keratoconus & dry eye by Wendy D

So before I start telling you my story about having dry-eye syndrome I will explain a bit about it for those who haven’t had any experience of it:

Dry-eye-syndrome

Dry-eye symptoms

  • Pain
  • Light sensitivity
  • A gritty sensation
  • A feeling of a foreign body or sand in the eye
  • Itching
  • Redness
  • Blurring of vision

At times you can actually have tears running down your face which can be confusing when you have just been told your eyes are dry.  This happens because the eye is not producing enough lubrication and your eye then sends a distress signal through the nervous system for more lubrication and this is why you get flooded with tears.  These tears however do not have good qualities and are mostly water, they will flush out dirt from the eye but not to lubricate the surface properly.

 An explanation of the different parts of the eye

dryeye

The Lacrimal unit is made up of a number of different parts that all work together:

Larimal Gland –   This is in the upper corner of the eye socket behind the bone and produces the watery liquid that makes up the majority of your tears

Goblet Cells –   In the lining of the eye and this produces a sticky mucin which allows the watery liquid part of the tear film to stick to the edge of the surface.

Meibomian Glands – Found along the entire length of the upper and lower eyelids and they produce a special oil that forms the outer layer of the tear film preventing evaporation.

Eyelid – Spreads tears across the surface of the eye when you blink

Cornea – The clear window at the front of the eye which is vital for sight as us KC’ers are all well aware of.

Conjunctiva – A clear membrane that lines the back of the eyelid that forms a natural gutter between the eyelid and eyeball

Tear Ducts – Two small drainage channels at the inner ends of the eyelids (next to nose) that allows tears to drain in the nose through the tear duct openings

The cornea itself is made of 5 different layers

 Epithelium – This is the surface layer of cells they provide a barrier function for a smooth tear film surface.

Bowmans – A membrane layer under the Epithelium.  This keeps the cornea from swelling forward so if it does swell it must go backward into the anterior chamber.

Storma – Collagen fibre and supporting kerocytes, Injuries can scar here.

Descemets – The inner layer of membrane this is important for health of the endothelial cells.

Endothelium – A crucial layer as this works as a barrier and pump that keeps the cornea from getting too wet.

 My experience with dry-eye

I have had dry-eye on and off since being diagnosed ten years ago with KC but never severe until lately that is. I am now 17 weeks post graft and pretty much had it the whole time. When I saw the emergency on-call Dr mid January she said I had Punctate  Epithelial Erosion Staining (PEE’s) along with the dry-eye and this was diagnosed under the slit lamp having used the flurocein dye.  At times I find it quite painful and my eye has been at times very watery and light sensitive.  Most of the time it just feels very uncomfortable.  I have been prescribed the celluvisc preservative free drops that I use every 2 hours in addition with Lacri-lube used at night-time.  I also now make sure I drink plenty of water during the day as I have a bad habit of not drinking enough and this really doesn’t help matters.  I have also included flaxseed supplements as many swear by this.  I would also recommend that anyone should buy A MGDrx Eye –bag as I find this helps a great deal.  Also I have read in a recent study how bad drinking alcohol is for the eye even when you don’t suffer from any problems.  It showed even after very little drink the cornea became dry very quickly so my advice to anyone with dry-eye is to avoid alcohol altogether.  I was also given this advice by the very helpful Mr David Gould, So I am just keeping going with the treatment I have and hope in time that the symptoms to go away or at least get better!

Useful link to recent articles

 www.allaboutdry-eye.com  The articles I found interesting where Drinking is bad for dry-eye and also how Herbs & spices have shown to alleviate symptoms.  Also caffeine in one study shows to alleviate symptoms as well

Wendy Dickson

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5 thoughts on “keratoconus & dry eye by Wendy D

  1. Hey Wendy,

    Great post! Did we already talk about this–feel like we did? I have meibomitis or MGD, which is what you must have due to the watery eyes. No tears at all now post-CXL (and no more runny noses!), so using ointment 24/7 to deal with it. Last month, I completed the last of 5 IPLs to treat the meibomitis. Not a cure but it helps a lot. This is the latest technology and apparently my lipid layer is better, but no tears still going on 6 mos due to the surgery. Are IPLs available in the UK? Do you by chance have rosacea? I developed it about 5 yrs ago and so I really have ocular rosacea (believe it turns into MGD or acts the same or ?) and we are the best candidates for IPLs. Now I have the no tears problem, but meibomitis just sucks and nothing works (I tried everything the doc threw at me). Heat made it worse due to the rosacea and I had no luck with omegas as my glands were so plugged (rather nasty). They do work if you don’t have fully plugged glands. This preceded my KC by at least 3 yrs so no connection for me. Interesting…

    Good luck!
    Alisa 🙂

  2. Hey Alisa yeah I think we probably did discuss this at one point LOL. I found out by accident that I had Meibomian Gland Dysfunction about 6 weeks after my graft. I had posted a photo on the KCGB forum page about something else & it was David Gould an optom who gives advice to us noticed it in the photo. I still have blocked glands & I still use my MGDrx EyeBag (hot compress) and it does help. I believe we do have IPL treatments available in the UK. I don’t suffer from rosacea. Hope you are otherwise well. No doubt talk soon.

    Wendy 🙂

  3. great and interesting article and your experience sounds very daunting to me hopefully i don’t have to have a graft and god bless and take care!

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