Dry Eyes - Scleral Lenses - Why I chose them for my dry eyes
I have suffered from dry eyes for a long,long,long time. My previous posts detail when and why I have dry eyes - more impressively known as keratoconjunctivitis sicca. In summary I have sjogrens syndrome which leads to less tear production in the eyes which means the eyes are constantly dry. After having various treatments for my dry eyes I finally found a wonderful solution - scleral lenses - which have been a god send. In my next posts I will explain what they look like, how they are inserted and how they have helped!
My scleral contact lenses
I've had a rather interesting journey with my dry eyes over the last few months. After the bout of corneal ulcers I suffered from last year, I set out to seek a more effective treatment for my dry eyes. After spending some hours researching on alternative treatments, I came across scleral lenses. These are very large, hard lenses, shaped like a dome with a flat edge (a bit like a flying saucer!). They cover the whole of the sclera (the white part) of the eye. The magic for dry eye patients is the dome of the lens is filled with saline, before being placed in the eye. The result is that the eye is kept covered with this fluid until the lens is removed.
How my dry eyes are 2 years on...
Hello! Well it's been over 2 years since I wrote my last post. At the time my dryness was being exacerbated by working on a laptop for a few hours a day. I was also just beginning to lose eyebrow hair (I know - weird).
I thought it might be interesting for some of you to hear how my dry eyes have progressed since then. Firstly a number of things have changed. I stopped working for a start (for various reasons) which I guess temporarily helped my eyes. Overall though, my eyes have worsened. Last year I experienced a couple of months of severe dryness. My main symptoms were pain, extreme sensitivity to the sun and of course more severe grittiness, soreness, closing of eyelids. I also had a few episodes of eye infections (conjunctivitis). After a few weeks of trying to manage my symptoms on my own I asked my GP for a referral back to the ophthalmologist.
It had been about 6 years since I had been to the hospital for my dry eyes (which they treated by closing my punctal ducts). By now I felt desperate and tired of this condition. Anyway, as it happened things were about to get worse. My first appointment was at a general eye clinic (not the hospital). However about 2 days before this my right eye had been more painful than usual and bloodshot. When I looked closely at my eye I noticed a grey spot on my iris. This scared me and I immediately phoned up the clinic and asked to be seen sooner. They booked me in on the same day.
When the doctor examined me, to my shock he said the grey spot was a corneal ulcer and needed immediate treatment... (tbc).
I thought it might be interesting for some of you to hear how my dry eyes have progressed since then. Firstly a number of things have changed. I stopped working for a start (for various reasons) which I guess temporarily helped my eyes. Overall though, my eyes have worsened. Last year I experienced a couple of months of severe dryness. My main symptoms were pain, extreme sensitivity to the sun and of course more severe grittiness, soreness, closing of eyelids. I also had a few episodes of eye infections (conjunctivitis). After a few weeks of trying to manage my symptoms on my own I asked my GP for a referral back to the ophthalmologist.
It had been about 6 years since I had been to the hospital for my dry eyes (which they treated by closing my punctal ducts). By now I felt desperate and tired of this condition. Anyway, as it happened things were about to get worse. My first appointment was at a general eye clinic (not the hospital). However about 2 days before this my right eye had been more painful than usual and bloodshot. When I looked closely at my eye I noticed a grey spot on my iris. This scared me and I immediately phoned up the clinic and asked to be seen sooner. They booked me in on the same day.
When the doctor examined me, to my shock he said the grey spot was a corneal ulcer and needed immediate treatment... (tbc).
It's been a while...
I haven't updated my blog for a few weeks for a number of reasons, mainly because I've been working in the evenings on my laptop. One of the by products of working has been an increase eye dryness. This time round it has manifested as excessive tear production in my left eye - yes this can happen with dry eye as the eye tries to compensate the dryness (and for me it is more likely to happen as I have had my punctal ducts closed). My right eye has just been feeling very dry/tired/sore. I've been treating by using more of my eye drops.
On a separate note - something bizarre has been happening to my eye area - I have been losing eyebrow hair! I have no idea why but my eyebrows are looking very patchy. In a panic I had my self tested for thyroid disease but (thankfully!) this isn't the cause. I just hope they start growing back as otherwise I'll have to start penciling in the patches :).
On a separate note - something bizarre has been happening to my eye area - I have been losing eyebrow hair! I have no idea why but my eyebrows are looking very patchy. In a panic I had my self tested for thyroid disease but (thankfully!) this isn't the cause. I just hope they start growing back as otherwise I'll have to start penciling in the patches :).
To see without smell...
Out of all the senses we have sight is probably the most precious. Ask yourself which sense could you be without – Hearing? Touch? Taste? Smell? Sight?.
It’s a thought provoking question, which will hopefully remain just a question for most of you. I say most of you because I know what it’s like to be without one of these senses completely. I can hear, see (with glasses) and touch, but I can’t smell – which in turn means I can’t taste properly.
Now most people do a double take when I say I can’t smell – some instant questions are along the lines of “just this smell?” or “do you have a cold?” or “so you can’t smell anything?”.
That’s right – I can’t smell anything. Nothing good and nothing bad. I wish I could smell food, flowers, perfumes, I guess just ‘life’ but no such luck. Of course there are some benefits – whilst others wretch at the smell of vomit or baby pooh or some other repulsive scent I remain blissfully unaware.
I’ve never been given a medical explanation as to why – to be honest out of all the senses to lose this would be the top one it’s doesn’t require medical intervention. The only thing I worry about is not being able to smell something potentially toxic (this is on my ‘things which might cause my death list’!).
It’s a thought provoking question, which will hopefully remain just a question for most of you. I say most of you because I know what it’s like to be without one of these senses completely. I can hear, see (with glasses) and touch, but I can’t smell – which in turn means I can’t taste properly.
Now most people do a double take when I say I can’t smell – some instant questions are along the lines of “just this smell?” or “do you have a cold?” or “so you can’t smell anything?”.
That’s right – I can’t smell anything. Nothing good and nothing bad. I wish I could smell food, flowers, perfumes, I guess just ‘life’ but no such luck. Of course there are some benefits – whilst others wretch at the smell of vomit or baby pooh or some other repulsive scent I remain blissfully unaware.
I’ve never been given a medical explanation as to why – to be honest out of all the senses to lose this would be the top one it’s doesn’t require medical intervention. The only thing I worry about is not being able to smell something potentially toxic (this is on my ‘things which might cause my death list’!).
Dry eyes - how bad can they get?
I know I said my next instalment would be continue to be about eye drops but I have to share another dry eye experience. I visit some dry eye forums regularly and recently came across a lady (Mel) who also has dry eyes. When we exchanged stories I felt like I was the lucky one. I thought I would post Mel's story to give you an idea of the different ways dry eye can manifest. In case your wondering I have Mel's permission and Mel isn't her real name :).
Mel has dry eyes caused by meibomian gland blocked by a cyst leading to to recurrent corneal erosion. Below is her description of corneal erosion.
"Corneal erosion is like having someone drive a sharp screwdriver through your eyeball totally unexpectedly in the middle of the night! If you have had damage to the surface of your eye at some point in the past (e.g. a paper cut or, in my case, a cut from the sharp edge of a vicious houseplant leaf) it leaves a weakness in the structure of the cornea. Then when you get dry eye for whatever reason, overnight your eye dries out, your eyelid sticks to it, and when you involuntarily open your eye or move your eyeball in the middle of the night, the eyelid rips the surface of the cornea away from the layer below along the line of the old cut.
It's painful and scary. But I'm dealing with it well now. I put the Lumecare gel in last thing at night and then put on the Tranquileyes goggles, soaked in filtered water. They hold my eyes shut all night. In the morning I put the Lumecare drops into the corner of my eye before I open it and allow the drops to moisturise my eyeball before I open my eye. No pain. And I don't get any symptoms during the day so I'm very lucky. I did see a consultant about having the remains of my meibomian cyst removed which may unblock the gland but I haven't decided whether to risk the operation - I'm a real coward about scalpels and eyes."
A big thanks to Mel for sharing!
Drops for dry eyes
Right now as I'm typing this my eyes are feeling really gritty and sleepy. Entirely self induced as I've taken on some work this week (laptop based) so have therefore been staring at my screen far too much.
At the moment I'm using some eye drops called Vismed. After years of using Celluvisc drops (active ingredient hypromellose) I started experimenting with alternatives a few months ago. I'm so glad I did! I hated using celluvisc, for 2 main reasons, a) the relief from them would only last a couple of minutes and b) they would leave a horrible crust on my eyelashes and skin around my eyes. I know this is bad, but I would only really use them when I was completely desperate (in other words when physically I couldn't keep my eyelids open).
The first alternative eye drops I tried were Hycosan. I was recommended these on my last sight test. I LOVE Hycosan! As soon as I put the drops in my eyes felt soft, cushioned and almost doubled in size! (OK I know the double in size is a bit extreme but you can imagine the difference between tired sleepy looking eyes and bright, vibrant healthy looking eyes!).
After a couple of days on the Hycosan I felt confident enough to wear my daily disposable contact lenses - Johnsons Acuvue Moist. I usually only wear lenses on a special occasion - wedding/party/other special day. For my eyes to feel good enough to wear lenses on a normal day was a big achievement for me. My eyes felt fine with the lenses and at the end of day I was able to take both lenses out easily. In the past one lens used to get stuck to my eyeball. The last time this happened after 10 minutes of trying to get the lens out I panicked and thought I would have to go to A&E, but I continued poking my eye and eventually the lens came out (I swore I would never wear lenses again!).
Anyway, with the Hycosan I wore lenses for two days before my eyes started to feel a little sore again. But at least I now know I can wear lenses comfortably on special occasions.
More on my drops saga next time!
At the moment I'm using some eye drops called Vismed. After years of using Celluvisc drops (active ingredient hypromellose) I started experimenting with alternatives a few months ago. I'm so glad I did! I hated using celluvisc, for 2 main reasons, a) the relief from them would only last a couple of minutes and b) they would leave a horrible crust on my eyelashes and skin around my eyes. I know this is bad, but I would only really use them when I was completely desperate (in other words when physically I couldn't keep my eyelids open).
The first alternative eye drops I tried were Hycosan. I was recommended these on my last sight test. I LOVE Hycosan! As soon as I put the drops in my eyes felt soft, cushioned and almost doubled in size! (OK I know the double in size is a bit extreme but you can imagine the difference between tired sleepy looking eyes and bright, vibrant healthy looking eyes!).
After a couple of days on the Hycosan I felt confident enough to wear my daily disposable contact lenses - Johnsons Acuvue Moist. I usually only wear lenses on a special occasion - wedding/party/other special day. For my eyes to feel good enough to wear lenses on a normal day was a big achievement for me. My eyes felt fine with the lenses and at the end of day I was able to take both lenses out easily. In the past one lens used to get stuck to my eyeball. The last time this happened after 10 minutes of trying to get the lens out I panicked and thought I would have to go to A&E, but I continued poking my eye and eventually the lens came out (I swore I would never wear lenses again!).
Anyway, with the Hycosan I wore lenses for two days before my eyes started to feel a little sore again. But at least I now know I can wear lenses comfortably on special occasions.
More on my drops saga next time!
Dry eye tests
Over the years, I've had two main tests done to diagnose my dry eyes (but I would say for me even without these tests I knew my eyes were abnormally dry).
The first test I had was with the yellow dye. This is a fluorescent dye which stains the dry patches on the dye. This enables the ophthalmologist to evaluate the extent of the dryness. I've had this done a few times and can tell you the dye does not sting at all. The only downside was that my eyes were tinged yellow afterwards and perhaps took longer to return to normal because of the dryness and hence the dye clinging to my eyes.
The second test I had done is called the Schirmer test. This involves placing a strip of filter paper in the middle of the lower eye lids for 5 minutes and then assessing the wetness of the filter paper.
I will never forget this test as it turned out be a very embarrassing and funny situation for me. I had gone for a rheumatology appointment and the consultant wanted to examine me. So I stripped down to undergarments, she examined me and then to my surprise asked if some medical students could take a look. I agreed (thinking not to agree would appear stupid). Anyway after being gawped at, the consultant then wanted to test my eyes for dryness. So my glasses came off and in went the strips in my eyes. As all this was very quick, I had to sit on the edge of the couch, without my clothes on, with two bits of paper hanging out of my eyes and all I could see were the blurry faces of the medical students and the consultant!
As I sat there waiting for the longest 5 minutes of my life to be over, all of a sudden the door opens and in bursts another doctor - I was right in front of her! I don't know who was more shocked her or me! She had come into the wrong room! At this point I felt like laughing (as I'm sure did the medical students). Luckily this interruption reminded the consultant that my 5 minutes were up. My ordeal had finally come to an end!
Crying ice and blood...
After all my excitement about setting up my blog I haven't been able to post in the last few days as my little one was unwell. We are over the drama and I can talk about eyes again! I saw two amazing stories in the metro - one about an arctic ice cap which has melted to look like a face crying. I'm very sceptical when I see these types of photos but this one is quite spooky:
http://www.dailymail.co.uk/news/worldnews/article-1210706/Caught-camera-Mother-Nature-cries-river-tears-global-warming-threatens-planet.html
The other story was about the boy who cries tears of blood at random times. I know from experience normal teary eyes can be annoying (yes - you can get tears with dry eyes) but to have blood flowing from your eyes must be horrific.
http://www.youtube.com/watch?v=d0r4ABAqd7M
In terms of my own eyes they are feeling ok at the moment. I have started to work from home again (on laptop), will have to see how that begins to affect my dry eyes.
http://www.dailymail.co.uk/news/worldnews/article-1210706/Caught-camera-Mother-Nature-cries-river-tears-global-warming-threatens-planet.html
The other story was about the boy who cries tears of blood at random times. I know from experience normal teary eyes can be annoying (yes - you can get tears with dry eyes) but to have blood flowing from your eyes must be horrific.
http://www.youtube.com/watch?v=d0r4ABAqd7M
In terms of my own eyes they are feeling ok at the moment. I have started to work from home again (on laptop), will have to see how that begins to affect my dry eyes.
New post coming soon!
I haven't been able to post a new blog for a few days as my son is unwell. Hopefully he will be better soon and I will post more soon.
How dry my eyes feel right now
So you have that dry eye feeling? Not sure how dry your eyes are? Well, I thought I would give you a description of how my eyes are feeling right now.
First some context - up until this time last week I was using my laptop for maybe an hour a day and my eyes had been feeling good, I have two small children and was able to tend to them during the night as well without my eyelids sticking to my eyeballs (I know yuck - but that's the sensation).
Since last week I have been using my laptop for maybe 4/5 hours a day (more in the evenings and during the day when kids are playing) - as I've been developing this blog and learning about blogging.
My eyes have been feeling progressively drier since then. I've not been able to try my new daily disposable contact lenses as I'm too scared to put them in - although they are meant to be good for dry eyes - they are called Acuvue Trueye.
I've had to eye drops more often than usual to help my dry eyes, especially so in the evening. Without the drops they feel 'shriveled' as if the skin around my eyes is doing it's best to stay open. My right eye is feeling much worse and compared to my left looks slightly closed. But the moment I use the drops my eyes are revitalised and instantly open up, although for me this optimal state lasts a few mintues before the dryness starts settling in again.
The eyesight from right eye is also slightly blurred (although I know this is temporary as the eye drops clear it up again).
So that's how dry eye my eyes feel right now! More from me soon :).
Treatment at hospital - closing of tear ducts
The first treatment for my dry eyes involved blocking my tear ducts - technically known as punctal ducts. Up until this point I never even knew I had any! These are the tiny holes on the inner lower and upper lids of your eyes (If you look really carefully close up you should be able to see them). Their job is to drain away tears from the eyes into the nose (hence the runny nose when crying). They are constantly working as the eyes continuously produce small amounts of tears to keep our eyes lubricated, protected and healthy.
Eye diagram
To insert the plugs (by the way these are just made of silicone and are flexible to enable easy insertion), I was told to lie down on the couch. The opthalmologist and nurse then positioned a large magnifying glass over my eyes, sterilised my eyes and then inserted the plugs.
YouTube video showing punctal plug and punctal duct (hope your not squeamish!)I would describe this process as more uncomfortable than painful. As it was done on the same day as my eye exam my eyes looked a little messy and sore when they finished. My eyes also had a strange yellow tinge caused by the dye used to examine for dryness (my eyes probably resembled something from a sci-fi movie :)).
I went home from this appointment with my eyes plugged, bag full of eye drops and ointment and new hope that all of this will be the magic solution to fix my dry eyes. Little did I know I would have to return for an even more daunting eye procedure...
The eye examination
So, on to the treatment. At my first visit to the hospital the medics conducted a thorough eye examination - it was very up close and personal - with the ophthalmologist only inches away from me!
They used a yellow dye to highlight the damaged areas and were so astounded that they called all the eye doctors in to have a look. I felt quite privileged and secretly pleased at the thought of having all these expert opinions :). They even photographed my eyes to use as teaching material.
After all the examination excitement I was told the somewhat dreaded news that indeed my eyes were producing very few natural tears and my corneas had become damaged. They wanted to use a two pronged approach for treatment- firstly to retain the tears I did have and secondly to keep my eyes lubricated using eye drops (which were called celluvisc) and an eye ointment for night time use (called lacrilube).
Use of the eye drops and ointment was simple (although not pleasant - I will cover my experience with these in later posts). Preserving the tears was a different matter, which involved two small, separate procedures - first blocking my tear ducts and then closing the tear ducts permanently!
More on these in my next post! thanks for reading and please visit again!
My journey from normal to dry eye...
My dry eyes are the reason I have decided to start this blog in the hope of helping others who may be suffering the same problems as I have with my eyes. I hope you find it informative and useful – and please do leave a comment or share your story with others.
What is dry eye? Eyes become dry when there are not enough natural tears to help keep them lubricated (tears are there all the time not just during episodes of crying). This lack of tears may be caused by either insufficient tear production or increased evaporation from the eyes. Whatever the reasons the effects are just as pleasant blurred vision, irritation, grittiness.
My dry eyes are caused by a condition called Sjogren's syndrome which is an autoimmune disease. It can have many manifestations with a main symptom of dryness - which I have both in my eyes and my mouth (how it affects my teeth needs deserves it's own blog :)).
My eyes first started to deteriorate when I was in my early twenties (I am now 32) - after about 3 years of wearing contact lenses. I don't think the contact lenses caused the dry eye but the continuous use probably magnified the effect Sjogren’s was beginning to have. By the age of 24 I stopped wearing lenses daily (reserving them for social use), and became a permanent wearer of glasses.
At this stage my eyes were feeling continuously gritty. Blasts of air from air conditioning etc. would make my eyes go red and sore. By early evenings my eyes would be semi shut - people would ask me why I was feeling so tired or sleepy. When I did wear contacts my eyes would be sticky and weeping after taking them out. My eyes stayed in this state for a few years. I did not know there was any treatment for them and nor was I aware of the extent of damage.
It was when I went for a routine sight test, aged 27, that the optician noticed both my eyes had corneal damage. I was naturally shocked and worried at this discovery and promptly attended a hospital eye clinic...
...So what happened next I hope your asking – well, I will explain in my next blog as things get a bit technical here – I have to conjure up an eye diagram to properly describe the treatment – wish me luck and please do revisit for my next instalment of my dry eye journey!
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