In reading my LASIK story, you’ll note that I’ve mentioned tear diagnostic tests multiple times. From what I’ve learned (as my own patient advocate), eye doctors and specialists use these tests to measure tear health and production.
LASIK doctors SHOULD use them to determine if you are a good candidate for the procedure (If they don't run!) To review, they are:
Why is it important for your LASIK surgeon to use these tests?
They need to pre-screen you to see if you are at risk for developing dry eye after LASIK surgery. AND they are going to administer your post-surgical care! If you develop LASIK induced dry eye, your surgeon needs to use the proper diagnostic tools to assess your tear production and health.
In my case, my LASIK surgeon DID NOT USE ANY tear diagnostic tests to pre-screen me. Prior to LASIK, I had no eye health issues or dry eye. However, post-LASIK it has been a miserable experience dealing with the chronic dry eye. My research has shown that 50% of LASIK patients encounter dry eye symptoms post-surgery. For some, it is a temporary nuisance. For others, it can last a lifetime, severely degrading that person’s quality of life.
When I started seeing my new Doctor (20 months post-surgery). He did all three tests mentioned above. This was the first time someone had used these diagnostic tools to assess my dry eye. I saw at least five doctors prior to my current physician. My LASIK surgeon treated me for 20 months and never used these tests. He did put yellow colored numbing drops in my eyes to see visible dry spots (areas on the eye that are not getting lubricated). They also refer to this as ‘Staining.’
In the gruesome picture shown above, I had a Schirmer tear saturation test performed (September 2016). My number was a "6." The doctor places a solution in your eyes and then paper strips on the eye (for about 5 minutes). The strips collect moisture from your eye and the resulting number gives an indication of your tear production. Apparently, the lowest (very very dry) is a “5.”
The Tear Break Up test determines how quickly your tears evaporate. They put a solution in your eye and then touch it with another paper indicator. In my case, tear production was healthy, but my tears were evaporating very quickly. This is a symptom of MGD - your glands aren't producing enough oil to prevent the tears from evaporating.
The LipiView (see picture above) takes film of your Meibomian Glands. Mine were very dysfunctional (see a large spot where they atrophied on my right eye lid). This test also films you blinking. Another issue identified in my case showed that I don't always close my eyes completely. This can lead to dry eye as well. See my earlier blog about this concept HERE.
Course of Treatment with Tear Diagnostic Results:
The doctor advised me to stay on my current regimen and he added the following:
I returned to see my doctor last month, seeing a major improvement in symptoms. My Schirmer test was a 12’!!!! Thank God. His prognosis: see him in six months unless things get worse. Stop taking Alrex and the Azasite. My symptoms have improved greatly, although I still deal with dryness on a daily basis. Frequency of using drops is every 1-2 hours vs. every 15 minutes.
Since having Lipiflow, I have had several periods (4-6 hours) when I did not notice my eyes. I didn’t think about them. Folks, when I get a glimpse of what it used be like pre-LASIK. I get a lot of hope.
If you are considering LASIK surgery….RECONSIDER. If you must, make sure your surgeon discusses all options (PRK, EpiLASIK) and performs the proper screening to measure tear health. There are no guarantees of course, but these tests can give you an indication of potential dry eye complications post-LASIK.
What's your number?
Bluesifyin' LASIK Dry Eye sufferer. Read my blog to get tips, struggles, blues, reviews, whatever on this journey through hell.