Dry Eyes Deserve Attention
I stumbled upon an article from The New York Times recently about dry eyes, which at first glance seemed like a pretty dry topic to delve into. The article, "Dry Eyes Deserve Attention," provided a lot of important and detailed information about dry eye disease, however, and how it affects the tens of millions of people afflicted with it. But why did this article catch my eye? Well, simply put, my eye is DRY. Both eyes are, actually, and my ophthamologist and I have suspected for years that RA inflammation is the culprit.
Help, I'm Going Blind!
O.K. that might sound a bit alarmist and I'm not really going blind. I've never been blind, thankfully, and I hope I never am. But 13 years ago I was terrified that I actually was losing my sight. All of the severe and bizarre symptoms I was suddenly experiencing with my eyes, such as blurred vision and severe pain, caused me a lot of panic and fear. The burning pain I felt was probably the worst pain of my life, and that's saying a lot after living with RA for 20 years. I'm no stranger to pain.
Anyway! I think we can all agree that eye pain is terrible. And back then, it was terrible that I was having so much of it and at such an intense level. Every second I was awake I felt like I had shards of glass cutting into my eyes. I'm not exaggerating; the only relief I got was when I was asleep. This lasted for weeks.
It was also terrible that nobody knew for sure what was causing the sudden dryness and inflammation in both of my eyes. Not knowing was the worst part of the whole ordeal, I think, because of course my hypochondriac self imagined all sorts of devastating diagnoses: blindness, eye cancer, eyelid cancer, tear gland cancer, flesh-eating eye disease, CANCER--you get the picture.
Luckily, I wound up getting treated by a wonderful dry eye specialist at Region's Hospital in St. Paul. This incredibly insightful and kind doctor helped start me down the road to recovery once I began seeing him, which was after a month of no answers from other specialists. He was literally a life (and eye) saver.
I'll never forget my first appointment with him; I was terrified that I had Sjögren’s Syndrome (after reading up about it) and that the tests he performed on my eyes would prove my fears correct. How can I live the rest of my life with my eyes in this unbearably painful condition? The pain and discomfort was bad. Really bad. No moisturizing eye drops were going to make a drop of difference in my blurry bloodshot eyes.
Sjögren’s Syndrome is also an inflammatory autoimmune disease, similar to RA. But instead of your body attacking your joints with inflammation, Sjögren’s attacks the tear ducts and other tissues in your eyes (and salivary glands). If inflammation compromises the amount of tears you produce or the quality, your eyes will get dry very quickly. A similar thing happens when the disease attacks salivary glands, causing dry mouth problems.
Probably needless to say, dry eyes are painful--especially severely dry eyes. If your eyes aren't lubricated well enough, the dryness can cause blurred vision, irritation, inflammation, infection, and even tissue scarring and damage.
Well, I had the blurred vision, severe inflammation and pain, and I was scared to death of permanent eye damage. Ironically, I basically cried the entire time during my first appointment with Dr. N. at Region's. I certainly didn't have a shortage of tears, so why were my eyes so dry?
After enduring several different eye tests, the doctor left the room and I sat in the exam chair, my heart racing with a dead weight in my stomach. I'm going blind, I just know it. I'm going to have this forever. Sjögren's/RA/my stupid body is attacking my tear glands! Panic, panic, panic. More crying. What was taking him so long to get the results?
Dr. N. came back into the room after being gone seemingly for hours. "Well, I think I know what's going on," he said.
"It's extremely rare and dangerous eyeball cancer, isn't it?" I asked in my head. Bracing for the worst (damaged vision, the pain never going away, etc.), I sat there and waited with a blotchy tear-stained face and swollen eyes.
"The problem isn't that you're not producing enough tears," he explained. "It's the quality of your tears that's bad." Oh, thank you God, thank you God, the inflammation isn't attacking my tear glands! I let out a huge sigh of relief. He probably thought I was crazy getting so upset about all of this, but I couldn't help it. The fear was real and stabbing me right in the eyes.
"Your eyes are dry because your eyelids are inflamed," he said. "It's called blepharitis." Inflamed eyelids? What? Does that happen? Apparently so. "The quality of your tears is poor due to the inflammation affecting your eyelids," he went on. "Not enough oil is able to secrete through your lids so your tear quality is compromised."
It was a relief to hear that I wasn't going blind or needed to have my head chopped off or anything dramatic like that. I had bad tears. "What's causing this inflammation?" I asked. He replied that he couldn't say for sure, but there was a good chance it was Sjögren's and/or RA messing with my eyelids.
Thankfully Dr. N. did know how to treat this blepharitis, which first called for steroid eye drops to clear up the inflammation. I also had to use some special preservative-free drops every day. And, most importantly (after the steroids), I needed to hold a very warm (hot!), wet compress against my eyes several times a day.
The warm compress would help with the eyelid inflammation and help release my eyelid oil (I didn't know I had eyelid oil), Dr. N. explained--to improve the quality of my tears. Following this regimen was a giant pain in the...eyeballs...but it worked, eventually. I think my eyes finally returned to "normal" about a year after I began treatment.
An entire year, however, is a long time to have your eyes messed up and to have to drag wet hot washcloths with you everywhere you go, as well as a mini cooler for your precious preservative-free eye drops. I quickly grew tired of this treatment plan, yet the excruciating pain I had just been through, for a month, was too vivid and traumatizing to risk a relapse.
When I think back to 2004 and this experience, I can still clearly recall the agonizing pain my eyes were in and the terror I felt about my future eye health. It's also pretty amazing to realize firsthand just how powerful and bizarre inflammation is and how quickly it can wreak havoc on your body and in your life.
But above all, I think about how grateful I am for Dr. N.'s help and care. I can never thank him enough or adequately express how deeply appreciative I am for him giving my eyes and my life back to me. I still suffer from dry eyes and can probably never wear contacts again, but I'm also happy to report that I've been blepharitis-free for 13 years!
When was your last flare?