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1547280 tn?1294170469
corneal edema - unclear cause
Hi there,

I am a 43 year old woman (who used to be an optician), I've always had better than 20/20 (usually 20/10) without correction, though did have a script of -0.50ou for a few years until I became mildly presbyopic about 2 years ago, then back to plano for distance.  My newest exam showed od plano -0.50x90; os -0.50 sph, with a +1.00 add.

I have a condition they think is either ocular rosacea or atopic dermatitis - I have symptoms essentially of blepharitis - swollen lid margins, a lot of debris and scaling, foreign body sensation, can become very dry, very itchy, very bloodshot - if left untreated. I am successfully using protopic on my lid margins as needed and doing lid scrubs daily to keep it "fairly well" under control.  I don't use the protopic every day because of the risk it carries for skin cancer.  Haven't used the protopic in the past 2 or 3 days.

My problem occurs sometimes when I read in the morning.  This happens with or without using my reading glasses.  Today, for example, I read for a couple of hours (with my readers +0.75 ou).  I noticed the lines on the page were beginning to double.  I wasn't experiencing any dry eye discomfort (very familiar with this sensation).  I came downstairs and looked out the window and panicked a bit.  Things were VERY blurry, couldn't read the "no parking" symbol I know is across the street etc.  I drove to my optician (a scary experience, couldn't read licence plates or street signs), he checked my K readings, and said the mires were not clear, there was corneal staining as well.  My visual acuity was a bit better than 20/40.  He held up -0.75's and it cleared to 20/25-, he felt that was the best I could achieve like this, though of course would get better when edema cleared.  I called my optometrist as my optician suggested, and have started on a hypotonic drop to reduce the edema, and preservative free rewetting drops.  

My question is could minor dry eye have this big an effect on my corneas, when other times the dryness can be much worse, and it does not affect my vision then?  Or could this be a part of the Ocular Rosacea/atop derm thing that I'm dealing with?  Should I be seeing a general ophthalmologist or corneal specialist?  I would greatly appreciate your insight :-)
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233488 tn?1310696703
I would suggest seeing a cornea/external disease specialist Eye MD. There may be more going on than you think
JCH MD
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