I had epi lasek surgery on one eye 8 months ago. I am still getting dry eye symptoms which is making my life a misery. I am now obviously past the magic 6 month point. Is there any hope that my condition could still clear up and could my eye still be healing? Why does my other eye get the symptoms as well? I have had one eye plugged with limited success. Should I ask for both eyes to be plugged? Dr. Trattler or Glenn Heagle, please help!

What is rerquired is a comprehensive evaluation of your tear film and the health of your corneas, including the epithelium. From that information your doctor can determine what treatment is best.

Punctal plugs may be an option, but if your problem is a poor lipid layer or inflammation round the channels that carry the fluids, this will not really resolve the problem. You may do better with flax seed oil supplements or Restasis. Returning your tearing function to balance is what is needed and you want to be sure to apply the proper treatment for the proper resolution. We have a detailed article on dry eye treatment at http://www.complicatedeyes.org/dry_eye_treatment.htm that may be helpful.

Glenn Hagele
http://USAEyes.org
Patient Advocacy & Surgeon Certification

I am not a doctor.

Thanks for that Glenn unfortunately I live in the UK and Restasis is not available yet (I think)although I haver tried the Flax Seed Oil. I was just wondering wether it is still possible that natural healing is still occurring even after 8 months and it may yet resolve itself over time.

Yes, healing can continue, but at 8 months postop your difficulties probably do not relate to healing issues. Do read through the article referenced above. Flax seed oil is ideal if you have a lipid deficiency, but would provide little or no relief if inflammation is the problem. This is why you need a comprehensive evaluation. Call around to the different eye doctors and see if you can find someone who specializes in dry eye problems. Most communities have someone who is especially talented.

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

>Yes, healing can continue, but at 8
>months postop your difficulties probably do
>not relate to healing issues.

Glenn - What exactly do you mean by the above statement? That the dry eye he is experiencing now is not due to the lasik? That his corneal nerves can not still be healing? I thought that the nerves could be healing for years?

Barry - I'm so sorry to hear of your troubles. I'm at 1 year post-op and still dealing with the dry eye thing. I do understand how miserable it can be. I've spoken with alot of people who have been in our shoes and many of them have seen improvements, even after one year, so hang in there. I know that sometimes it is hard to stay positive when our eyes hurt though. A good website that I visit is www.dryeyezone.com. There is a wealth of info. on dry eye treatments, and plenty of support from others going through this. There are several people from the UK that post on that site, and I believe some of them are getting access to Restasis now. You might want to check it out and see if you can find any good info. that could help you out. Good luck.

-Shells

For the vast majority of patients Lasik induced temporary dry eye is resolved by the end of the normal six-month healing period. If at six months postop a patient continues to have a dry eye problem, it would be wise to start looking at other issues that can cause dry eye, especially those causes that could have been exacerbated by surgery. Mild blepharitis, poor tear quality, poor tear quantity, medications, hormone changes (especially in peri-menopausal women), allergies, etc.

At six months it is time to start looking for base causes of dry eye other than Lasik, but Lasik can be a contributor and can exacerbate underlying problems. It is possible that the patient had borderline dry eye problems that had not presented, but the disruption of surgery was enough to cross that border.

Most certainly additional healing, increased corneal sensitivity, and tearing function can...and will...occur after eight months. There have been several case studies of patients who had dry eye problems at one year postop and later, which resolved with proper treatment. People react differently to surgery and people heal differently.

Glenn Hagele
http://USAEyes.org
Patient Advocacy & Surgeon Certification

I am not a doctor.

Thanks Michelle and Glenn for your response. Sometimes all we need is a little hope and things do seem a little better lately.
I went to the clinic for what will be the last time on Friday and the Opthamologist put two punctal plugs in and basically said that that was all they could do. My next stop if this does not work is the Eye Clinic at the hospital. She has referred me to there as she says that some concretions have formed under my right eyelid and these could be causing problems.Have you had any experience of this condition?

Anyway, thanks again for your thoughts and concern
and keep on smiling! Nil Desperandum, as my old Latin teacher used to say!