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Lasik induced dry
eye testimonial by L
(Portugal)
My
statement is based solely on my personal experience. I do not intend to make
a judgement or give an opinion about the pathology and its causes. Therefore
my goal is simply to share facts, with people that may be going through a
similar experience, with their relatives and friends, and, if possible to
sensitize everybody, specially the medical community to the impact that this
pathology has on life quality.
Since
April 2003, following a surgery to correct myopia (lasik), I started to have
a problem of eye dryness, lesions in the cornea and keratitis in both eyes.
This situation got significantly worse in November of the same year.
My
decision to have lasik surgery was taken following a personal motivation and
the opinion of three different experts, for whom I was considered to be a
simple case, either for the surgery or for the use of contact lenses. I
always refused the contact lens solution because just thinking about the
logistics of the solution made me feel uncomfortable.
However,
during the surgery, the corneal epithelium of both eyes suffered a big
lesion, being worst on the left eye, for which was estimated a recovery
period of months. I had to use protection lenses. At that time, my
cicatrisation process was slow, and created small scars, that improved
nonetheless as weeks went by, and also my sight. The treatment was based on
aggressive hydration (lubrication). During that stage I restarted working
and despite not feeling well I managed to continue working and forced my
eyes to work with computers and in an “intelligent” office, where you can
not avoid air conditioning.
In the
spring I started to have allergies in the eyelids and inflammations in the
eyes, which I never have experienced before. In fact I have never had
problems with my eyes, only some feeling of tiredness at the end of a days
work with a computer in an “intelligent” office. At that time, I started to
wake up during the night with a deep pain that lasted about 10 to 15 minutes
and stabilized leaving a strange feeling of a foreign body in my eyes, a
light to medium sting when I blinked and a feeling of sore eye. My life
quality began to be affected in a social manner. I started to avoid places
with smoke, sitting outdoor in cafes or walking in windy days. Besides this,
there was always an uncomfortable feeling in my eyes that prevented me of
relaxing even in my spare time.The treatment consisted in aggressive
hydration and histaminics.
In
August I was on vacations and I started to recover. I can not justify it
with a single cause, but I think that several factors may have contributed,
totally or partially, to my recovery: temporary punctual plugs, total rest
from the use of the computer and aggressive environments, acupuncture
treatments, and hydration of the eyes during the night (by the end of July I
was waking up at night every two and a half hours).
In
September I felt better, but I suffered 3 or 4 small lesions in the
epithelium after my return to work, situation that stabilized after a few
weeks. When I say to stabilize I do not mean that I did not suffer lesions.
What I mean is that I maintained my care with constant hydration (on an
hourly basis or less) during the day and with 3 hours break during the
night, and restrained myself from certain public spaces, which limited my
social life increasingly.
After a
month and a half, for professional reasons, I went to a project, which made
me a frequent airplane traveller, but no doctor disapproved it (with the
exception of the acupuncture experts that I was attending). During the month
I was in the project I was always very careful with the hydration,
and during my airplane travels I always put compress with cold water in my
eyelids as an attempt to maintain a moist environment. At the end of
November I started to have small nocturne lesions. I returned to Portugal,
and my doctor observed that I had lost my temporary punctual plugs. They
were inserted again, but in the same week I had an ulcer in my right eye
when I was waking up.
From
that day onwards and during several months I went through a very complicated
stage. The idea of having an ulcer whenever I woke up created in me a
feeling of insecurity and fear. I spent days trying to make sense of
patterns that could allow me to have a reference framework of cause and
effect, and whose only result was just the frustration of achieving nothing.
I started to shorten the sleeping periods to avoid the recurring lesions on
my cornea, but that did not work too. Days went by walking around at my
home, with pain in my eyes, or in the best chance, with stings, burn, and a
foreign body sensation, besides a contained feeling of despair. The
treatment was still constant hydration and my doctor told me about the
definitive punctual plugs. At that time, my doctor explained to me that I
had the syndrome of serious eye dryness and keratites due to a loss of
sensibility in the cornea. As in the process of cicatrisation the epithelium
did not adhere to the deep parts of the cornea, the probability of tearing
off whenever I woke up (the eye gets dryer while I am sleeping) increased
significantly, and that led me to have recurring lesions in the cornea.
My
doctor kept telling me that he did not see any reasons that I should not
overcome the situation. It was all a matter of time for the affected nervous
tissues to recover, a process that could take 2 or 3 years. The exception
was the functioning of the lachrymal system that he considered difficult to
recover to the normal levels. Regarding the treatments, my doctor considered
that the most appropriated was a lot of hydration, punctual plugs and
letting the body do the rest. His attitude was always firm in the sense of
not using antibiotics, steroids and definitely not analgesics, with the
exception of when I had the ulcers, because then I had to use protection
lens for some days/weeks and the pain in the first days could (and they
were) be very strong.
This
diagnostic was confirmed, by two more doctors that considered, regarding the
situation of my cornea, that maybe it was not the time to try therapies
based on steroids or other more recent therapies.
In
January I made the definitive punctal plug and I started on a macrobiotic
diet with the goal of helping the process of recovering my eyes and
stabilization of my nervous system, which my counsellor considered to be an
important factor, given that my sleep quality was very bad for so long and
that could be contributing negatively to my recovering. At the end of that
month, I had another ulcer on my right eye, and my doctor chose to scrap my
corneal epithelium. My process of recovery was very quick, the cornea became
transparent and I started to be a little more confident. However, my left
eye continued to suffer small lesions, I was getting very tired and started
to loose weight significantly, although I attributed this fact to my diet.
In March
I returned to allergies in my eyelids and inflammation in my eyes, which
made me stay more at home. I felt everything was prejudicial, cold, wind
sun…I do not have to emphasize that watching television, working with the
computer, reading, were activities impossible to pursue since November, or
in the best of chances, they were pursued in small doses, never at night and
only in the days that I felt better.
Following my friend’s suggestions, I went to two more doctors. One told me
my left eye would never be good, although he admitted not being a specialist
in corneas, and the other suggested I could have rosacea. Following
this, I went to the dermatologist, that always accompanied me through my
problems of allergies/eczema, but he did not agree with that diagnostic.
According to his opinion, my eczema stemmed from contact (excess of drops in
my eyelids and being constantly cleaning with anti septic gauze), aggravated
with spring dust and city pollution.
I made
medical analysis to detect self immune diseases (arthritis, Sjorgen
syndrome) which result was negative, just as my ophthalmologist doctor had
predicted. For him, the cause was always the loss of sensitivity in the
corneas.
In May,
following an infection, I had erosions in my left eye, and a big ulcer, and
my doctor opted to do again a scrap of the epithelium, a process that had
made my right eye improve. (the cornea of that eye was transparent and the
sight was pretty good). I returned to histamine and did the definitive
punctal plugs. The recovery of this eye was also good, although the sight
was slightly worse than the one of my right eye, because it seems I was left
with a post surgery scar mark.
Meanwhile, my doctor opted to start prescribing me steroid drops at bedtime,
in order to try to stabilize my sleep, as he was aware that I woke up every
night, for more than a year, and since November, at periods of 1 hour, 1.5
hour or 2 hours in the best days, and he thought that could be making
difficult my own recovery.
Since
June, I started to improve in a more sustained manner, from my eyes and my
general well-being (which is correlated, if not synonymous). Some days
better than others and always watchful to any sign that could lead my to
take protective actions, that consist in staying at home and doing a
aggressive hydration of the eyes. At that time I started to rest in the
afternoon (half an hour to an hour) and I realized that my discomfort and
end of day stings diminished. Slowly I started to wake up not so upset and
managed to wake up within periods of 3.5 hours to 4 hours.
My
doctor told me about a new medicine (Restasis), that seemed to have good
results in stimulating the tears production, but that is only sold in the
USA (however, cyclosporine is available elsewhere). The efforts to obtain
this medicine, from my doctor and myself, were not successful, which I,
after all I have gone through, consider at least absurd. About the medicine
and supports, there would be a lot to write about. I just comment the fact
that there is not a minimum of sensitivity and even knowledge about these
pathologies in terms of the consequences to the daily life of people that
suffer from them. At a given point, my eyes stopped supporting drops with
conserves, which led me to use preservative free lubricating eye drops and
serum in individual doses. Besides the eventual toxicity of the
preservatives, not all the drops provided relief for some reason I do not
know, and I think doctors in general do not know too. What I know is that
regarding drops in individual doses, their cost are not shared by the
National Healthcare Service in Portugal, making them very expensive. In my
case my monthly budget with eye drops varies between 300 and 400 euros,
which is a amount impossible to cope with for many people, which leads me to
the question, of what alternative do people have: less hydration of the
corneas, using drops that are also aggressive to the eyes? And the long term
results in the corneas health, which is already enough compromised?! Not to
mention the talks in the health centres where there seems to be doubts, more
or less subtle, about the suffering we have.
I
returned to work in the end of August, working half day in the office and
half day at home, and without putting to much effort in my eyes while using
the computer. As my job is demanding at that level, it is almost pointless
to say that my health limitations may have negative consequences at the
professional level. Anyway, I try to keep in mind that although my eyes go
through positive and not so positive stages, I consider they have been
gradually improving, which allows me to release gradually the emotional and
physical tension I accumulated during this stage.
Today,
14 months after the crisis, and one year and 9 months after the surgery, I
may say that I am better. Of course I still continue to hydrate aggressively
my eyes and using cortisone, and I still have several limitations: I can not
travel by plane for an undetermined period, I work at my office only half
day, I keep reading to a minimum, just as watching TV, I have not been to a
cinema or theatre, I avoid closed spaces (the effect of tobacco is
terrible). In short, I save my corneas to work. Besides that, I continue to
hydrate aggressively my eyes (today I can do periods of 1 to 1.5 hours at
day and 4 hours at night), I keep using cortisone, and doing some resting
periods during the day. Regarding practical consequences and more or less
structural: I changed my diet to try to balance my organism as much as
possible, I try to reinvent my hobbies and work methods in order to reduce
the pressure on my eyes, and everything that might have an impact in my
corneas, and at last or specially that, I try to learn to live again with
the accrued tiredness of yet another setback.
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