Whats your opinion

Two year battle   20 moths ago Cataract surgery  deteriating vision during day  was problematic by Mid afternoon.  After surgery situation  worse and deteriated by noon or earlier. Had  Capsolotomy both eyes , torn detatched Retina RT Eye-repaired with Buckle  
surgeon told the wife that Retina was very thin and in poor condition. ( yet computer Topagraphy that shown on or above the red line )  Vitrectomy and Peel for macular Pucker--Laser on several occasions for lattice degeneration and suspect areas in both eyes--laser to repair holes near and around buckle on rt eye. In the 10 months following cataract surgery vision got as bad as 20-120 Rt and 20-80 left eye. Glaucoma specialist was also treating high OP"s with several drops and combinations to try and lower op's ( best was mid to upper 20's )  Had to leave a lucrative position Jan 2007 due to poor reading vision and inability to drive . My company kept me active in 2006 even though I was unable to do my job.

  
went to my 6 th doctor in April and He got me off Glaucoma drops  was having reactions --flushed eyes was to start treatment all over -however since the drops were stopped , eyes flushed op's have been from 15  to a high of 20 ( 8 months )  yet to
start treatment , monitoring regularly
  diagnosed
1. Keratitis Sicca
2. Rosecea  (  meds and  positive results )
3.Chronic Conjunctivitis
4. Changed  glaucoma to Ocular Hypertension

using Celluvisc  the only drop to date ,and I've tryed many , relief for up to an hour ( of course less in bad conditions )
Warm compresses-Meds-
Diet- Fish Oil
vision  now about 20 50 RT 20-40 left    Huge improvement , Celluvisc works

Could you shed some light on the above diag.  how they pertain to
on comp or watch TV for about an hour untill eyes get fuzzy and burn
occasional pain--extreme light sensativity--can't be in bright room or outside for extended time w sunglasses
Thanks

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

You have had enough eye problems for a dozen people My sincere regrets. However without the many advances of moder ophthalmology you would probably be completely blind in both eyes.

Your best corrected vision is probably a function of your lens/retina/macula.

your comfort issues probably most affected by the keratitis siccs (severe dry eyes) this is from a recent post on dry eyes.

JCH III MD

General Information on Dry Eyes

a Schirmer test of zero indicates that you have severe dry eyes. I'm assuming from your posting that you have tried both preserved and unpreserved artifical tears, gels or lubricating ointments at bedtime, environmental modification, etc. Don't discount eye drops. There are over a 100 different brands of artificial tears and they can't all be lumped together. Sometimes one will find the perfect drop. Because the problem is so prevalent the pharmaceutical compies are coming out with new products all the time. Some of the newest are Systane preserved and unpreserved drops and Optive drops.

If you took Restasis you have used the best prescription medication. A "trial" of Restasis is a minimum of 8 weeks of therapy using one drop in each eye twice/day. Because of the way Restasis works, it takes two months to "start working". I have found that many patients use it for a few weeks then conclude it won't help. The medication often stings when therapy is begun--it usually gets better by week three or your Ophthalmologist (EyeMD) can prescribe a mild steroid drop for a couple of weeks. If you did not take for 8 weeks you need to restart therapy. Improvement often continues for up to 6 months.

If you have tried tear duct plugs you should have had all for tear duct openings (puncta) plugged with a permanent plus (not a disolving one). Usually just the lower lids are done with mild dry eyes. If your problem is as bad as you say, you and your ophthalmologist should discuss permanent closure of some or all four of the tear duct openings with cautery.

Additional things that can help include a diet rich in fatty fish (eg salmon, sardines, etc). Fish oil taken by mouth usually 2 to 4/day has been show to help some patients. In addition there are non-prescription pills for dry eyes available at most major drug stores or by direct order from the companies. Thera-tears formula for dry eyes is probably the most widely used. You can use any search engine to pull up the websites of the companies that see these.

In dry eyes associated with corneal damage, moisture retaining goggles are used for sleeping. Be absolutely certain you do not sleep under a fan, heating outlet or situation where air moves over your face during sleep. Make certain you home is humidified in the winter, put a humidity gage in the bedroom. If you cannot maintain a 50-60% humidity put a room humidifier in the bedroom. Run the A/C or heater of your car through the vents on your feet not in your face. Long car or plane trips put your tears in every couple of hours.

If you are menopausal or post-menopausal be sure you and your gynecologist maintain optimal hormonal balance. (Many women with dry eyes have dry mouth and dry vaginal canal). If you have joint pain have that evaluated to be sure you don't have Sjorgren's syndrome. Many medications eg antihistamines can make dry eye worse. You might review your medications with your ophthalmologist.

If you reach a point of exhausting all the above see an ophthalmologist that specializes in "Cornea and External Disease". This is their special area of expertise. A final new treatment that they can often do is “Autologist Platelete-rich plasma” therapy. This uses eyedrops made out of your blood products. (reference Ocular Surgery News: November 1, 2007 page 46  lead author Jorge Alio MD.

Keep digging and moving forward. I suspect you have not exhausted all the ways you can be helped.