Don
One other thing you might consider is getting a room humidifier, or
take two flaxseed oil capsules per day.
Don
On Wed, 02 Nov 2005 18:00:07 GMT, Ragnar <ragna...@yahoo.com>
wrote:
A symptom of dry eye is as you describe; an abrasion of the corneal
epithelium (outermost layer of cornea cells) when you open your eyes
in the morning. The abrasion requires the epithelium to regenerate
cells and heal every day, which is not a great way to treat your eyes
and can lead to poor vision quality.
The recommendation of superficial keratectomy (removing the epithelial
layer and allowing a new layer to cover the cornea) indicates that
your optometrist believes what is wrong is the epithelial layer not
holding to the underlying cornea. When you have "sticky eye" in the
morning, the epithelial layer is lifted. The problem I see with this
approach is that the dry eye will undoubtedly continue and will
disrupt the epithelium. Superficial keratectomy may not cause any
damage other than the discomfort and weeks of poor vision while your
epithelium heals, but may not provide much improvement.
Using a bland nighttime ointment, such as Refresh PM, will add the
lubrication that you apparently need. This too is treating the
symptoms, not the cause.
It seems clear that the cause of the dry eye, such as limited lipid
flow, low aqueous, poor mucin production, etc. is what needs to be
diagnosed and treated. Restasis has been shown to be very beneficial
in this regard, but what is needed most is a good evaluation of your
tearing function by someone who is knowledgeable.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
This is a recurrent corneal erosion, NOT dry eye. The problem is with
the adhesion of the basal epithelial cells to the basement membrane. It
is most likely unrelated to Lasik and can be caused by numerous things
such as epithelial dystrophies and foreign bodies, particularly organic
matter such as gardening mishaps.
Treatment options are:
1) gel/parafin lubricants such as lacrilube prior to sleep. These leave
a layer between the cornea and lid to hopefully stop adhesion. Drops
are no good as you need something that will still br there in the
morning.
2) Bandage contact lens. This is beneficial after the act to relieve
soreness, but is better used overnight to create a barrier between lid
and cornea. Needs to be used for lengthy periods, nightly for 4-6
months or more.
3) PTK - this is what the optom you saw was talking about. The 'T'
stands for therapeutic. It is PRK, but instead of making a refractive
change, a small layer off the surface is ablated. The ablatd surface
generally has better adhesion than the existing basement membrane.
4) Stromal puncture - the surgeon uses a needle to make small puncture
marks at the area that is causing problems. Not entirely sure what it
is supposed to do, possibly rough up the area, but it is relatively
effective and roughly the same benefit and success rate as PTK.
Hope this helps a bit.
dr grant
SErebel
and if you had dryness problems before lasik, you should not have had
the surgery.
and 1996 would make you one of the very first LASIK patients.
RCE usually goes eventually, but it can take 12 months to happen (as it
did in my case). It can go for weeks and months, then occur suddenly.
Treatment needs to be aimed at resolving the underlying issue not
superficial glossing over the surface.
In your case Glenn, if it is a small erosion, it can be resolved in as
little as 0.5hr, so by the time you see your doc, there is no trace of
it, but you do not get the feeling of a needle in your eye on lid
opening from dry eye.
Cheers,
dr grant
1) on the gels... they are INTENDED for only use during sleep,
however, from personal experience I have found that the gel "melts"
sufficiently to provide clear vision and great lubrication - which is
nice during the first 2 months post op.
2) bandage contact lens is really only relevant to PRK or non-LASIK.
although they can be used in lasik too.. they can have some benefit
with lasik. They are nececessary for PRK
3) PTK is probably what the guy was referring to. And I do not
think that is a viable solution for his problem.
4) Stromal puncture? you started off chiding about talking about
things not known about, then you freely admit that you don't know what
stromal puncture is about. We could have gone without hearing about
stromal puncture which is a voodoo technique.
On 2 Nov 2005 11:47:36 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
This thread should be ample proof to you to never seek a diagnosis over
the internet. You will get as many opinions as there are people willing
to answer.
Please make an appointment ASAP with an OPHTHALMOLOGIST, not an
optometrist. You need to see a medical specialist. Please let us know
what happens so that we can all learn something.
Best of luck!
--
~RT
For those who keep saying this has nothing to do with Lasik all I can
say is for 43 years I never had my eyelids stick to my eye.
Immediately after Lasik (June of 97 not 96 as I first reported) till
today this has been a problem. So telling me this isn't related to
Lasik is a very hard sell here. You draw your own conclusions.
By the way about a year ago Denver local ABC TV station did a report
on people just like me who have this sticking issue after Lasik
surgery. They had no shortage of people who were experiencing exactly
what I have been through. Another reason that telling me this isn't
related to Lasik is a hard sell. I still have a weak 20/20 in both
eyes. This part I absolutely love. So in no way am I putting down
Lasik procedures. I'm just trying to get to the bottom of a problem.
Thanks to everyone for your advice/opinions. I'll let you know what
the Doc has to say once she sees me. In the meantime I'm wearing a
patch contact lense in my left eye while this thing heals. I thought a
contact lense would be the last thing on earth I'd want in that eye
while it was so irritated but I must admit it has helped a lot with
the pain. More to come.
Don
The only think I would add is that it's ofen not so easy t get a free
consultation wth an ophthalmologist.
> RT has been right on the money quite ofen lately.
>
thank you. I only post things I believe to be true.
> The only think I would add is that it's ofen not so easy t get a free
> consultation wth an ophthalmologist.
Nothing worth anything in life is free.
--
~RT
1) Gels or petroleum based products are better than drops as they last
longer on the eye. You need some lubricant to be there in the morning
and drops will never do that.
2) A bandage CL has nothing to do with PRK vs Lasik, it is a means of
prevention of adhesion, and a good one at that. If you had learnt
anything over the years, you may have realised that we can use the same
item for many different purposes. In the case of a bandage CL, it can
be used to prevent adhesion of epithelium to the lid, as well as post
erosion to reduce pain.
3) PTK is what the original OD was talking about and if this is an
erosion, is a perfectly viable treatment option.
4) Stromal puncture has been used as a treatment option for RCE for
decades with high success rates. WHile I may not know the precise
mechanism as to why it works, it does, and has been successfully
treating RCE for years by ophthalmologists. You may try looking up a
textbook some time. Like Lasik, corneal grafting and cataract implants,
it is another voodoo technique used by ophthalmology.
drgrant
1: I Pointed out that the gels were intended for night use only, but
I find them useful for daytime use also.
2. You are 100% wrong about this. You surprise me.
3. PTK is fine.. however, you are not qualified to even mention it.
Since you are posting as a doctor (which you aren't) you must have
the qualifications to speak about such things.
When one gives out information under the guise of being a doctor, they
are liable for what they say. One person here even points out on
every message that he is NOT a doctor.
4. So you, someone who is not even a doctor, is the expert on stromal
puncture. I just hope that nobody is duped by you..
On 5 Nov 2005 11:21:30 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
2) 100% wrong about what? A bandage lens is just that, a bandage. It
can be used for many things. PRK used the lens to reduce post-operative
pain. With RCE it is used in exactly the same way, except that the
whole epithelium has not been removed. They are also used for abrasions
which are large and painful. They are used overnight for RCE patients
to prevent the erosion. If I am wrong, so are 1000's of OD's and MD's
across your country. Maybe you should ring them all and tell them they
are wrong too?
3) You state PTK is not viable, now say it is fine???? Make up your
mind....if you can find it. As much as I may not perform the process, I
do need to know about it and its viability. The success of PTK is
around 70-80% effective - not bad for a treatment you said was not
viable.
4) Stromal puncture has a success rate of ~70% also. Generally, the
difference in choosing PTK vs stromal puncture is the preference of the
doctor. Some do one, some do the other. Those with ready access to a
laser generally do that, those without use stromal puncture in their
rooms with a fine guage needle.
Once again my little friend, you are spouting rubbish and making
yourself look stupid. I am giving advice based on the symptoms
described by Don, especially on knowing that the pain occurs on OPENING
his eyes in the morning. He states that if he rolls his eyes before
opening then he is OK. This smacks of RCE as we will often tell RCE
patients to roll their eyes around before opening them in the morning
(not always easy to remember). As a licenced optometrist, this is the
thing I do every day, so yes, I am qualified to give this advice.
I also gave options that may be viable for treatment. Don is not my
patient and I do not expect that he will do as I say, but at least he
knows what the choices may be and what to discuss with his doctor.
I am sorry for your peteulant diatribe that again has hijacked the
thread and gone off topic, which should remain as to what to do about
Don's condition. As seen in this thread, Glenn has a similar thing,
which may also be RCE as well, but you wouldn't know that as you wish
to try to flame me once again, but can you at least learn what you are
talking about before you start raving as I am giving standard text-book
advice, and had you read the text-books, you would know this. You may
like to start with Clinical Ophthalmology by Jack Kanski, a nice
general ophthalmology text, well written and lots of nice pictures.
dr grant
On 6 Nov 2005 11:48:44 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
This is probably becaude you got done again with a structured arguement
vs your flaming and contradiction. If you would like, I will post the
text, which by the way, I actually looked up my Kanski text yesterday
while looking up something on another topic (retinopathy of prematurity
if you are interested). Guess what the 4 points in treatment were?
Funny, they were in exactly the same order as I wrote off the top of my
head at 4.00am one morning.
I do not need to twist your words, you do a good enough job of that
yourself.
dr grant
On 7 Nov 2005 12:46:53 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
Like I said, if you want to teach me something, get a textbook, read it
and quote something of value.
dr grant
You are another one that is not worthy of a reply.
And by the way folks, his name is Mr. Grant Mason, not Dr. Grant. If
he were a doctor, which he is not, he would be Dr. Mason
On 8 Nov 2005 10:40:25 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
Having read my posts, you now know how to treat RCE in a heirachical
order. That is teaching you something.
dr grant
On 9 Nov 2005 11:42:12 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
Rags, you read his posts, enough to respond with a spelling correction.
Really, are you retarded or something? You've reached credibility rock
bottom and you keep on digging.
next he will tell me that I have been killfiled for years so it is
impossible for him to read my posts. Now there's some logic.
dr grant
On 10 Nov 2005 07:58:25 -0800, "ycdbsoya" <the_bo...@hotmail.com>
wrote:
It's amusing that there are doctors who post who don't let it be known
that they are doctors - and there are also people who are NOT doctors
such as Mr. Grant Mason aka "Dr. Grant" posting under the false
identity of being a doctor.
On 10 Nov 2005 12:02:14 -0800, "CatmanX" <gra...@connexus.net.au>
wrote:
you're still yabberring cliffy, but we are waiting for you to say
something.
This was a thread on recurrent erosion, why don't you add something to
the topic???
dr grant
Go to an ophthalmologist.
The bottom line is that I was quite impressed with her. Much more so
than any other ophthalmologist or optometrist I've been to. I was also
impressed that she never once asked the names of the guy who did my
Lasik or the guy who wanted to do the keratectomy on the first visit
ever.
For those of you who say my sticky eye issue has nothing to do with
Lasik she would disagree. She says the Lasik took a dry eye problem
and made it worse which led to the recurring corneal abrasion. She
also says she has seen this a lot and that a Denver TV station did an
entire story on it last year.
Don't think I wake up every morning screaming in pain. I don't. I
still have 20/20 vision at the ripe old age of 51 which says that part
of the Lasik worked quite well. The abrasion stuff happens about once
or twice a year. But the pain associated with that is horrific as many
of you may know. It's like a paper cut on your cornea. Ouch!
I hope this post doesn't create too much Monday morning quarter
backing. I just wanted to follow up and let you know what I found out.
Thanks for all the advice.
Don
I hope this regimen works for you, sounds like you found a good doc.