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Medical Forum / General / Vision / December 2004

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Dry eye help?

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AndyB - 19 Dec 2004 23:45 GMT
I have been to a few Doctors and non have really helped. I have horrific dry
eye. Long story short, I had a bone marrow transplant about 12 years ago.
After the massive radiation I was told that I should have the part of my
eyes that drain tears cauterized. I did not want to take the chance on doing
both eyes. I was unsure of the procedure. So I just did my right eye.

   Today my right eye is fine and my left eye is a wreck. I need drops
almost every 10 to 20 minutes.

Two years ago a Doctor tried to cauterize the left eye and it did not work,
it remains open. I am taking clevis, Refresh tears, liguigel, Restasis and
just started Lotemax. I am even taking 2000mg in pill form of flax seed oil.
Nothing helps. the Doctor has put plugs in the upper lid, it helped very
little and temp plugs in the lower lid and it did not help at all.

My problem seems to be getting worse and is making the quality of life real
tough. I know there are bigger problems in life but I need something to help
I am going nuts.

ANdy
Neil Brooks - 20 Dec 2004 00:58 GMT
> I have been to a few Doctors and non have really helped. I have
> horrific dry eye. Long story short, I had a bone marrow transplant
[quoted text clipped - 16 lines]
> life real tough. I know there are bigger problems in life but I need
> something to help I am going nuts.

Dry eye is a real problem . . . but you know that.

I have all four puncta cauterized.  Why is it that they can't cauterize the
puncta on the left?  Maybe a different doctor??

Humidifier in your bedroom at night?  Lacriserts??

Best of luck,

Neil
AndyB - 20 Dec 2004 22:20 GMT
Thanks for responding Neil

Yes I have a humidifier in the room.  Lacriserts? I have the top left part
with what I think is lacriserts. The Doctor says they are permanent. The
lower left were the dissolving type just to see if it would be worth it to
put in permanent ones.
The cauterization is an issue because no doctor that I have seen seems to
recommend it. Except for my Doctor in the West(Seattle). The one Doctor who
tried it years ago obviously did not do it right because it reopened. My
present Doctor says he has only done the procedure a couple of times.

Andy

> Dry eye is a real problem . . . but you know that.
>
[quoted text clipped - 6 lines]
>
> Neil
Neil Brooks - 20 Dec 2004 22:46 GMT
Neil wrote:

>> Dry eye is a real problem . . . but you know that.
>>
>> I have all four puncta cauterized.  Why is it that they can't
>> cauterize the puncta on the left?  Maybe a different doctor??
>>
>> Humidifier in your bedroom at night?  Lacriserts??

AndyB replied:

> Yes I have a humidifier in the room.  Lacriserts? I have the top left
> part with what I think is lacriserts. The Doctor says they are
[quoted text clipped - 5 lines]
> because it reopened. My present Doctor says he has only done the
> procedure a couple of times.

1) Lacriserts: Also called hydroxypropyl methylcellulose, this is a small
pellet that you put in the eyelid that lubricates the eye surface and slows
the evaporation of natural tears. If you are allergic or sensitive to
methylcellulose, you won't be able to use Lacriserts. Requires a
prescription.

http://www.merck.com/product/usa/pi_circulars/l/lacrisert/lacrisert_uspc_pi.pdf

Talk to your doctor.  May be worth a try.

2) Hmmm.  No doctor recommends the cauterization.  I wonder why.  It seemed
to bring you relief on the other eye, no?

3) Do you wear contacts?  If so, can you switch to glasses??

4) If you don't wear corrective lenses at all, have you heard of moisture
goggles?  Some of them actually look /fairly/ cool:

http://www.dryeyepain.com/Goggles.htm

Again, best of luck.  I know what a pain this is....
AndyB - 21 Dec 2004 17:54 GMT
HI Neil

Thanks again for the reply. I presently wear Wiley-X  sunglasses. It also
surrounds the eye.

I will ask the Doctor about the Lacriserts. My Doctors in Seattle have
suggested that also. I am presently taking Celluvisc which seems to be made
of the same stuff. Have you tried the Lacriserts?

Andy B
Neil Brooks - 21 Dec 2004 18:04 GMT
> Thanks again for the reply. I presently wear Wiley-X  sunglasses. It
> also surrounds the eye.
>
> I will ask the Doctor about the Lacriserts. My Doctors in Seattle have
> suggested that also. I am presently taking Celluvisc which seems to
> be made of the same stuff. Have you tried the Lacriserts?

I have.  For /me/, there were two problems:

1) transient blurring of the vision.  I have accommodative spasm issues, so
forcing my eyes to respond to frequent blurring is a bad thing;

2) I guess my -- whatever they're called -- cul-de-sac's, I think -- the
place where you have to position the Lacriserts -- are a bit shallow.
Because of this, the capsule would frequently pop out.

I checked out those Wiley-X's.  Some pretty cool frames (at least).  My Rx
is too high (nearly +10) for wraparounds.

I take it you have the Dry Eye Syndrome pretty bad, eh?  Prior to having the
full punctal cautery, my Schirmer's test was about 3mm; my Tear Breakup Time
was about 3-5 seconds.  Once they did the cautery, my Schirmer's increased
dramatically, but the T-BUT didn't; the tears were plentiful, but very
watery.

Ordinarily, I would suggest that--for severe dry eye--where you live makes a
huge difference, but . . . you're in /Seattle/ ;-)

My wife and I visited Colorado (we live in San Diego) over T-giving,
considering a move there, but . . . the dry climate . . . .  Easily fixed in
the house (whole-house humidifier), but what about the car, the grocery
store, the office, friends' homes, etc., etc., etc.  I think you'll
understand.

'tis not much fun.....

Neil
Rocketman - 22 Dec 2004 01:21 GMT
Neil/Andy,

Just out of curiosity, did either of you take a drug called finasteride
(brand name Proscar or Propecia)?  That drug caused dry eyes for me and a
few other young men I know.

Thanks.

>> Thanks again for the reply. I presently wear Wiley-X  sunglasses. It
>> also surrounds the eye.
[quoted text clipped - 38 lines]
>
> Neil
Neil Brooks - 22 Dec 2004 01:52 GMT
> Neil/Andy,
>
[quoted text clipped - 3 lines]
>
> Thanks.

Not me.  Had three surgeries for strabismus, though.  It's thought that--in
my case--this is the primary cause of the dry eyes.

Neil
AndyB - 25 Dec 2004 05:46 GMT
No Rocket man

I have dry eye due to radiation I received prior to a Bone marrow
transplant.

Andy

> Neil/Andy,
>
[quoted text clipped - 46 lines]
> >
> > Neil
 
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