Blinded by the Light

Grasping my companion’s arm, slowly I walk to the car. My eyes closed to block out the bright sunlight.  I feel the heat warming my eyelids; even my sunglasses are useless. I am like a blind person, but I am not blind.

Coming home from a party, New Year’s Eve 2004, it felt like something was in my left eye.  Without thinking, I reached up to rub it out.  Instead of feeling better, the pain got worse. After a sleepless night of worry, I went to the emergency room.  The doctor put drops of dye into my eye.  The dye made the scratches on the cornea a fluorescent green, practically the whole area turned green.  A speck of dust had gotten in my eye and damaged a large part of the cornea. The E.R. doctor put a patch over the eye and I make an appointment with my ophthalmologist—a medical doctor who specializes in diseases of the eye.  He told me I had keratoconjunctivitis sicca, more commonly known as Dry Eye Syndrome.  A reduced production of tears causes scratches on the cornea, which makes my eyes sensitive to bright light.  Any bright light—outdoors or indoors—will cause the reflexive action of the eyes closing and making me “blind.”

With DES, you feel like there is something in your eye. A gritty, sandy feeling, burning sensation, blurred vision or the presence of a white, stringy mucus-like substance is also possible.  The causes are poor quality of tears, limited tear production, or some medications.

Many things can affect DES, but I will only cover the ones that are a struggle for me.  If you want more information talk to your doctor, or do an internet search for “Dry Eye Syndrome.”

Treatment for DES depends on the severity of the condition.  Sometimes an over-the-counter (OTC) eye drop called artificial tears is enough to relive the dryness. If it is more severe, the doctor will prescribe a medicated eye drop called Restasis.

When I first started experiencing dry eyes I used OTC eye drops a couple of times a day.  When I began using them every hour or more, my ophthalmologist prescribed Restasis. He also told me to use an eye gel every night to keep the eyes from drying out as I slept.  My eyes got better for a while, but soon my condition worsened.  I was unable to do anything that involved seeing.  I couldn’t watch TV, work on the computer, or even turn on my lights after dark.  I spent my days sitting on the couch, listening to the television. Some days it was so bad I didn’t even get out of bed unless it was necessary.  I would lie in bed with the curtains closed to block out the sunlight.

That was when my doctor decided to try using plugs. According to WebMD.com, tiny silicone plugs, called punctal plugs, inserted in the tear ducts prevent the tears from draining too quickly. These plugs can be easily removed if the condition improves.  The tear ducts, called puncta, are near the inner corner of your eyelids.  You can see them by gently pulling down on the eye.  Some people have larger openings than others do.  My doctor says I have extremely large ducts.  He has tried four times to use the plugs on me; each time they have fallen out.  One set even fell out later the day he inserted it.  The last pair of plugs is more permanent because they set deeper into the opening, if these fail, or fall out, cauterizing the tear ducts is the next option.  The doctor would do this by numbing the area and then applying a hot wire to create a scar and close the tear duct.

Along with the prescribed treatment, there are things I do to reduce my symptoms.  I try not to rub my eyes, which can irritate them.  I avoid smoke as much as possible and wear sunglasses when I’m outside to protect me from wind, dirt and bright light.

When you blink, you allow the tears to moisten the cornea. Forgetting to blink, or not blinking often, will increase drying of the eyes.  Reading, watching television, and working on the computer reduce the number of times you blink

A windy day, sitting in front of a fan or the heat of a fireplace will increase the evaporation rate of tears.  We’ve been using our fireplace a lot this winter so my eyes feel gritty, as if they have sand in them. Replacing the moisture in the air by using a humidifier makes them feel better. Another way I find relief is by drinking plenty of water to stay hydrated.  I also put a warm, wet washcloth over my eyes a couple of times a day; the heat from the cloth warms up the oil glands, helping the protective oil to flow more freely.

DES can’t be cured, but it can be controlled if you see your ophthalmologist regularly and follow the treatment prescribed.  Left untreated you increase the risk of serious infections, scarring, or even permanent vision or eye loss.

I still have days when my vision is blurry and my eyes burn, but with continued treatment and self-care, I know that one bright, sunny day I will be able to go outside and not be “blind.”