A symptom is something the patient feels.  A sign is something the
doctor sees.  I have seen terrible signs of dry eye and the patient had
very little awareness.  And yes, dry eye can cause corneal defects,
which predispose to corneal ulcers.

But, as with most things, there are degrees.  There are degrees of dry
eye.  They range form "sub-clinical," i.e. without signs, to "clinical"
with signs.

Without a detailed examination, it's impossible to tell where you are
on that spectrum.  The diagnosis and treatment of dry eye is one of the
most challenging clinical problems that exists.

DrG

Forgot to include something. The dry eyes with contacts is no big deal
as far as comfort is concerned, it is unwanted, but I am not sensitive
and can stand it and would much prefer to wear them. My concern is that
I believe more serious complications could result from continuing to
wear them such as corneal ulcer or cataract.. am I correct? Can I just
wear them if I can put up with them? Basically after a few days of wear
I leave them out for a few days, and repeat..

I would also add Purevision Toric to your list.  If you intend to use
soft lenses, I think you will need a toric lens for that much
astigmatism.  Purevision has a lower water content than A/V Advance and
will not show as much dimensional variation with the dry eye.

RGP?  I don't think so.  At least not the customary type that float up
and down on the cornea.  There are large format lenses on the market,
called corneascleral lenses, that cover the entire cornea.  They don't
move up and down, and tend to trap moisture in.

The bottom line is that ALL contact lens wear is made more difficult by
dry eye.  Maybe you should consider evaluation and treatment for that
first.

DrG

Been trying to figure out what I should do, will see the
ophthalmologist soon.. Here is my prescription (contacts):

OD: sphere -3.50 cyl -1.25 ax 180
OS: sphere -3.50 cyl -1.25 ax 010

I've worn soft contacts for around 7 years and recently have had dry
eyes + slight corneal impression\red ring after wearing them for a few
hours, mostly at 3 o'clock around my cornea (left eye). Since the
problems are dryness and possible lens tightness, I'm thinking to try
one (or more) of the following lenses, maybe with a larger BC:

Acuvue Oasis
Ciba 02Optix
Purevision
ProClear Compatibles
Focus N&D
Extreme H20

The Acuvue Advance I currently wear have shown a significant
improvement over previous lenses, Toric 66's, but above problems still
exist. My first thoughts are to try the Oasis, not sure they correct
astigmatism though. Full astigmatism correction is a must..

- also considering trying RPGs.
- thought about IOLs but if I am correct these are only for if you are
having cataract surgery.
- not going for Lasik.. it's too early.

Questions:
- Which above contacts should I try?
- Would RPGs fix the tightness problem?
- Does anyone know when Focus Dailies (or any dailies) will become
available in for my strength astigmatism?

Thanks