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Doctor DanB, Board Certified Ophthalmologist
Category: Eye
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Experience: and eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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i have dry eyes and when i put in drops, seems my right eye

Resolved Question:

i have dry eyes and when i put in drops, seems my right eye fogs up. why would one eye fog up and the other remain clear when using dry eye drops

Submitted: 1 year ago.
Category: Eye
Expert:  Doctor DanB replied 1 year ago.


Doctor DanB :

Hello and thanks for your question. I think the reason for this is also the reason why a person with allergies may only feel itchy in one eye even though the same process is going on in both eyes--its because the eyes often times feel and experience things assymetrically. In other words, it is very common for the same process--such as dry eyes--to be going on in both eyes, yet the patient only has significant symptoms in one eye. The eyes are inherently a little bit different from each other (they aren't exactly the same eye and don't always exactly behave as the other one does). Does that make sense?

Customer: replied 1 year ago.

ok, so lets focus on the one that gets all foggy. what causes this? it last for like 1-2 minutes then it gets clear

Expert:  Doctor DanB replied 1 year ago.

I suspect that this tear film is just more unstable than the other one and takes longer to clear because of that. I don't think this is anything that can be made to go away--the treatment for the dry eye is what will improve the stability of this tear film, but I would expect as the dry eye improves, that this would improve as well.

Customer: replied 1 year ago.

ok, so tear film causes this stuff and part of dry eye?

what helps tear film? Restasis?

will bad tear film cause astigmatism vision

Expert:  Doctor DanB replied 1 year ago.

A dysfunctional tear film can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to a dysfunctional tear film Allergies in the eyes can also contribute (and or make worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis can have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.

 

Depending on what factors are causing your tear-film dysfunction, then yes, Restasis can help in several of those--it is a very effective drug. But if you have tear film dysfunction that requires other treatments besides Restasis to treat (like, say blepharitis), then just doing Restasis and not the blepharitis treatments would make it seem as though the Restasis wasn't working.

 

A dysfunctional tear film can cause vision fluctuations that can induce astigmatism, though it wouldn't be permanent and stable astigmatism, just moment to moment fluctuations of the vision which could momentarily induce astigmatism.

 

Customer: replied 1 year ago.

Thats me

Expert:  Doctor DanB replied 1 year ago.

Does that make sense? Do you have any other questions about this?

Customer: replied 1 year ago.

yes it does, how do they test for blepharitis besides just guessing?

Expert:  Doctor DanB replied 1 year ago.

Oh, blepharitis is not diagnosed on guessing--it is very easily diagnosed on an eye exam as long as the eye doctor is looking for it. It is very commonly overlooked.

Customer: replied 1 year ago.

Ok so it should be looked at on dry eye test.

Expert:  Doctor DanB replied 1 year ago.

Absolutely. Any ophthalmologist doing an exam for dry eyes should be able to look for this and diagnose it, if it is there.

Customer: replied 1 year ago.

awesome, my vision after lasik problem sure points to dry eyes. i have light fogged vision with double vision and it fluctuates and on one exam, they said put some dye in eye and told me to keep eyes closed and under slit lamp they told me to open them and in less then 1 second it was gone on my right eye and like 3 seconds for my left eye, but they did not check for the cause, i hope it is just because i had a high prescription that it is not permanent.

Expert:  Doctor DanB replied 1 year ago.

How long ago was your LASIK?

Customer: replied 1 year ago.

8 months.

Expert:  Doctor DanB replied 1 year ago.

Many people have dry eye after LASIK. I hope that with intense, dedicated treatment, which often times needs to include Restasis, that this resolves for you.

Customer: replied 1 year ago.

yes, me too, i heard that hyperopic lasik, dry eyes can last longer and with the high astigmatism i had, it does not help. maybe it is still trying to recover.

Expert:  Doctor DanB replied 1 year ago.

I suspect that it is. Try to be patient and be diligent about keeping up with the dry eye treatments and hopefully this resolves for you.

Customer: replied 1 year ago.

yes, i had one question, i found out that the ones that check eyes for prescription use a - mehtod and the others use a + method and that if the eye glass prescription is a +7, the other one it would be like a +2, etc? Is this true?

Expert:  Doctor DanB replied 1 year ago.

I understand what you're saying. It ends up being the same refractive error, it's just a different way of writing it. If a +7.00 -2.00 x90 prescription is written in (+) format, it would be a +5.00 +2.00 x180. It's just convention.

Customer: replied 1 year ago.

Rick told me that it would be converted to +2.00 not +5.00. Is this true? Because i had a +6.75 and they wrote it as +2.00. Im confused so much. Does that mean that if contact lenses say they go up to +6.00, what are they talking about?

Expert:  Doctor DanB replied 1 year ago.

Contact lens prescriptions and glasses prescriptions are different prescriptions entirely--you can't juxtapose between one and the other as you could between + or - convention of writing glasses. Do you have an actual glasses prescription that you want me to convert from + to - or vice versa?

Customer: replied 1 year ago.

yes, check this out.
my eye glass prescription at time of initial pre op lasik exam was

+6.75 -4.25 X 7
+5.75 -4.75 X 175

i handed this prescription to my lasik doctor and recently asked for my medical records and they put that my present eye glass rx at time of pre op exam was

+2.75 +4.25 X 106
+1.25 +4.10 X 84

How can they convert +6.75 to +2.75

Expert:  Doctor DanB replied 1 year ago.

When I convert your glasses prescription from minus to plus, this is what I get:

 

OD: +2.50 +4.25 x97

OS: +1.00 +4.75 x85

 

However, I wonder whether what they're telling you your eye glass rx at the time of your pre-op exam was what they measured your refractive error to be, and not just a conversion of your paper prescription?

Customer: replied 1 year ago.

ok, so it does convert alot down.
just one question. you know on the lasik they tell you that the recommend no higher then +6, i wonder what prescription method they are using.

Expert:  Doctor DanB replied 1 year ago.

They're using the plus version for the most part, but the prescription (or the refractive error) is generally not the only thing they're looking at. For the most part, they're looking at the shape of the cornea to determine whether it's safe to do LASIK, and the shape of the cornea contributes to the refractive error.

Expert:  Doctor DanB replied 1 year ago.

 

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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Doctor DanB, Board Certified Ophthalmologist
Category: Eye
Positive Feedback: 98.9 %
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Experience: and eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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