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Dr. Chan
Dr. Chan, Ophthalmologist
Category: Eye
Satisfied Customers: 356
Experience:  Board Certified in ophthalmology
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Ever since lasik 3 years ago, apart from now having dry

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Ever since lasik 3 years ago, apart from now having dry eyes, I have aching and stiff eyeballs and they feel pushed into the socket somehow .. they feel very stiff and strained and the eyeball muscles feels so strained when looking up and I get continous headaches behind the eyes and the eye balls are often tender and so is the surrounding tissue .. Also the muscles in my temples and round the eyebrow keep going into a locked spasm .. it is all very disturbing and claustrophobic .. I have had fibromyalgia for many years .. but never a problem with my eyes, till the day after the lasik.... the lasik surgeon does not know why... is basically stumped except he has identified some inflammation in the whites of the eye . Any clues as to what is going on please? Would be very grateful
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. Chan replied 8 years ago.


I'm sorry to hear of your difficulties. How is your vision? What is your age? What other medical conditions do you have (other than fibromyalgia)? What medications do you take?

Customer: replied 8 years ago.
My vision is improved .. but I still need glasses for reading.. and the improvement was just not worth the fall out. Apart from FMS I suffer from Proctitis (IBD) and also from severe IBS and both have flared up badly in the last few months. I am 60... and I know eyes get dryer with age .. but this was a sudden catastrophic dryness after the Lasik. I am ANA positive. I am on amytriptiline for the FMS and have reduced it to only 10 mg a night .. because of its drying effect, but it has not really helped. I know I was a bad candidate for Lasik .. but the surgeon apparently chose to risk it without me knowing the implications (so of course I am quite angry) He is supposed to be one of the best lasik surgeons in the worId, which is why I chose him. I also had a history of occular herpes in the right eye about 18 years ago .. which was treated successfully (no scarring) ... but that eye has now much reduced sensation after the lasik and is the dryer of the two eyes by far... clearly because the nerves in that eye were already compromised. Again the surgeon knew about this history. My right eye really aches all the time and feels distorted in its socket and looks smaller now than the other eye. (I am not suing btw).. The clinic who did the operation is providing me with autologous serum which I have had for about 4 months .. and although it helps in terms of instant lubrication .. it has not improved the fundamental situation.. drops just do not really help relieve the eyeball pain and discomfort. Hope that helps.. thank you
Expert:  Dr. Chan replied 8 years ago.


I think there are two major factors in your problem: 1) dry eyes and 2) fibromyalgia.

You already understand about the severing of the corneal nerves leading to bad dry eyes. Sometimes it is quite sudden, because you were probably on the edge prior to surgery. You are already on serum. I also presume that you have had punctal plugs (if not, that can be done to help). If you haven't already tried it, Restasis was made for conditions like yours (dry eyes due in part to autoimmune process). It can help stimulate more tear production.

The second problem is the fibromyalgia, which we don't know a whole lot about; but I think there definitely is an autoimmune component to it which can also dry out your eyes. Perhaps treating that (antiinflammatories) can also help.

Hope this helps and thank you.

Customer: replied 8 years ago.
thank you .. I tried punctal plugs but they did not help .. and I used Restasis ... but because of the history of corneal herpes,I was told it was a bad idea as it reduces the immunity of the eye making the eye vulnerable to another herpes attack . The restasis made my eyes very painful and red when I tried it .. Will the dryness ever get better . ie can the nerves still grow back to what they used to be? Also, what is causing this stiffness of the eye ball when I try to look up ? Also is the tightness I feel in my eyes (as if they have been screwed too tightly into my head) ... a result of the dryness?
Expert:  Dr. Chan replied 8 years ago.


I think the symptoms may be a combination of dryness and inflammation; so treatments need to be directed at both. Of course, the problems that you have does not preclude you from having other common problems (like sinuses). Some of these symptoms may be from sinuses as well.

You have a multifactorial problem that needs a multifactorial approach -- dry eyes, inflammation, and possibly sinuses.

Customer: replied 8 years ago.
My sinuses are fine. One last thing please.. will the corneal nerves continue to regenerate and grow back to base line with more time .. it is 3 years since the procedure.
Expert:  Dr. Chan replied 8 years ago.


In a study in 2004, it was noted that corneal nerves start to regenerate about 6 months after LASIK. By 2 years, they were similar to the preop stage. In some people the nerves decrease again between the 2nd and 3rd year to 60% of preop amount. There have been experimental uses of growth factors that seem favorable in increasing nerve regeneration (at least in rabbits). Also use of Cyclosporine has been shown to increasing nerve regeneration (ironically, this is Restasis).

Unfortunately, I would think that your corneas should have been back to peak by now. Keep in mind that your peak in the right eye is much more reduced due to the Herpes.

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