Long-Term Eye Issues After Laser Surgery and Chemical Injury

Q: Long-Term Eye Issues After Laser Surgery and Chemical Injury

Hello： 1. Dry eye syndrome can easily lead to eye fatigue. 2. Dry eye syndrome cannot be completely cured. 3. It is uncertain whether there are residual symptoms from dry eye syndrome. 4. The extent of alkaline injury is unknown, so it has not been det

Long-standing eye problems?

Hello, I have a few questions.
I underwent laser surgery for myopia in 2000, and in 2002, both of my eyes were severely injured by a chemical substance - an alkali, resulting in complete vision loss.
The doctor drew my blood to create serum, which was then instilled into my eyes.
I was hospitalized for 19 days, with daily examinations and eye drops applied for the first five days, but there was no improvement, and I remained completely blind.
Eventually, the doctor could not find a treatment for my condition and had to give up.
After that, my eyes were just covered with gauze, and there was little action taken.
I was very afraid of never seeing this beautiful world again, so I cried every day.
Strangely, my vision gradually returned, but to this day, it is sometimes blurry, and my eyes often feel dry and sore.
I have been using artificial tears and fatigue-relief drops, but they sometimes make my eyes feel even more sore.
At night, I apply vitamin A ointment, but when I wake up, my eyes are dry and so sore that I can barely open them without using eye drops.
(All medications are prescribed by an ophthalmologist.) I have seen countless eye specialists, and my eyes appear normal.
I have also undergone dry eye tests, which confirmed that I have dry eye syndrome, but the cause remains unknown.
I have been using eye drops and ointments for four years, and there has been no improvement.

I would like to ask:
1.
What is the cause of these symptoms?
2.
Is there a cure? How can it be treated?
3.
Is this a complication from the myopia laser surgery?
4.
Or is it a consequence of the alkali exposure?
5.
Is crying the best response for eyes that seem beyond help? Is it a miracle that my vision returned?
6.
Is it acceptable to use eye drops and ointments long-term? Could it be harmful to my health?
7.
Are there any curative methods for dry eye syndrome?
Thank you very much!

Bi Bi, 30~39 year old female. Ask Date: 2005/02/20

Dr. Ke Meilan reply Ophthalmology

Hello: 1.
Dry eye syndrome can easily lead to eye fatigue.
2.
Dry eye syndrome cannot be completely cured.
3.
It is uncertain whether there are residual symptoms from dry eye syndrome.
4.
The extent of alkaline injury is unknown, so it has not been determined if it is a "consequence of alkalinity." 5.
There is no correlation between crying and improvement of the eyes; it may be a miracle, as your eyes have not been treated, making it impossible to assess.
6.
For long-term use, it is best to use preservative-free ointments and eye drops.
8.
Punctal occlusion can be used for dry eye syndrome and may provide partial improvement.
Sincerely, Dr.
Mei-Lan Ke, Chief of Ophthalmology.

Reply Date: 2005/02/20

More Info

Hello! Thank you for sharing your experiences and concerns regarding your eye health after undergoing laser surgery and suffering from chemical burns. It’s understandable to feel anxious about your vision, especially after such traumatic events. Let’s address your questions one by one.

1. What are the causes of your symptoms?
Your symptoms of dryness, discomfort, and occasional blurriness can be attributed to several factors. The laser surgery you underwent may have altered the structure of your cornea, which can lead to long-term changes in tear production and stability. Additionally, the chemical injury from the alkaline substance likely caused significant damage to the corneal epithelium and possibly the stroma, leading to scarring and inflammation. These factors can contribute to dry eye syndrome, which is characterized by insufficient tear production or poor tear quality.

2. Can these symptoms be cured? How?
While complete restoration of vision may not be guaranteed, there are various treatments available to manage your symptoms. For dry eye syndrome, treatments can include prescription eye drops (such as cyclosporine A or lifitegrast), punctal plugs to reduce tear drainage, and lifestyle modifications like using a humidifier or taking breaks during screen time. Regular follow-ups with your ophthalmologist are essential to monitor your condition and adjust treatments as necessary.

3. Are these symptoms a result of the LASIK surgery?
It’s possible that the LASIK surgery contributed to your current symptoms, particularly if there were pre-existing conditions that were exacerbated by the procedure. However, the more significant factor in your case seems to be the chemical injury, which likely caused more immediate and severe damage to your eyes.

4. Are these symptoms a consequence of the alkaline exposure?
Yes, the exposure to alkaline substances can lead to severe ocular damage, including corneal scarring and inflammation. The alkaline burns can disrupt the normal healing process of the cornea and lead to chronic symptoms like dryness and discomfort.

5. Is crying the best response for eyes that seem hopeless? Is a miracle possible?
While it’s natural to feel emotional about your situation, crying won’t necessarily help your eyes heal. Instead, focusing on appropriate medical treatment and self-care strategies is more beneficial. Miracles can happen, but they are often the result of consistent medical care and personal resilience.

6. Is long-term use of eye drops and ointments safe? Can they be harmful?
Long-term use of artificial tears and ointments is generally safe, but it’s crucial to use preservative-free formulations to minimize the risk of irritation or toxicity. Regular follow-ups with your eye care provider will help ensure that your treatment plan remains effective and safe.

7. Is there a cure for dry eye syndrome?
While there may not be a definitive cure for dry eye syndrome, many effective treatments can significantly improve symptoms. These include prescription medications, lifestyle changes, and possibly surgical options like punctal occlusion. Your ophthalmologist can help tailor a treatment plan based on the severity of your condition.

In conclusion, your situation is complex, and it’s essential to maintain open communication with your eye care providers. They can guide you through the management of your symptoms and help you find the most effective treatments. Remember that while your journey may be challenging, there are options available to improve your quality of life and vision. Stay hopeful and proactive in seeking care. Thank you for reaching out, and I wish you the best in your recovery!

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