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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7376
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I went to an eye surgeon in 2011 for a check up to discuss

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I went to an eye surgeon in 2011 for a check up to discuss cataract surgery which I had in Januay 2012. At that appt in Nov 2011, the had me take out my RGP lenses-I had my glasses with me too. She said I could put them back in or use my glasses. She asked if the Rx was the same and I said similar but that I could see out of my contacts better. She had me read with the glasses. The tech kept telling to me keep trying on the eye chart like she didn't believe I couldn't read it (I was 55 at the time and my visiion was about -7.75 both eyes) I eventually started crying because I was trying so hard I was in a sweat. She finally looked up from whatever she was reading. She was putting drops in my eyes. I asked if any of the drops were dilating drops and she said yes. I asked if she read in my chart that full strength drops were too strong and I'd end up with a migraine and not see clearly for about 10 hrs. She rushed over and got some other drops and put those in my eyes then. The Dr eventually came in and told me about the different implants. He also said I'd have to wear just my glasses for possibly several months-checking every 4 weeks until my eyes were ready.
That very night(about 12 hrs after the exam) I woke up during the night and couldn't open my eyes as my eyelids felt like sandpaper on very dry eyeballs. I was scared and kept yawning and trying to water up my eyes. Eventually I was able to painfully open them and put some of my contact solution in them as I didn't have any drops. I'd NEVER had symptoms of dry eyes before. I could wear my RGP contacts comfortably for 14 hrs. I'd worn just my glasses before for several days, even recently at that time and never had my eyes feel anything like that. Anyways, I was given all kinds of OTC drops to try. No one seemed to listen that this had never happened before-they just said it was because I wasn't weaing my contacts anymore. Doesn't make sense. And then I noticed that at the top of my eyelids, my eyes would ache like a toothache.
After my eye surgeries (the result was not what I was told-he didn't get the implant Rx correct), my eyes continued to be very sensitive especially after the steroid drops were discontinued (I was put on stronger drops because of the pain). I was eventually put on Restasis and that very first night, I could open my eyes without the lids feeling like sandpaper, but the dryness continues. I go for days feeling like more corneas are irritated. I think something happened at that first appt that injured my tear glands. Any ideas. Any other treatments. No OTC products help much-they only feel good the first few minutes while the moisture is there. I can't even use the shampoos and face cleansers that I'd used for years. By the way, I'd worn RGP contacts for 42 yrs-never a problem. Now I've been trying all kinds of soft lenses along with readers, although I was told they were going to make it so I'd "never have to wear contacts or readers again" HA!
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

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Expert:  Dr. Rick replied 1 year ago.
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Expert:  Dr. Rick replied 1 year ago.
Nancy,

Thank you for that very extensive post.

I can tell you, with 100% certainty, that your dry eye problem was not caused by the drops the nurse put in your eyes back in 2011. This is just not possible.

I am sorry to hear about all the difficulties you are currently having due to the dryness of your eyes. There are, however, other things that can be done to help you in addition to using drops.

Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

You most likely also have blepharitis. This is very common.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.

How could this had gotten so severe so quickly when I'd had absolutely so symptoms until hours after that eye exam. Also, why did my vision come out wrong? I have always used baby bath to wash my face and eyelids but will try the warm compresses.

Expert:  Dr. Rick replied 1 year ago.
Nancy,

That is an excellent question and, to tell the truth, I don't know why you all of a sudden started noticing so much difficulty after that eye exam. :(

I can tell you, however, that after almost two decades of clinical practice I have had patients have the same experience you had.....it might be that the drops were the "straw that broke the camels back" and tipped you over into having problem.

As to your vision, it is not unusual for dry eyes and recently removing contacts before a refraction leading to glasses that don't work so well, hence the idea of keeping them out and making sure your eyes are in good shape prior to a refraction for now glasses.

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

I hope you feel better soon. Have a good weekend.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7376
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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