Hi. My name isXXXXX and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
That is a very good question and, the answer is yes.....
Severe dry eye can cause all the symptoms that you are experiencing. I am glad that you have been evaluated by both an optometrist and an ophthalmologist recently....This makes me feel safe in believing that any and all other, possibly more serious, reasons for your discomfort have been ruled out.
Now, that being said, with you symptoms I feel you are going to need more then new glasses and artificial tears to get relief.
One drop that my help is called restasis. It is only available by Rx and takes a few weeks to "kick in" but I've had patients like yourself get excellent results with using this medication.
In addition you should start some home therapy to address the possible causes of your dry eyes. Let me tell you a little bit about some simple, but very effective, thing you can do on your own:
It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.
When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. 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.
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.
Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.
Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.
I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.
Does this make sense to you?
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. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations. Thanks in advance, Dr. Rick MD FACS
Well, I have been using artificial tears now for a few weeks. I think the ones that come in the individual little plastic containers that have no preservatives appear to work the best. I think the others eventually begin to irritate my eyes as I have used those before.
The last ophthalmologist I have seen said to wait a couple months or so and see if persistent use of artificial tears and the glasses helps. He said my eyes look like someone who has been wearing contacts for ten years (from the dryness) even though I have never worn them. They said the new glasses would help too. I guess the glasses are supposed to reduce my eye strain and promote more blinking?
They also said that the Rx eye drops you mentioned (they were mentioned last week before you said it) are a last resort of medication for dry eye because they are permanent.
Hello Dr. Rick
Since your last message, I have been taking the following steps:
1. I do a warm compress for 30 min twice a day
2. I do eye lid scrubs twice a day with baby shampoo
3. I take 3000 mg of fish oil per day
4. I am back taking zyrtec for my eye allergies
5. I use Systane gel at night when I go to bed
I know it has only been a week but my eyes seem to feel better? There is still some very mild soreness sometimes in the evening but I have had no more "complete meltdowns" where they get so inflamed that I cannot open them easily. Also, I have been using fewer drops of preservative free tears during the day.
Does this mean it is working and restasis may not be necessary?