I too took Accutane roughly 8 years ago. The eye problems you described are very similar to what I experience on a daily basis. My eyes burn every morning when I wake up and as the day goes on, they are left with a nasty feeling (no other way to describe it...but very uncomfortable). Throughout the day they are usually red -- or extremely red. For some reason, when I am outdoors, they do feel much better, though. I have consulted with an opthamologist for the last 2 years. I have used corticosteriods (Econopred, Vexol and Lotemax). I have also had punctal plugs installed. When I used them, the steriods helped a lot....but I think the plugs were a waste of money. I try not to use the steriod drops, though, because of their side effects.
Like you, I am desperate for any new ideas. Feeling like I look hung over or on drugs is really starting to affect my social skills at work.
This is what I have tried so far. Maybe they will work better for you than they did for me. I do know that you should avoid Visine-like products at all costs.
I have not seen the kind of eye irritation you describe after Accutane. My Accutane patient have tended not even to get much in the way of dry eyes even when they take the drug. I notice that there is no mention in your question of consulting an ophthalmologist. Since your symptoms are in the eye, I think that is what you ought to do. When you do, you should tell him or her that in the opinion of your dermatologists, the dry eye symptom is very likely not related to the Accutane you took 10 years ago. There are other causes and treatments for dry eyes.
As for the skin around your eyes being irritated, that may be dry skin or it may be eczema--also unrelated to Accutane. Your dermatologist should be able to assist with that.
Take care.
Dr. Rockoff