DRY EYES & MGD

How did anyone get on with cancelling surgery when they realised that any dry eye symptoms they had would worsen after surgery? I've cancelled but had a call from oe saying they can sort my dry eye out before surgery and are getting a clinician to call me to discuss!
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admin: 'Clinician' - they must be desperate if a doctor is going to try and pressure you into surgery!

As for sorting out your dry eyes pre surgery, they have thousands of post op patients left with permanent dry eyes who they've been unable to 'sort out', and have even stopped supplying most with eye drops since implementing their 12 months aftercare policy! (see Which? for more about this conversation.which.co.uk/health/optical-...ee-laser-eye-surgery )

Pls send your phone number asap and I will call to advise info@opticalexpressruinedmylife.co.uk

I came across this info while looking for reasons why my eyes became photo-sensitive and painful after Lasik - and getting worse 2 years on. A bit wordy but useful in understanding the complexity of this complication.

Centralized Corneal Neuropathic Pain following Laser Keratorefractive Surgery.
In a cohort of patients (n=21) that developed putative CCNP following laser keratorefractive procedures in which its duration had ranged from 2 to 15 years at the time of the initial consultation, 81% reported that photophobia was a significant component of their symptoms [see case report series published on this website]. Strikingly, the majority (62%) described an asymptomatic postoperative period prior to the onset of CCNP that lasted years in some that is similar to reports of somatic neuropathic pain that followed surgery involving other body parts [42]. If confirmed, it suggests that some of the currently asymptomatic post keratorefractive surgery patients may continue to be at risk for developing CCNP.
bostoneyepain.org/inadequately-explained...ghts-and-concepts-2/

The insight that dry eye-like symptoms is a form of corneal pain points to the
corneal nociceptive system as an important player in the spectrum of disorders
collectively labeled as dry eye disease. It has been suggested that chronic dry eye-like
symptoms (DELS) following laser keratorefractive surgery (LKS) are the result of
reduced tear secretion cause by impaired function of the afferent limb of the
functional lacrimal unit . Nevertheless, this model often fails to explain many of its
clinical features; especially the disparity between the high intensity of symptoms
and paucity of external signs which was a uniform finding in this cohort. On the
other hand, a recently proposed neuropathic model for otherwise unexplained
chronic corneal pain ± photosensitivity is supported by these enigmatic findings and
highlights a rare, previously unreported and devastatingly painful complication of
massive axotomies caused by laser keratorefractive surgery.
Rosenthal P, Borsook The Corneal Pain System Part 1: The missing piece of the Dry
Eye Puzzle. Ocul Surf 2012, 10(1):2-14

Important reading for all sufferers of dry eyes and Meibomian gland disease(MGD) - especially if you've been told that laser surgery 100% does not cause MGD, when the majority of us had never even heard of Meibomian glands pre surgery!

Dr Perry Rosenthal runs the Boston Eye Pain Foundation, and he is one of the few doctors I know who takes seriously the dry eye problems and consequent pain suffered by countless laser eye surgery patients.

After reading his article below, if you would like to be included in Dr Rosenthal's ongoing research, please send him an email asking for a copy of the
'INJURY / SURGERY-ASSOCIATED EYE PAIN QUESTIONNAIRE'.
prosenthal@bostoneyepain.org

Perry is a lovely man and will reply to all emails, but please be patient as it may take him a week or two!

"Imagine a surgical procedure being performed for cosmetic reasons and patient convenience on a healthy organ critical to our ability to function. Considering that this surgery neither treats nor prevents disease, what is the acceptable rate of serious and permanent complications? Shouldn’t it be zero? How can we even consider a rate greater than those of vaccinations that, while also given to healthy people, provide invaluable disease-prevention benefits? LASIK/PRK laser surgeries do not.

How has it been possible that the well-documented, disastrous, permanent complications of these procedures have been ignored by the FDA—never mind the eye care professions? I have a confession to make. Despite my having been aware of the many blinding consequences of this surgery having treated many of them when I worked at the Boston Foundation for Sight (which I founded but no longer am affiliated with), I too failed to act on my observations that these surgical procedures can destroy the quality of life of these victims.

I did nothing until I became aware of a complication that had not been previously reported; long lasting and in many cases, probably permanent suicide-provoking eye pain. This is not the pain that many patients experience after the surgery. Why hasn’t this devastating complication been previously reported? The answer, I had assumed, was that eye doctors had been misled because these eyes typically look normal and well healed. And since, we have been trained to believe that the cause of chronic eye pain can always be identified during traditional examinations and that if nothing is found to explain it, this devastating eye pain must be imaginary. Moreover, as I discovered, the onset of this type of pain can occur years after the surgery and its connection to the surgery easily dismissed. I hadn’t even considered that there could be a coordinated effort to suppress this information.

I did detailed examinations on 21 such patients (how rare can it be?) and wrote a paper detailing the characteristics of this pain disease which I call corneal neuropathic centralized pain. I explained why it differs from typical temporary post operative pain. In it I presented my theory about its mechanisms and included suggestions on how it might be possibly prevented. Shouldn’t it be of interest to eye doctors, the FDA and prospective patients? In fact, it was summarily rejected by a leading peer-reviewed journal in ophthalmology. I shrugged my shoulders and submitted it to one that specializes in corneal laser procedures, fully expecting it to be accepted. It too was rejected outright for reason, according to the reviewers, that were impossible to address. I could have explained that, because of the infrequency of this complication, it would take more than 15 years at an incredible cost to perform the studies they insisted would be needed by other journals. In other words their suggestions were beyond the pale. Nor was I allowed to respond. The decision was irreversible. I was confused. So I sent the paper to world-class pain researchers for their opinions. All supported its being published. (One called my work “transformative”.) It is interesting that both journals ignored my recommendation that at least one of the reviewers be an expert in pain. I began to wonder if they had a hidden agenda. Was I becoming paranoid?

As I began to read the history of LASIK and its complications I became aware of the central role of the FDA in continuing to sanction these procedures despite their history. So I sent my paper to the FDA to document this previously unreported complication despite being warned that they will not respond. I didn’t believe it. I was wrong. I sent the paper twice without it even being acknowledged. Of course they could always say that the paper has no standing because it had been rejected. However, a cursory look at the results of any search engines provides a day’s read. Where is the shame?

I would never have imagined that editors of scientific peer-reviewed journals, a vast, profitable manufacturing/marketing industry and even some practicing doctors would collaborate to hide these complications from the public and prospective patients. And what about the government agency whose primary responsibility is to protect the public?

As of 2011, it was estimated that more than 11 million of these procedures had been performed in the US. ( bmctoday.net/crstodayeurope/2013/02/arti...-epithelial-ingrowth ) and more than 28 million have been done world-wide ( www.aao.org/publications/eyenet/200906/feature.cfm ) and it was predicted that at the current rate of 800,000 procedures per year, the available pool of surgical candidates is growing by 2 million eyes per year ( bmctoday.net/crstoday/2011/08/article.as...-poised-for-recovery ). This is a huge industry with tentacles that appear to reach the bowels of the FDA. In the meantime, I think about what will be happening to the vast numbers of the people who will be undergoing these procedures ignorant of their possible life-destroying complications. Shouldn’t they at least be able to make an informed decision?

I have been accused as having an over-abundance of naivety. But, I can no longer be silent."
www.bostoneyepain.org

vimeo.com/152163692

Realistic statistics for Dry Eye problems following laser eye surgery :sick:
"Responses from 231 PRK patients and 550 LASIK patients revealed an incidence of dryness symptoms in 43% and 48%, respectively..."
www.ncbi.nlm.nih.gov/pubmed/11311627
www.ncbi.nlm.nih.gov/pmc/articles/PMC505...opthal00015-0084.pdf
en.wikipedia.org/wiki/Recurrent_corneal_erosion

Hi Imran, I'm so sorry that the dry eye and MGD is causing you such problems. A great many of us know how you feel, and I too suffer from depression at times, as these two conditions frequently seem to trigger depression and even suicidal thoughts, when the dryness and pain just seems relentless.
I tried all the usual treatments that the NHS recommend, but found it best to modify these to suit my own eyes. I find that if I massage my lids in a gentle circular motion with a little moisturiser when they are naturally warm (say after a bath), I can do better. I use my finger tips, and the moisturiser makes them slide gently over the lids instead of pulling them about (which I find painful). Putting Vaseline on the lids, top and bottom, also seems to help protect from harsh environments. If I don't seal the moisture in my lids as well as lubricating my eyes, my condition is definitely worse, and I find that while it's important to clean my lids daily, if I clean them too harshly, then they just get even more sore. My advice to you, would be to try different methods and treatments on offer, and see what works best for you, but don't give up experimenting. I tried plugs in my lower lids for a few months, but found them painful, and of no benefit, yet I would still say, try them if you haven't, because they may work for you.

I am one of the many unfortunate ones. I paid £2500 for Lasek at OE Harley Street. I am now suffering severe dry eyes, cornea inflammation and MGD. I never heard of these before surgery. It is 5 months after surgery and countless trips to OE clinics in Reading, Harley Street and Shaftesbury Ave in London.
They first kept telling me"it is early days… you will be fine…” and now all they say is unfortunately it is one of the side effects and I have to live with it.
Optical Express ruined my life! yet the surgeon is one of their finest.
This was daylight robbery and worse than murder. I have lost my job, and gone deep into severe clinical depression. The lives of my 3 kids and wife have turned to hell because of this. I have nothing left to look forward to.
All because of this brutal industry with no regulations being run by murderers. It is called Optical Express
If you know anything which could help me with MGD pls let me know ASAP.

I too, had healthy eyes pre- surgery, and immediately developed severe dry eye and MGD post op. The latter feels like tonsillitis of the eyes - hurts like hell! I have now had dry eye for 8 years, and the MGD flares up frequently. It sucks, and any doctor that says it's not related to the surgery is either a liar or an idiot, as way too many victims only have these problems AFTER surgery.

Unrelated condition? Absolute nonsense! I too have MGD after surgery. I don't remember having any of these symptoms before. Is it a total coincidence that all this started when I had the surgery? Bol**cks!

I had laser surgery last year and like so many of you have got problems. I've also got 'Meibomian Gland Dysfunction' which I'd never heard of before surgery let alone had it!!
But according to what Stephen Hannan sent me in an email I must have :ohmy:

"In terms of the presented symptoms, you have a unrelated condition which is known Meibomian Gland Dysfunction. To explain further, we all have gland which run along the upper and lower eye lids and through these glands the oily layer of the tear is secreted onto the eye. The oily layer then mixes with the water layer of the tear so that the teat becomes more viscous and therefor does not evaporate as quickly. When a patient has Meibomian Gland Dysfunction some or all of the glands become blocked therefore the oily layer is not being secreted at the same level, which in turn causes the tear to evaporate quicker resulting in ocular discomfort. The recommended course of management is to administer hot compresses which help unblock the glands. In addition to help with the ocular discomfort a regime of Hycosan and Clinitas eye drops were dispensed. This condition is something which you will have for life but it can remain dormant for significant periods of time before being activated by such factors are stress."

Defintley got stress after being left in this mess by Optical Express!

Grateful, so glad you've opted out! I have been to yet another appointment today, once again only to be given another bottle of some strange concoction that is doing very little for my dry eyes!

Thanks for your well wishes, I'm hoping Optical Express and their greedy money making scam doesn't end up ruining what is meant to be the best day of my life for me!