Possible macular degeneration

[Chipper21]

Hello all.  I have been struggling with eyes problems for a little over 1 year.  It started when I noticed I couldn’t read on my computer and my eyes felt out of focus.  I was given an amsler Grid and struggled with it, as I could not see all of the lines.  My first visit to the opthomologist diagnoses me with the dry eyes and put me on steroids.  My eyes are now getting significantly worse.  I had an OCT test in May and my test was normal.  My eyes hurt all the time, especially when I close them, my detail vision(including reading words and recognizing faces) is diminishing, and I still struggle to focus my eyes in the center.  I also struggle with tracking things with my eyes.  Does anybody have any thoughts?

[JohnHaganMD]

Yes, if your macular OCT was normal you don't have age related macular degeneration (ARMD). Especially if you are a menopausal or post menopausal female those are symptoms of dry eye (which Eye MDs call ocular surface disorder). There are two types  1. aqueous deficiency, the more severe, no tears, very irritated eye and often dry mouth.  2. Lipid deficiency in which the eyes water all the time.   This is a chronic problem that often worsens with time. It can't be cured but can be helped and controlled.  you can go on my blog and read extended discussion.  Treatment goes: trying lots of artificial tears to find what works best for you; environmental modification (don't sleep with fan in bedroom, don't run AC/heater in face,  if that doesn't help discussion of restasis (my favorite) or Xiidra (very expensive).  You need to be sure your ophthalmologist is patient, kind and will take an interest in finding what works for you. Not all are.  You can always get a second opinion from a different Eye MD ophthalmologist.

[Chipper21]

Thank you for responding.  I am a 31 year old male.  It feels like my eyes are spasming and it is painful to try and look out of the corners of my eyes.  It also appears that my range of vision is limited.  Can dry eyes really have all these affects?  At my last appointment, my rear production was 7 in my left eye and 10 in my right after 2 minutes, which was low but not terrible.  I have sleep apnea and floppy eyelids.  The optho also said I have eyelid inflammation, but the surface of my eye did not look too bad

[Chipper21]

My eyes get hurting so bad and give me a headache in the front and sides of my head that it is almost unbearable

[JohnHaganMD]

Several things would be in order.  1. if you are comfortable with your present Eye MD ophthalmologist you need to get back in and greatly elevate the level of treatment.  2. if you are not comfortable with the attention shown your problem find a eye MD ophthalmologist that specializes in cornea/external eye disease.    Both sleep apnea (especially if use large CPAP) and floppy eyelid can exacerbate.  You may need to see eye MD that specializes in oculoplastic surgery about fixing floppy eyelids.  

[at_239]

I have dry eye after cataract operations on both eyes, but it is not as bad as yours. You have my sympathy. I find my vision difficult to describe because it is so strange and very variable. The ophthalmist has been no help and I think Dr Hagan is right - second a second opinion is the best option. I am trying to get one through the same hospital with little success but I do not have my medical records to go elsewhere and I am trying to get these. I also had inflammation and found that a warm compress and tea tree oil wipes worked wonders.

[JohnHaganMD]

Thanks for the suggestions and comments

[Chipper21]

I should also mention that I really struggle seeing in the dark and have trouble adjusting from light to dark