Watery eyes
Salmon Egg
right eye. Ir was watering heavily then, It has only become waterier
since. I have complained a number of times. At first, I was told that it
was dry eye. I do not think so, It is so watery that tears stream out, I
get drips on my glasses and clothing. Various preparations like Systane
do not seem to help. I feel no irritation that would cause the problem.
For the next step, the drain ducts were examined using dyes. I had no
trouble tasting the test fluid. The problem does not seem to be taken
seriously. I suppose tearing is better than losing total vision. That ey
is my better one. The tear deluge is aberrating my vision.
So, what suggestions can I get from the group?
Bill
--
As the years go by, dying just before having to fill out a tax return has merit.
Neil Brooks
Bill,
The symptom you're describing is known as epiphoria.
IMHO, it still /could/ be a dry eye condition.
If it were me, I'd find an experienced dry eye doc -- likely a corneal
specialist /with/ a dry eye expertise -- and have a full workup.
Tears have to be present in the right quantity AND the right quality
for everything to be okay.
If, for example, you have an unusually fast Tear Break-Up Time (a/k/a
TBUT), then you have a tear quality issue, and there may be additional
measures to help.
One option -- if this IS the case -- is to look into a product called
Lacriserts. While they don't work for every user, those who like
them ... swear by them.
Good luck!
Neil
Mike Tyner
"Salmon Egg" <Salm...@sbcglobal.net> wrote
> For the next step, the drain ducts were examined using dyes. I had no
> trouble tasting the test fluid. The problem does not seem to be taken
> seriously. I suppose tearing is better than losing total vision. That ey
> is my better one. The tear deluge is aberrating my vision.
>
> So, what suggestions can I get from the group?
The thicker wetting drops like Genteal, SootheXP, and ointments like
Lacrilube at bedtime, these all deserve a try. Your problem sounds like a
mucin deficiency.
Nighttime exposure gets overlooked. Patch the eye shut at bedtime for a week
or so, and evaluate the impact. It doesn't have to be taped shut, use a
padded pirate patch, or a sleep mask over both eyes, and sleep with a
humidifier in winter.
Four or five weeks of doxycycline po 50 mg/d is something else that deserves
consideration.
-MT
Neil Brooks
> "Salmon Egg" <Salmon...@sbcglobal.net> wrote
I didn't think about the ol' lagophthalmos. Quite common, from what I
recall. My wife has it, unilaterally, but is asymptomatic.
Bill, you may also want to google "meibomian gland expression."
Mike referenced mucin. There's also meibum. I notice a fairly
substantial relief of symptoms when I use a warm "corn bag" over my
eyes for 10 minutes, and then do the gland expression thing.
Also, ISTR that Minocycline proved slightly more effective and/or
better tolerated than doxy (I'm guessing Mike's thinking MGD --
Meibomian Gland Dysfunction), but don't hold me to that....
In some ways, you can certainly try to manage dry eye empirically:
treat the symptoms. If you get relief, you've tentatively confirmed
the diagnosis, albeit withOUT getting to a potential underlying cause
(not always possible, but sometimes).
For some people, some sorts of "moisture goggles" or eyeglass shields
(start here: http://www.dryeyepain.com/Goggles.htm) can make a WORLD
of difference.
Salmon Egg
> I didn't think about the ol' lagophthalmos. Quite common, from what I
> recall. My wife has it, unilaterally, but is asymptomatic.
>
> Bill, you may also want to google "meibomian gland expression."
>
> Mike referenced mucin. There's also meibum. I notice a fairly
> substantial relief of symptoms when I use a warm "corn bag" over my
> eyes for 10 minutes, and then do the gland expression thing.
>
> Also, ISTR that Minocycline proved slightly more effective and/or
> better tolerated than doxy (I'm guessing Mike's thinking MGD --
> Meibomian Gland Dysfunction), but don't hold me to that....
>
> In some ways, you can certainly try to manage dry eye empirically:
> treat the symptoms. If you get relief, you've tentatively confirmed
> the diagnosis, albeit withOUT getting to a potential underlying cause
> (not always possible, but sometimes).
>
> For some people, some sorts of "moisture goggles" or eyeglass shields
> (start here: http://www.dryeyepain.com/Goggles.htm) can make a WORLD
> of difference.
For now, I am overloaded with interesting responses. I will try to study
and look up references. That way I will be able, I hope, to ask pointed
questions and maybe get the docs to look for the zebras.
Jane
tearing. These include aniseikonia and glasses in which a lens is not
properly centered. I'd advise you to have a complete eye exam.
Salmon Egg
<42b5fd7a-e3dc-4051...@g23g2000yqh.googlegroups.com>,
Jane <clint...@hotmail.com> wrote:
I am being examined by ophthalmologist more often than I would like to
be. Actually the exams are not too bad. It is the traveling and waiting
for hours for a few minutes of examination and inadequate consultation
that will drive me crazy.
I looked up aniseikonia in Wikipedia. I do have different sizes of
retinal images for the eyes. AFAIK, that is do to distortion of the
retina in one of them. In any event, excess tearing was not a listed
symptom, and it was not so before the cataract surgery. In any event, I
see no obvious mechanism that would cause tearing from aniseikonia. Is
there some black magic going on that is taught in medical schools?
Jane
tearing! Actually, 67% of the people with aniseikonia are reported to
suffer from astenopia (excessive tearing, fatigue, burning, ache,
pain, pulling). I'm very familiar with your problem, Bill, because I
also have aniseikonia related to damage from an epiretinal membrane,
and my primary symptom is excessive tearing. There is good
information about retinally-induced aniseikonia and its treatment at
www opticaldiagnostics com. In my case, wearing a plus contact lens
under a minus glasses lens reduces the image size in my affected eye
and makes my vision more comfortable.
Jane
for someone with aniseikonia. The cause relates to the difficulty
fusing two different sized/shaped images. Headaches and double vision
are also possible symptoms.
You mentioned in your first post that your symptoms worsened after
cataract surgery. This is common. Cataract surgery sharpened the
image in your affected eye, making it more difficult for your brain to
ignore the distortion. One of the "treatments" for this condition is
to blur the vision in the affected eye by putting magic tape on the
inside of your glasses lens. This works for some people, but it
didn't help me at all.
When I developed excessive tearing (following a botched surgery to
peel an ERM which left me with an image size disparity), I was advised
to try a dozen prescriptions and OTC dry eye treatments. None
helped. When distant images began to double, I started doing my own
research to diagnose my symptoms. It didn't take me long to find the
answer, but then I couldn't find an eye care professional who could
treat my symptoms. All of them told me that my condition was
"untreatable." So I went online again to find some treatment.
There's almost no research in this area in the USA. The very best
papers on this topic are by Dr. Gerard de Wit of the Netherlands. You
can download "Retinally Induced Aniseikonia" at no charge from his
website www.opticaldiagnostics.com (although you have to search for
it) This is the best summary about this condition and its treatment
available anywhere. The article discusses optical solutions (contacts/
glasses), which can reduce the image size disparity/distortion. The
paper, unfortunately, is quite technical. Hopefully, you can find an
eye care professional to work with you (lol). Otherwise, you can do
it yourself by consulting with Dr. de Wit. I've had no problem
finding optometrists to write the prescriptions. In my case, my
symptoms immediately and dramatically disappeared with a contact/
glasses solution.
Mike Tyner
"Salmon Egg" <Salm...@sbcglobal.net> wrote
> see no obvious mechanism that would cause tearing from aniseikonia. Is
> there some black magic going on that is taught in medical schools?
Aniseikonia would be more of a "hail mary."
I got email offering Lacrisert samples today. That's another approach you
might want to try.
-MT
Salmon Egg
<6af4334f-238c-4a5a...@v30g2000yqm.googlegroups.com>,
Jane <clint...@hotmail.com> wrote:
> Bill, I didn't address your question about what might cause tearing
> for someone with aniseikonia. The cause relates to the difficulty
> fusing two different sized/shaped images. Headaches and double vision
> are also possible symptoms.
I already had difficulty fusing images in the two eyes because of CRVO
(central vein occlusion) way before the excessive tearing began. Even
now, my left eye vision is displaced by what I estimate to be 5 degrees
wrt my right. I do not get headaches. Even if I did, I do not understand
the neurological mechanism as to how that would affect tearing.
>
> You mentioned in your first post that your symptoms worsened after
> cataract surgery. This is common. Cataract surgery sharpened the
> image in your affected eye, making it more difficult for your brain to
> ignore the distortion. One of the "treatments" for this condition is
> to blur the vision in the affected eye by putting magic tape on the
> inside of your glasses lens. This works for some people, but it
> didn't help me at all.
I do not have to do anything to blur vision in my right eye. It is
blurred enough without any help. If anything, latanoprost drops
prescribed by my glaucoma surgeon irritate me. They have more BAK
preservative in them than latanoprost. He prescribed the drops even
though my IOP is at about 10 torr. When asked about it, he said that in
my case, even lower IOP might be beneficial.
>
> When I developed excessive tearing (following a botched surgery to
> peel an ERM which left me with an image size disparity), I was advised
> to try a dozen prescriptions and OTC dry eye treatments. None
> helped. When distant images began to double, I started doing my own
> research to diagnose my symptoms. It didn't take me long to find the
> answer, but then I couldn't find an eye care professional who could
> treat my symptoms. All of them told me that my condition was
> "untreatable." So I went online again to find some treatment.
> There's almost no research in this area in the USA. The very best
> papers on this topic are by Dr. Gerard de Wit of the Netherlands. You
> can download "Retinally Induced Aniseikonia" at no charge from his
> website www.opticaldiagnostics.com (although you have to search for
> it) This is the best summary about this condition and its treatment
> available anywhere. The article discusses optical solutions (contacts/
> glasses), which can reduce the image size disparity/distortion. The
> paper, unfortunately, is quite technical. Hopefully, you can find an
> eye care professional to work with you (lol). Otherwise, you can do
> it yourself by consulting with Dr. de Wit. I've had no problem
> finding optometrists to write the prescriptions. In my case, my
> symptoms immediately and dramatically disappeared with a contact/
> glasses solution.
--
Salmon Egg
<87a4ac1e-e361-4c24...@a32g2000yqm.googlegroups.com>,
Jane <clint...@hotmail.com> wrote:
It may be worth a shot. The lens combination you describe is that of a
galilean telescope. You describe looking into the "wrong' end of the
telescope to reduce the size of the image. I would be tempted to do that
in order to fuse the images there are to get some binocular depth
perception. I still cannot see a connection to tearing. But I hope I
have an open mind.
Jane
maximize) the central image in the affected eye in order to equalize
the image size in each eye to the extent possible. This might also be
accomplished by changing the base curve, center thickness, and vertex
of the lens(es) of your glasses.
I'm a psychologist, not a medical professional. While researching my
own problem, I read a study in which excessive tearing was reportedly
caused by a glasses lens which was incorrectly centered. (The tearing
stopped when this problem was corrected.) I assume that it's the
strain involved in binocular fusion that causes the tearing.
Salmon Egg
<84229a24-0e2c-46cf...@u7g2000yqm.googlegroups.com>,
Jane <clint...@hotmail.com> wrote:
I have to agree with Mike Tyner. Your explanation makes little logical
sense. From what I know, the probability of this explanation is low. I
would say 10% at most. As a psychologist, you may of heard of Baye's
theorem for hypothesis testing. The low a priori probability can be
increased by evidence. Do you have any? If not, I go along with the
"Hail Mary" hypothesis about your hypothesis suggested by Tyner.
Jane
Equalizing the image size difference between my eyes had an immediate
effect on the tearing of my affected eye--it stopped. In this case,
perhaps the proof of the pudding is in the eating. Best wishes.
Mike Tyner
anisekonia and relieves your epiphora - ie, the watering stops when you wear
aniseikonic correction and resumes when you remove it.
It's just hard to come up with a known mechanism, so you wonder about other
explanations like air circulation or nosepads affecting the nasolacrimal
duct.
-MT
"Jane" <clint...@hotmail.com> wrote in message
news:c27ee13b-f32d-43c0...@m26g2000yqb.googlegroups.com...
Jane
reported to be one of a number of possible symptoms of aniseikonia in
several papers. Besides stopping the tearing, the contact/glasses
correction gave me a subjective sense of tension relief that's hard to
describe. My best guess is that fusing images of different sizes
causes some strain.
BTW, Bill, if you can find an eye care provider who has size lenses,
looking through them will give you the same effect as a contact lens/
glasses correction. You could try various powers, maybe starting with
3%. It's not necessary (or even possible, in the case of retinally-
induced aniseikonia) to completely eliminate the image size difference
in order to get symptom relief.
Salmon Egg
<6199eaff-9b46-49ae...@z7g2000vbl.googlegroups.com>,
Jane <clint...@hotmail.com> wrote:
> BTW, Bill, if you can find an eye care provider who has size lenses,
> looking through them will give you the same effect as a contact lens/
> glasses correction. You could try various powers, maybe starting with
> 3%. It's not necessary (or even possible, in the case of retinally-
> induced aniseikonia) to completely eliminate the image size difference
> in order to get symptom relief.
When you see the distortion of an Amsler grid (I use an Excel
spreadsheet as an approximation), it is rather evident that ordinary
lenses cannot correct that distortion. Nevertheless, it might be better
than nothing. I am tempted to take the nothing because of its simplicity,
Jane
correction I suggested only works when there is an obvious image size
difference between the eyes.
David Combs
>caused by a glasses lens which was incorrectly centered. (The tearing
^^^^^^^^^^^^^^^^^^^^
I had a pair of (stupidly!) incorrectly-centered glasses once.
I don't know much about centering, but this is how I verify that
it is done CORRECTLY.
Now, this works only for bifocals or trifocals, probably much
easier to test with "executive" type bi- or tri-focals.
I put on the glasses, and point my head horizontally so that
I'm looking directly at a vertical line, eg a door, a pole-lamp,
a flag-pole, whatever. (No dancer, though -- too distracting,
screws up the test.)
Anyway, with both eyes, ie the head, pointing straight at
the pole or door-edge, where it passes vertically through
where the two lenses meet (if executive, it's a straight
horizontal line), the pole or whatever should NOT "jump"
as it goes (vertically) from the far into the near part
of the lens.
Now, twist the head SLIGHTLY, and you should see that the top
and bottom of the pole doesn't "line up" any more -- it's no
longer one tall pole, but two short ones, one starting at
the bottom and ending at the horizontal (executive) line, and
the other STARTING there (offset a bit from the bottom one)
and going to the top.
Suggestion: if you are ever given glasses that are NOT centered
correctly, demand a new pair that IS done correctly!
-----
Of course, if you're a spy, paid to sit in a hotel lobby
pretending to be a statue, always slyly having your eyes
pointed 30-degrees to the left (with dark bifocals), then
you want them centered where you're always looking through
them, ie where your line of sight (30-degress off from the
rest of us) passes through the glasses, at that horizontal
position on the executive-line.
If not executive type, but rather curved, well, I *think* the
principle would be the same, but harder to test. Can't beat
a straight line!
Hope this at least *approaches* the truth.
David