Sudden Eye Pain and Dryness Part 1

This is the first in a series of posts about my difficulty with dry and aching eyes this year.  I have spent countless hours searching for answers.  I have also spent a lot of money on various remedies, most of which did nothing.  At multiple points during my journey, I thought that I had found a solution.  In most cases, I was wrong.  I also discovered that some of the remedies caused my eyes to worsen.

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I have had dry eyes for around 20 years, but the situation worsened last year.  My eyes began to be uncomfortably dry late each day.  Still, as far as dry eyes go, my condition was quite minor.  I know that now based on how awful I've had it this year.

I was referred to an ophthalmologist after my Sjӧgren's appointment in January, mainly for testing connected to a new prescription for hydroxychloroquine.  I had an allergic reaction to the medication and quit taking it after just four days.  Nevertheless, I decided to keep my February 26 appointment since I was interested in anything that could help with dry eye.

My eyes were dilated during the exam.  I agreed to get punctal plugs to help with dryness, and numbing drops were used when the plugs were inserted.  My lower tear ducts were blocked so that fewer tears will drain from my eyes. 

Immediately after the appointment, my dry eye became much worse.  I'd say that my condition was easily 10 times worse.  I had noticeable discomfort and terribly dry eyes most of the time from February 26 into April.  This time period was horribly difficult as I searched for answers online. 

I learned that some people have a bad reaction to the dilation fluid and/or to numbing drops.  This is apparently uncommon, but I did find several discussions with people who suffered for months with dry eye caused by an eye exam. 

Long term eye trouble after dilation

Oddly, my eyes fluctuated during the time period from right after my eye exam into late March.  They would go back to nearly how they were before my appointment, and then suddenly, they would be awful again.  I couldn't make sense of it.  [This part is important, and I will mention it again in later posts.  It's important to consider all possibilities, even the ones that seem remote.] 

I was miserable, wondering if this is what the rest of my life would be like.

I was using preservative-free eye drops, which weren't helping at all.  I used an eye ointment at night.  I tried a warm compress.  I tried eyelid wipes.

I figured out quickly that eyelid wipes dry out my eyelids terribly.  Of course.  With Sjӧgren's syndrome, everything dries me out.  I can't use any kind of soap on my face, so I wasn't surprised that the eyelid wipes were a problem.  It was disappointing.

I quit using the eyelid wipes and didn't bother with the warm compress.

I increased my usage of the eye drops, since suggestions online indicated that liberal use of the eye drops would help after dry eye caused by an eye dilation.

I also read online that punctal plugs don't always work and that sometimes they cause inflammation in the eye.  I couldn't rule that out, either.  My next eye appointment was May 28.  I wanted to give the punctal plugs a fair chance before having them removed.  I wondered if I could make it to May 28 with the horrible discomfort. 

I kept searching online for anything that could help.

I read that warm compresses might make dry eye worse in some people.  The suggestion was to use a cold compress.  I used a washcloth moistened by cold water.  It did help, perhaps for half an hour.  That was better than what the eye drops were doing, since they only helped for a few minutes.

I felt like my eyes were getting worse and worse.  I continued searching online for answers.  I finally found some useful information on March 22.

First:

Success story!  My RECOVERY Guide

Here's a screen capture of what this person said didn't work.  Click on the image in order to see it clearly.

This is what stood out to me:

VARIOUS eye drops, including antibiotics, steroids, allergy and hydration drops.

Hydration eyedrops (preservative free) only got me addicted and dependent to the point I was using them every 5 minutes or I was going to go insane.  I stopped them altogether and saw massive improvement after some time.

Huh.  This resonated with me.  I found that I was using the eye drops more and more often with little relief.

I also noted that this person didn't feel that the warm compresses helped and also stated that the eyelid wipes irritated their skin.  Same here.

This is what they said helped:

 Most important:

ABSOLUTELY NO EYEDROPS.  NOTHING.  If you feel dry make yourself cry!

I decided to try to quit using eye drops.  It was counterintuitive, but the eye drops weren't helping, so I had nothing to lose.

I also found out some information about omega-3 fatty acids.  For years, I have been taking fish oil to counteract inflammation and dryness.  In the last year, I also began taking sea buckthorn oil, krill oil, and salmon oil.  My condition improved in various ways with each oil that I added.  

Sea buckthorn oil reduced the inflammation in my mouth, and I have been able to floss without bleeding and pain.

Salmon oil reduced the pain in my legs.  I can't point to anything specific, but I feel that when I added the krill oil that my symptoms overall improved slightly.

What I learned is that I need 2000mg to 4000mg combined of EPA and DHA.  The amount varies depending upon who is giving the advice, which is of course the problem with online advice.  It seems that people with dry eye need around 3000mg combined of EPA and DHA.  I've heard anywhere from 2000mg to 4000mg for Sjӧgren's.

I thought I was taking enough.  I checked my supplements and discovered that I was only taking around 1500mg combined of EPA and DHA.  I searched online and found a high potency fish oil. 

Nordic Naturals Ultimate Omega 2X has 2150mg combined of EPA and DHA.  I purchased it and took 3 soft gels beginning on Saturday.  With what I was already taking, 3 soft gels brought me up to over 4000mg combined of EPA and DHA.  

I mostly went off the eye drops on the morning of March 22.  I noticed that morning that my eyes seemed worse after using the eye drops.  I felt like by noon that my eyes were feeling a little better.  I took the Nordic Naturals Ultimate Omega 2X that afternoon after Amazon delivered it.  My eyes seemed even better after taking the supplement.

On March 23, my eyes were very dry when I woke up, but that's always the case.  I had also read another good piece of advice about eye drops.  Someone said to use them very sparingly and never use so much that it runs out of the eyes.  I had been flushing my eyes, and this person said that they had done that and disrupted their tear film.  On Sunday morning I used eye drops just once, a very small amount in each eye.  Nothing ran out of my eye.

That night, I placed one small drop in each eye.  I did the same on March 24 when I woke up.

I felt like my eyes had improved to the level of dryness that they had prior to my eye appointment.

However, my eyes were awful again by later in the day on March 24.  It seemed that I wasn't making any progress.

I found that my eyes were still bad on March 25, and my use of eye drops was increasing.  I was using them sparingly, but I had to use them at least once every hour or so.