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Medical Forum / General / Vision / June 2006Morning dry eye?
For the last few months I've had this thing where the vision in one or both of my eyes is foggy when I wake first thing in the morning. I'm not sure, but which eye is foggy seems to be related to which side I was sleeping on. The problem clears in 5 minutes or so, so it's hard to diagnose. This morning I put a few lubricant drops in both eyes right away and it cleared, so I'm thinking dry eye. Any thoughts on what might have brought this on, and what I can do about it? I mentioned it at my last eye exam, but the doc didn't seem too concerned and suggested drops before bed. The weird thing is that I don't think I have dry eyes in general. Since I got RGP's (about 3-4 weeks ago now), my biggest problem seems to be excessive tearing... although at times I think I do go dry too. > Since I got RGP's (about 3-4 > weeks ago now), my biggest problem seems to be excessive tearing... > although at times I think I do go dry too. I have a similar issue. It strikes me as reasonable, given that tear production is likely different while one is sleeping... and I did have an adjustment phase with my lenses. I used eye drops in the morning for awhile, but at this point, my daily routine of just getting up, hopping into the shower and slowly blinking for a little while while my eyes aren't really needed yet... that seems to work fine. > For the last few months I've had this thing where the vision in one or > both of my eyes is foggy when I wake first thing in the morning. I'm [quoted text clipped - 11 lines] > > -- It does sound like dry eye and I would recommend any number of good artificial tear products (I get good results from the gels such as "Refresh Liquigel") on a regular basis at night and first thing in the morning. The tearing you get from irritation from your gas perms is referred to as "reflex tearing" and has no real association with dry or non-dry eyes. In fact, one of the classic complaints of a dry eye patient is of excessive "watering". frank > The tearing you get from irritation from your gas perms is referred > to as "reflex tearing" and has no real association with dry or > non-dry eyes. In fact, one of the classic complaints of a dry > eye patient is of excessive "watering". > > frank Is there anything that can be done with respect to the watering? Or is there a chance that it might go away eventually? I remember my doc talking about RGP's with different levels of water absorption - would this have any bearing? You mention irritation, but my RGP's feel totally comfortable at this point. There doesn't seem to be any correlation between felt irritation and eye watering. There is, however, a strong correlation with wind blowing into my eyes, or even the air from walking quickly down the hall. My eyes have always been like that to some extent, but much worse with the contacts. >> The tearing you get from irritation from your gas perms is referred >> to as "reflex tearing" and has no real association with dry or [quoted text clipped - 4 lines] > >Is there anything that can be done with respect to the watering? Yup. All of the aforementioned treatment modalities for dry eye syndrome. Here's a good overview: http://www.agingeye.net/dryeyes/dryeyesdrugtreatment.php >Or is >there a chance that it might go away eventually? Yup. Really depends what the underlying cause is, IF that can be determined. I (not a doctor)'d probably pick a decent dry eye drop (maybe Refresh Endura or Systane) and try it for a few weeks. That's a bit of the shotgun approach. Probably a better way (notice that I'm *still* not a doctor) would be to have a dry eye workup at an optometrist's office where they check your Schirmer's (quantity of tears), Tear Break Up Time ("quality" of tears), and rose bengal (or equivalent) staining (see any evidence of dry eye associated damage on cornea or conjunctiva). If you come back to the board with those numbers, I/we/somebody can tell you if you have dry eyes, whether they're aqueous deficient, evaporative, or both, and ... if your luck still holds out ... what the best treatment options are for you! >I remember my doc >talking about RGP's with different levels of water absorption - would [quoted text clipped - 6 lines] >down the hall. My eyes have always been like that to some extent, but >much worse with the contacts. Sounds like a symptom of dry eyes to me. I'd get 'em looked at ... for specifically that issue ... by a good dry eye doc near you. Best of luck! > ... > > I'd get 'em looked at ... for specifically that issue ... by a good > dry eye doc near you. > > Best of luck! Thanks. Kind of counterintuitive to put drops in watery eyes, but I'll check it out. > Is there anything that can be done with respect to the watering? Or is > there a chance that it might go away eventually? I remember my doc [quoted text clipped - 7 lines] > down the hall. My eyes have always been like that to some extent, but > much worse with the contacts. Try rewetting agents when you're wearing your cl's and artificial tears when not. Gas permeable cl's do not have any water content like soft cl's. Your doc may have been referring to wetting angle or the dk (amount of oxygen permeability). Any irritative reaction, from allergies to drying to environmental factors (ie.wind blowing) can cause this reflex tearing. It does sound paradoxical, but in simple terms, quelling the irritative reaction will reduce the amount the reflex tearing. If it's due to a dry eye, artificial tears will indeed reduce the irritation (and thus the reflex tearing). frank > Try rewetting agents when you're wearing your cl's and artificial > tears when not. Gas permeable cl's do not have any water [quoted text clipped - 9 lines] > > frank Thanks. Can you explain wetting angle? From what I could Google, it sounded like lower is better, but is that the whole story? Also, what's the story with semi-scleral RGP? All I know is that they are bigger and thus possibly more comfortable? I wonder if they might also help prevent some of the "edge effects" I've been having sometimes. |
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