Don't make me cry!!! | Arthritis Information

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I am suffering alot w/ the sjogrens issues lately.  They have overwhelmed my RA issues (which are minimal at this time)

 
I cannot stand to work.. My eyes burn so badly .. constantly .. that it's making things really bad for me.....
I feel like I'm in a smokey room all the time..
 
I can't spare a drop of tears for a good tear jerker movie.. or a happy ending.. or sadness for anyone hurting more...  I can not spare ONE.
 
Does anyone have any suggestions?  I use Systane.. I have the gel for nights.. I wear the goggles w/ moisture inside.. run a humidifier in my bedroom....
I cannot use Restasis at this time.. it BURNS MORE!! even refrigerated it does not help..
 
working on the computer is agonizing.  I look like I haven't slept but spent the weekend on a bender!!!
 
I want to cry about this.. but I can't.
 
I have an appointment w/ my opthahmologist on Friday a.m.
 
 
((((((((((((((((((((((((((((((((((((((BABS))))))))))))))))))))))))))))))))))))))))))))))))))))
Man that sounds awful. I do not like it when my contacts get dry. I could not imagine my eyes dry like that.
 
I'll cry for you ...if only it could really help.
 
Take care and hang in there...
 
Lisa
 
Babs, I don't have any help for you......sorry that this is hitting you so  badly.   Remember I live in Nevada and there's no moisture at all.  Mine are just dry due to the climate and I don't have any extra tears. Lindy

Dry Eyes

Every time you blink, a film of tears spreads over your eyes. For the wet-eyed crowd, that film can turn to an eye bath when you're watching a classic weeper like, say, Old Yeller. But if you suffer from dry eyes, even the tear jerkingest flick can leave your hanky dry.

But another thing happens when you have dry eyes: They actually ache. Lacking the ability to cover or coat the cornea (the clear front surface of the eye) with a thin, protective coating of tears, your eyes start burning and stinging. At worst, it may feel as though a grain of sand is permanently embedded in your parched peepers. And because of this ongoing problem, your vision may be mildly blurred, or your eyes may become sensitive to light.

There are many causes: Medicines such as decongestants, tranquilizers and antihistamines, as well as drugs for high blood pressure, may all cause dry eyes. You can also get dry eyes if you have an allergy to contact lens products. Winter winds, air-conditioning and indoor heating are all potential culprits as well. Chronic cases often result from menopause, rheumatoid arthritis or Sjšgren's syndrome, a gland condition that also causes dry mouth and vaginal dryness. Sometimes dry eyes occur for no apparent reason. But whatever the cause, here are some ways to get your peepers dewy again--and to give you a chance to shed a tear the next time you hear a sob story.

Oil your eyes with a washcloth compress. "Place a warm washcloth on your closed eyelids for five to ten minutes several times a day to help open the clogged oil glands in the eyelids," says Eric Donnenfeld, M.D., associate professor of ophthalmology at North Shore University Hospital/Cornell Medical College in Manhasset, New York.

Here's why it works. Tears are made up of three components: water, oil and mucus. Artificial tears, the kind sold in eyedropper form in drugstores, can replace the water component of your tears. But those drops don't replace the oil: Only your own eyes can do that. So the warm compress helps your eyes do the work they're supposed to, according to Dr. Donnenfeld.

Using a compress is especially helpful if you have "crusty" eyes when you wake up or at other times of the day, says Dr. Donnenfeld. (About 50 percent of dry-eye sufferers get this crusty condition-called blepharitis-in the morning or during the day.)

Choose the right artificial tears. Over-the-counter artificial tears are a mixture of saline and some type of film-forming substance, such as polyvinyl alcohol or synthetic cellulose. This solution can be used several times a day, because it mimics real tears and provides a soothing balm whenever your eyes feel dry.

When choosing a brand, keep in mind that thicker formulas remain in the eyes longer, so you'll need to use them less frequently. But the thicker kind can blur vision and leave a gooey residue on your eyelashes. Thinner drops, on the other hand, need to be used more frequently. "You'll need to experiment to see what drops work for your condition," says Paul Michelson, M.D., senior staff ophthalmologist at the Mericos Eye Institute in La Jolla, California.

"But only use commercially prepared, preservative-free products," warns Donald Doughman, M.D., professor of ophthalmology at the University of Minnesota in Minneapolis. "If it doesn't say 'nonpreserved' or 'preservative-free' on the label or box, don't buy it. Preservatives can damage your eyes."

Nighttime Is the Right Time for Treatment

Even when your lids are closed, eyes can dry out, which is why your doctor will probably suggest that you use either a combination tear-replacement/moisture-sealing ointment or a "moisture chamber" at night.

These over-the-counter superthick ointments, which contain petroleum and mineral oil, last longer than drops, says Paul Vinger, M.D., assistant clinical professor of ophthalmology at Harvard University in Cambridge, Massachusetts. To insert, pull the lower lid down, look up, and squeeze a dab of ointment in the trough between your lid and eye. Blink to spread the ointment around. Keep in mind that ointments can blur your vision for a while, so be sure you don't use them before driving.

Your eye doctor can supply you with ready-made moisture chamber glasses to wear during sleep, but a pair of ordinary watertight swim goggles will also do fine. In a pinch, says Mitchell H. Friedlaender, M.D., director of the Cornea Service at the Scripps Clinic and Research Foundation in La Jolla, California, you can even make your own chamber by taking a piece of plastic food wrap and securing it with petroleum jelly around your eyes. As tears evaporate, the air inside the chamber becomes slightly more humid, preventing further tear evaporation and creating a comfortable, moist atmosphere. To boost the moisture content, use ocular ointments along with your moisture chamber.

Turn heating and cooling vents away. A blast of heat or air-conditioning may be what your body craves, but it's no good for your eyes. "When you're driving, keep air vents pointed down, away from your face," according to Dr. Donnenfeld. "And when you're home, do the same: Point heating and cooling ducts away from areas where you spend a lot of time. This is really important if your home has forced hot-air heating, because that can dry out your eyes very quickly."

Dress for the slopes. The Great Outdoors can deliver a one-two punch to dry eyes: The sun's brightness makes them supersensitive, and the wind and low humidity dry them out. That's why many experts suggest that you wear eye-protecting sunglasses or goggles for any outdoor activity. "Wraparound sunglasses are very helpful because they protect the sides of the eyes, which are vulnerable to the wind," says Dr. Donnenfeld. "But if you have very dry eyes, the best thing you can do is wear ski goggles when you're outside. They create a moist chamber for the eyes."

Take a blink break. Doing close work--typing at a video display terminal, driving, sewing, even watching television--can exacerbate even mild cases of eye dryness, says Dr. Michelson. "People doing tasks that require concentration tend to stare and not blink as much." And when you don't blink very often, eye moisture evaporates rapidly. So if you're doing concentrated work and notice dry eyes, look away and take a blink break whenever possible. Blinking helps restore the tear film over your eyes.

Humidify your surroundings. Moisturizing the air can keep mucous membranes from drying out during sleep, especially in the winter, doctors suggest. "When moisture is low, your eyes dry up fast," says Dr. Donnenfeld. "If you can, get a humidifier for your bedroom or other places where you spend a lot of time." And when you're using a hair dryer, don't run it any longer than necessary.

Moisten up and fly right. If you know you'll be in the arid environment of an airplane cabin, be extra vigilant in using artificial tears. And be sure the overhead air vents are pointed away from your eyes, says Dr. Donnenfeld.

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thanks so much, Snow, LinB and Lisa.... and lev... that was a great informative post!! 

I do all that already.. almost all of that.  Seems this winter is the worst.. I have a humidifier for my bedroom.. ... I use the goggles... w/ little moisture packs inside.... unbelieveable that you can be THIS dry!! it seems the office is the worst part of my day  ...I know there have been times when I wanted to cry or should have been crying tears and though I was sobbing.. there were NO tears!!

Yes, Snow.. I look like I have the eyes of an albino rabbit!!!

I had the tear duct temp plugs put in my eyes... they worked while they were there.. but then fell out..I think during the night...  I am hesitant to get the permanent ones.. but I may have to at this rate.
 
I actually feel like I'm in a very smokey room and it's irritating my eyes. causing me to squint and feel the burn.
 
Thanks for your sympathy, empathy, and good ideas!!  I should call and get on a cancellation list for time before friday morning.
babs, boy can i relate...have all that which evolved into corneal melt in which i lost 50% of corneal in left eye.  had to be treated for months with eye drops and doxy. corneal is growing back but that is scarey stuff go to dr who specializes in these type of problemsI also have sjorgren's.  My eyes have been horrible for the past few months.  According to the dr. there is no tear film in either eye.  I have had the temp. ducts before and they have fallen out.  He put them in again and wants me to use Gentel eye drops to keep some moisture in.  He likes these drops the best-maybe they'll help you?  Restasis didn't work for me either.  Dr. said that he isn't very impressed with the med. 
 
I go back in two weeks.  He said there are other things he can do, but he needs to try the temp. plugs first.  I don't really feel a difference with the artificial ducts but I'll give them time.
 
I also get a ton of eye issues due to the dryness.  It makes you prone to infections.  Scleritis, Iritis, Keratitis...name it, I've had it.   Point is...you got to find some way to keep them moist.  Get on the cancellation list for the dr so you can get it.  I know how uncomfortable you are and Friday is a long way away.....
I tried to move my appointment up.. She's full til the end of today.. Tomorrow is surgery day... so, they said to call on Wednesday and maybe there will be an availability.  Otherwise, I do have my Friday appointment.
 
mabus!! OMG.. that's horrible.. I'm so sorry that happened to you.  I do see a great ophthamologist.. I am very pleased with her especially after my glaucoma surgery...
 
 
{{{Babs}}} I'll just add - ME TOO! Babs, I don't have any advice for you just wanted to give you a big waddie2010-02-01 17:57:37Babs, I don't post much but a couple of years ago my eyes were having muscle spasms from dryness and when they got that bad my Opth. Rx'd steroid eye drops.  I know that they cannot be used a lot but during a particularly bad time they allow me to use my eyes without pain for hours.
 
Restasis helped at first but seems to have lost its effectiveness.
 
I hope your eyes improve soon.
Bonny
 
 
Waddie, Bonnie and Rebecca.. thanks .. I know you also understand..
Linncn and Reegie-- I appreciate your sympathies
I've no idea if it waxes and wanes or improves on its own.. or gets worse..  I'm a newbie with this one.
 
.. three things I changed and hopefully this is going to work.
 
I stopped the restasis.....  it is definitely an issue right now.. whether it will work again, I don't know.  (and I just got an order of 90 days worth!! ugh!!)
 
I started up the Salagen again.. It was making me have to go to the bathroom more often, but I will suffer with that over the eyes if it helps.
 
I also did the warm compresses!!  and that feels so divine!!
 
today is not feeling anywhere near as bad as yesterday... 
 
So... this low maintenance woman has turned into quite the project in the evenings and in the mornings!!  LOL
 
 
Hi Babs, I'm glad that the changes are working for you.  I'm one of the ones that didn't know that Sjor. could be so uncomfortable and resistent to therapy.  I sure hope continue with relief.  LindyThanks LinB.. I don't think there are really any treatments FOR Sjogrens... except treating the symptoms....
I think ALL the things that SS causes are just excessively irritating.... at least they are to me... but the eyes thing...  I really don't take that too well..

I am sure many have made good suggestions. i have not read the entire thread so I will just tell you what I do.
 
First drink two glasses of straight water before bed. Also no preservatives in your eye drops. Baush & Lomb Soothe Lubricant eye drops are good. For night time I use LubriFresh P.M. made by Major. They are not expensive but i get the best results from them. Better results then the priceier ones in my opinion.
 
I started taking pilocarpin , generic for Salegen, for saliva and I also got tears out of the deal. So that is a major gun in my war against Sjorgrens. I wish you the best.

okay...

back from the Ophthamalogist

She said:

My eyes are very irritated..

She gave me steroid drops and in two weeks I go back..

I MUST USE THE RESTASIS 2X a day after I go back to her.

AND she wants to plug my eyes again.  I said it fell out last time….

We'll try again, she said.

 
Milly:  I am using my pilocarpin again.. at least 2X a day.. It is a component in tear gas so you would think it would help with tears.. wouldn't you??  ;) 
 
I was using the Systane or Geltears ointment at bedtime along with the moisture goggles and the humidifier in my room.... 
 
So..... let's see how we do with this in the next month or so....
 
keep your fingers crossed and I will keep you informed... if it can help anyone.. I will keep the info coming.
 
Thanks so much to all of you.. I am so appreciative!!
Are you using PredForte?  I use these quite a bit when the Iritis flares up.
 
I now have cataracts due to steriod usage.  Optho says it's a fine balance.  When I am on steriods for RA issues-pericarditis and lung issues, my eyes are better.  But, the side effects will cause long term issues.  Right now the optho would like me on low dose systemic steriods cause the dryness and other issues are better.  He said we can deal with the cataracts, but the iritis, kerititis and scleritis will cause bigger problems.  These are all caused the the dryness making up more prone to infections. 
I hope the Restasis works for you.  I was really hopeful that it would be my magic med, but it wasn't :(  This time of year also makes things worse.  The cold outside a
nd dry heat inside.  The humidifer helps, but that is only at home. 
Question...how does the sjorgren's affect you mouth?  I tend to get more cavities which the dentist said is very common.  Really he wants me in every 3 months but insurance won't go for that.  They say 6 months.  Rigiht now I really need to get to the dentist but my mouth won't open for enough.  18mm basically will allow him to get a pinky in!  
I'll let you know what my dr. says when I go back.  I am curious to see what other ideas he has.  He is a great dr.  I see him so regularly he only charges me very rarely.  I also have a whole box of the Genteal drops---12 bottles.  He told me to put them in my purse and make a break for it!
rocckyd2010-02-05 09:59:46

Rebecca.. I am so glad you have such a good optho......  I like mine as well.. she's very good...  I have Alrex right now.. for the two weeks.. She said we need to relieve the irritation so that we can begin again aggressively with the Restasis.... I hate that stuff!! ;)

The sjogrens affects everything... and I mean everything.. glandular? then it's pretty much affected..... these are the worst symptoms of anything I've ever had..... I have an entire bag of paraphernalia to carry about with me for all my issues...  un-freaking-believeable....

Please do let me know the next time you meet w/ your dr......
Best to you, Rebecca...I hope your jaw loosens up soon.. so sorry.
Gees! I hope things turn around for the both of you (Babs and Rebecca). My son's 3rd grade teacher has sjogrens. She blinks so much it makes MY eyes feel dry....dryer that is.

Rebecca, any chance the dentist could have a look at you the next time you are under anesthesia? My baby daughter has to go under frequently for eye exams. She had cataract sx at 10 months old and now runs a high risk of glaucoma. Anyway, all her doctors coordinate so that anytime she's going under they all come and do whatever they need to. That way she only has to have general anesthesia once or twice a year. Just a thought...thanks leila..
I tried to PM you but your box is full...... If you don't mind me asking..What is your prescription toothpaste? 

Thanks Babs, I cleaned out my box.

My dentist says that either the RA or the RA meds is/are destroying my teeth. I never had a cavity until I was 28, and I never had another one until I was diagnosed with RA. Now I get 1 or 2 big cavities every 6 months. The tooth paste is mostly fluoride I think. But I find the idea of needing prescription toothpaste utterly ridiculous...   
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