There is little likelihood that a fungus or "something else" is keeping your tears from coming out.
Inflammation is part of dry eye syndrome and one thing that Restasis does is reduce inflammation.
When you read, watch TV, use a computer or do crafts, high speed photography has shown your blink decreases. To read put tears in before you start reading, don't read in a draft, look up from your reading every 15 minutes and blink 3-5 times forcefully.
JCH III MD
Thank you for all your suggestions. I am doing them all except I haven't had the upper plugs yet. That's my next step I guess. I am currently on Restasis and have been for 2 years. I also sleep with a humidifier and wear wrap around glasses when there's wind and put Lacrilube in at night. If I gently push on my eyelids, a small amount of tears will come out. Is it possible there's a fungus or something that is keeping them from coming out on their own? . . . or inflamation? Also, how common is the inabilility to read with dry eyes? Thanks.
FROM A RECENT POST (also use the search feature on this page to read other information)
JCH III MD
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.
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 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.
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.
Keep digging and moving forward. I suspect you have not exhausted all the ways you can be helped.