_tn
how are you doing,  I have the same problems, and am looking for solutions. Many things can cause these problems, and it is probably a detective story to solve.  Anyway was is happening or you.  I would appreciate knowing.  Thank you for your in depth description of your journey so far.  I am copying it for further research for myself.
All the best Donna
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Avatar_m_tn
All sounds very familiar to my symptoms. I suddenly got dry eyes and vertical double vision over the course of a couple of months. The condition has slowly worsened over the last 5 years and I have had most of the tests you mention. I was diagnosed with sjorgrens which explains the dry eyes but not the monocular duplopia. My ghosting is usually vertical but varies in degree and from hour to hour. Generally it gets worse in the evenings. My optotherapists have lead me on a merry dance blaming everything but never finding any correlation. I suspect that dry eyes are the trigger but that in some way squinting mis-shapens the cornea or tires out the eye muscles. It's not fluid film as the ghosting remains even after eye drops. I'm quite a scientific person but I just can't track down anything that correlates with the random pattern. Any clues from anybody would be most welcome.
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