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I am a female with prior Lasik surgery 12 years ago. Since I

Hello, I am a female...
Hello, I am a female with prior Lasik surgery 12 years ago. Since I have had cataract surgery on both eyes the last one 3 years ago. I have been a contact wearer off and on for 30 years, and I decided that I wanted to wear them again. So we finally found a lens to fit my right eye since it is a little flat on the surface from Lasik. I am wearing Acuvue Oasys for astigmatism in my right eye. Regular in my left.
I began the right lens in early May, and after 5 days my eye became sore to close tightly. Like a bruise. I left my lens out for 2 weeks and it felt better. After 1 day of wearing the lens again my eye was sore again. It has been 3 weeks since I have had a lens in my eye and it is still sore.
I went to see my Eye Doctor on Monday and he examined me and said that my eye looks normal. Nothing wrong and no symptoms other than soreness. He made me feel like I was crazy and had no explanation as to why my eye might be sore other than I might have worn them too long. just when it feels better put it back in.
I just wanted a second opinion on the matter because I do not understand why the soreness is ongoing. Maybe just a little worried. I have never had any problems with lenses in the past.
Thank You in advance,
Celeste
I
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Answered in 2 hours by:
6/21/2013
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,665
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick :

Hi. My name is***** and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

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.


Dr. Rick :

A history of lasik surgery can actually make this worse as lasik is a known cause of decreased tear production.

Dr. Rick :

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.

Dr. Rick :

After a few weeks of doing this home therapy I would bet that you can get back to wearing your contact lenses :)

Dr. Rick :

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. 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

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Dr. Rick says:
8:55 PM
Hi. My name is***** and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
8:55 PM
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.
8:56 PM
A history of lasik surgery can actually make this worse as lasik is a known cause of decreased tear production.
8:56 PM
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.
8:57 PM
After a few weeks of doing this home therapy I would bet that you can get back to wearing your contact lenses :)
8:57 PM
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. 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
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Customer reply replied 4 years ago

Thank you for your prompt reply. I will definately try the things that you have suggested.

I do have a couple of questions regarding antihistamines. can the drying affect of these drugs cause more dryness?

And I have seen advertisments for eye drops called Restasis. What is your opinion of these drops. I actually had been thinking about drops for I do have dry eyes.

Thank you in advance.

Celeste,
Yes, it is a trade off...they will help with many of the symptoms but they can also cause a bit more dryness. I think the benefits offered are worth a bit more dryness as increased use of natural tears can take care of this side effect.
Restasis is a very good drop and you should give it a try...just remember it requires daily use and takes about 3 weeks to "kick in"
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 :)
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,665
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
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Category: Eye
Satisfied Customers: 11,665
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