Doctor DanB : Hello and thanks for your question. Do you have any of the following: burning, tearing, caking or mattering of your lashes in the morning, intermittent vision changes, redness or light sensitivity?
Customer: some light sensitivity but I live in FL and only when I go out in the sun
Doctor DanB : How often are you using artificial tears? And is it consistently every day?
Customer: using eye drops several time daily, my symptoms arenon stop
Doctor DanB : Have you had any surgery or trauma to the eyes? What kinds if medicines do you take regularly?
Customer: they don't feel dry they are sore, they feel very strained
Customer: no surgery, I take Effexor 75mg daily and simvastatin daily I've been taking both for years
Doctor DanB : Do you wear glasses or contact lenses? Is there a certain activity or time of day that makes this worse? Any redness of the eyes? Customer: I had lasiks several years ago, no activity that makes it worse
Doctor DanB : Do you wear reading glasses for close up work?
Customer: yes I wear reading glasses to read or use computer
Doctor DanB : What strengths for each activity?
Customer: i believe they are 175
Doctor DanB : How far away are each of these activities?
Customer: 2 ft
Doctor DanB : You read and look at your computer monitor both at 2 ft?
Customer: reading probably 1 ft
Doctor DanB : But you use the 1.75 for reading too?
Customer: yes, my vision on last exam was 20/15 and i've used the same strength reading glasses for years, this condition has been present for about 6 months now
Customer: very strange
Doctor DanB : While I am at a distinct disadvantage because I cannot physically examine you, from what you have told me, I suspect that your soreness is the result of improper strength of your reading glasses that you're using for both near activities. For someone who reads approximately at 1 foot, is 57 years old, your strength should be at the very least +2.00 or more likely +2.25. To use the +1.75 pair for both reading and computer work is challenging your accommodative ability is very likely leading to eyestrain. Does this make sense?
Customer: I guess thats possible, but there are days where I don't read or use a computer and still have the same condition?
Customer: is eye strain something that will last days later even if no reading or computer?
Doctor DanB : I understand. It is quite possible that you are having accommodative spasm in the muscles that move your lenses. This can process can be a tonic state (persist for weeks to months) regardless of the fluctuation in your reading or near work activities from day to day. So I fully expect that this could still be the issue even though you spend little time with near vision activities on certain days. However it is also possible that this is related to a dysfunctional tear film. While you have been treated and are treating yourself for one particular kind of dysfunctional tear film (a tear deficiency state by using the artificial tears and the punctal plugs), there can be of numerous reasons why someone may have a dysfunctional tear film and if these individual reasons are not all being treated as well it can seem as though the treatment that is being used is not effective. For that reason if the change in the reading glasses use does not improve your symptoms, I would recommend seeing a corneal specialist who is an expert at dysfunctional tear film management. Does that make sense? I apologize but I need to pass through a particular area on my mobile phone that I know does not have very good cell service. I promise I will be out of this area within 7 to 10 minutes and I will get back to you.
Customer: Yes, I will set an appointment with a corneal specialist. Thank you
Doctor DanB : My pleasure. Do you have any other questions about this?
Customer: no thanks
Doctor DanB : If not, Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied. 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. Thanks for your inquiry!