HomeAnswersOphthalmology (Eye Care)dry eyesHow can I get cured from dry eyes?

I suffer with dry eyes and nearsightedness. How to get cured?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At December 27, 2020
Reviewed AtAugust 7, 2023

Patient's Query

Hi doctor,

I am a 42-year-old male living in a cold place. My weight is 171.96 pounds, and my height is 5 feet and 6 inches. I am suffering from dry eye problems for about ten years, and I have nearsightedness. My eyes are very sensitive to light. So, I use dark spectacles when I go outside and normal transparent spectacles when I am indoors. I used some eye drops when I had pain or irritation in my eyes. The doctor never prescribed it. Sometimes I use cold-pressed castor oil in my eyes. Both eye drops and castor oil helped me temporarily and I lived happily. Due to cold weather, the air is dry, and it causes dry eyes. Always heaters are used to maintain room temperatures to keep the room dry.

During the pandemic, I was staying inside the home for about nine months. I never went out. I stayed inside my home without using a humidifier. Before a week, my right eye got blurred and I felt as if I had a foreign substance in the eyes. I was unable to read properly when using both my eyes. It feels like the right eye vision is intervening with left eye vision and it creates a distorted image. I am unable to recognize the letters properly and it makes both my eyes tired and painful when I focus even for just five minutes. I visited the doctor, and my eyeballs were tested. The doctor told me that I have no problem. She advised me to take further tests of my optic nerve. Also, the doctor asked me to get a thyroid test. My left-eye vision is normal. My right eye is presenting with blurred vision and feels like looking through dark glass. Do these problems occur due to dry eyes? Can this problem be fixed simply by changing the glasses and fixing the distortion? Kindly help.

Hi,

Welcome to icliniq.com.

I can understand your concern.

Dry eye syndrome is a very common issue these days especially if you live in a cold place. Vision problems are common at the age of 40. You have not mentioned whether your visual issues are far or near. Presbyopia often sets in around the age of forty in most people. When you can read the smallest script at a distance of 9.8 inches and when your accommodation becomes weak, you will suddenly experience something similar to the double vision which is transient. Another thing, which I cannot really confirm without examining you, is the presence of a latent squint. If you break fusion (both eyes focusing simultaneously) by covering one eye, the covered eye will drift outwards.

This is different from a regular squint which is obvious all the time. So as you get older, the latent squint might cause a problem. The third possibility is severe dry eyes. As the tear film breaks up, it causes a temporary visual defect due to the diffraction of light through the broken tear film. For management, I suggest you add omega 3 to your diet which includes Flax seed powder, walnuts, fish, or taking omega 3 supplements. Secondly, talk to your ophthalmologist about lacrimal punctum plugs. These are tiny silicone plugs placed into the holes located near the inner corner of the eye that drains the tears. These plugs will prevent the tears from draining and will remain in the eye. I do not think the problem will persist once the weather settles down to a warmer climate. Use a humidifier in your home, as it will help. I cannot comment on the glasses as I have not examined you to determine if a refractive error is present or not, but you will require the OCT (optical coherence tomography) scan which will give a definitive diagnosis if there is any problem in the retina that is causing the distortion. If you have any report from the ophthalmologist, please send it as an attachment and I will reply to it.

I hope I have resolved your queries. Do get back if you have any further queries.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

I will go through all the tests and get back to you. I will try to use a humidifier and take omega-3 supplements. If I continue to live in this cold place, can I have a chance of losing my vision due to dry eyes? What could be the most serious damage that dry eye syndrome can cause? Please help.

Hi,

Welcome back to icliniq.com.

Glad to have you back.

You need to undergo two dry eye tests called the Schirmers and TBUT (tear break-up time). If your tear secretion is zero, further investigations may be required to rule out Sjogren or other autoimmune diseases like rheumatoid arthritis. If you have joint pain or dry mouth in addition to dry eyes, then you will need to meet a physician to rule out these conditions. As long as you are using lubricating eye drops frequently, you will certainly not go blind. Try to increase the frequency to reduce the symptoms.

For the distortion of vision, one test can be done at home until other tests are done. Take a printout of the Amsler grid and try plotting out the distortion. You need to shut each eye, focus on the central dot, and observe the periphery if there is any difference between each eye. If there is any difference, plot it out and send it to me. I am sure you will follow the instructions. But do not worry. If it is just dry eyes, lubricants will prevent it.

Thank you.

Patient's Query

Hello doctor,

I underwent the optic nerve-related tests that the local doctor prescribed. They found that I have dry macular degeneration in my right eye. The left eye has no problem. The Amsler grid self-test you prescribed also showed the possibility of AMD clearly as far as I understood. I have attached two pictures from the optic nerve tests. They told me that there is no cure for this problem, and I will gradually lose my eyesight and go blind. The doctor also prescribed thyroid and diabetes-related tests and I will get them done the day after tomorrow. Understandably, I am in panic mode. I have some questions and request you to answer them one by one.

  1. Is it remotely in any way possible that this diagnosis is wrong?
  2. Could they have mistaken this for something else? I am asking this question because I am still struggling to accept the situation as this came as a shock to me. I am only 42, so is it not too early for developing AMD?
  3. Does this degeneration affect both eyes or only the right eye?
  4. How can I stop or slow the degeneration down? I came up across a few vitamin supplements online (Areds 2 vitamins). Are they of any use? Do you have any other suggestions?

I do not smoke or drink alcohol. I am a bit overweight. Otherwise, I have a healthy lifestyle. My current situation is as below.

  1. Left eye vision: Ok.
  2. Right eye vision: Blur in the middle with all the symptoms of AMD.
  3. Both eyes together: Right eye vision is intervening with left eye vision and makes the final image a confused image or distorted image.

The biggest problem is I am not able to work on the computer and if I try reading, I immediately get a severe headache and my eyes become tired and painful. I read on the internet that AMD does not cause pain. Why am I getting pain then? The best I could read is for about 30 seconds. This could mean the end of my computer engineering career. In our last conversation, you mentioned the possible reasons for this confused vision as presbyopia, latent squint, and severe dry eyes. Are all or some of these three reasons still valid after diagnosis of AMD? Or is AMD alone causing this?

Could my vision be fixed by fixing the above issues if they are present? Do you think my thyroid and diabetes tests will still reveal anything interesting that could help me resolve the situation? One more thing, the laboratory doctor who diagnosed it to be AMD told me that I will be able to learn to live with AMD and I will be able to read on the computer gradually. Is it possible? Finally, the pressing problem is my inability to read on a computer which means it could be the end of my career. What can I do to get this resolved? Are there any tests or practices? Please help.

Hello,

Welcome back to icliniq.com.

I am sorry to hear about the diagnosis. It could be just a remote possibility of a macular issue since you are young. I was thinking more along the lines of a possibility of central serous retinopathy rather than AMD. To answer your question, there are a few dystrophies that can mimic AMD but those are mostly hereditary and extremely rare. I cannot comment on whether they are 100 % correct in the diagnosis as examination findings need to be correlated with the OCT and you have not sent a colored photo (attachments removed to protect the patient's identity) of the fundus. AMD dry type has a better prognosis than wet type and it could take years before it can cause permanent blindness. We prescribe capsules containing Lutein and Zeaxanthin which in research trials have been found to reduce progression (Macuvit capsule).

Also, curcumin which is basically turmeric is gradually gaining importance as a superfood and it is an anti-inflammatory agent. AMD does not cause eye pain. You could still be having pain due to accommodation stress or latent hypermetropia as you may be using your left eye only for reading. Please continue using the lubricating eye drops. You can pick up a pair of +1.0 readymade reading glasses for use on the computer and see if the pain goes away. Diabetes can cause diabetic maculopathy, but the level of the changes in the retina will be at a different layer of the retina.

As I mentioned earlier, a dry type of AMD might take a long time to cause deterioration of vision. In later stages, low visual aids will be required which are basically plus power lenses that are used for treating hypermetropia, and presbyopia but of higher power. You will have to change the font settings to make the computer fonts more readable. It should not affect your computer career. I am not sure about the quality of healthcare available in your country, especially the retinal specialists. Since it is a life-changing diagnosis, I recommend you get a second opinion from another doctor who specializes in retinal pathologies.

I hope I was able to answer your questions satisfactorily. Please feel free to write back.

Thank you.

Patient's Query

Hi doctor,

Thank you very much for the reply.

Here is some update. About a week ago, I received thyroid and diabetes-related tests (I have attached the report). I visited the doctor with the AMD report and the thyroid and diabetes-related test results. She tested my eyes again and prescribed new spectacles (I have attached the prescription) and told me that the thyroid results are normal. During the visit, I asked if she would like to prescribe any medication that would help me deal with AMD. She said that she was not sure but, she would discuss my case with another professor who is specialized in AMD and get back to me. Two days ago, she called me and told me that she had discussed my case with the professor and rechecked all my AMD-related test results with him.

She told me that I do not have AMD but they concluded that the condition could be central serous chorioretinopathy. She also told me that this is not a big problem, and this condition would resolve within a month or two without medication. However, she prescribed a medicine called “Spironolactone orion 25 mg” and asked me to take one tablet a day just to be on the safe side. I was relieved and felt much better after this new diagnosis. I also read about this problem, and it was mentioned somewhere that this occurs due to a lot of stress. I have been under a lot of stress for the past 10 years due to other lower back-related issues. Now I feel a lot better though. I have another appointment for the tests next month to re-evaluate the situation. Yes, you are right, the medical care quality is bad in my country. I will soon visit another country to get a thorough check-up as soon as possible. At this point, do you have any suggestions or foods or lifestyle changes to help me quickly resolve the situation?

Thank you.

Hello,

Welcome back to icliniq.com.

Glad to have you back.

I am relieved to hear that it is not AMD. If you remember I suggested the possibility of CSR as it is a more common diagnosis for your symptoms. I will write back to you in detail later this evening in reply to your questions, as a follow-up message as I am busy at work right now. I shall write soon.

I wish you good health.

Thank you.

Patient's Query

Hello doctor,

Here is the update, recap, and a few questions from my side. My local doctor ordered four tests to be done including the first one that I had sent you. I do not have the remaining three test reports, but please let me know if they are very important in your decision-making. I will get them. There were guidelines from her based on each test which are as follows:

  1. Test 1: My doctor confirmed that I have central serous chorioretinopathy and prescribed the tablet Spironolactone 25 mg once a day.
  2. Test 2: She mentioned that the situation was getting better and asked me to continue taking the tablet Spironolactone 25 mg once a day.
  3. Test 3: She said that the situation got worse and asked me to double the dose of Spironolactone.
  4. Test 4: She said that situation is not improving and suggested that I should take an anti-VEGF injection in my eye.

Now, I have some questions. Kindly answer. Do you also suggest taking anti-VEGF injection at this point or do you suggest any other solution? It has been about six months since the condition started. In case you suggest I opt for an anti-VEGF injection, is it good to take it as soon as possible or can I wait for some more time hoping that the condition would resolve by itself? Please help.

Thank you.

Hello,

Welcome back to icliniq.com.

Sorry for the delay in responding. I hope you have been staying safe over there. As for your query, I would like to know the approximate vision recording to have an idea of the extent of the worsening. Or perhaps you can gauge the extent of worsening as compared to when you first contacted me. Anti- VEGF (vascular endothelial growth factor) is being used extensively nowadays for macula-related issues and newer safer types are available that are approved by the Food and Drug Administration (FDA). I do not think that you should worry about undergoing the procedure as it takes less than five minutes. If she has recommended it, I suggest you have it done as soon as possible. I cannot really comment on the urgency of your case without examination or at least a report of your last visit. Let me know about your decision.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Asha Juliet Barboza
Dr. Asha Juliet Barboza

Ophthalmology (Eye Care)

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