What is wrong with my eyes

[Venata125]

I’ve visited 4 different clinics, several times so far and they can not find an answer to my case. So this is the perfect time I ask for advice here, where people across the world share information, knowledge and experience. I notice that ophthalmology here is not as advanced as it is in the US for example. This is another reason to ask here.

I am a foreign IT guy who just lost his job and all his money due to the eye problem that began occurring through the past year. I always had dry eyes bothering me from time to time, especially outside (probably because of wind), but it did not stop me of working intensively on PC (sometimes up to 14 hours at a time), so I did not pay attention to it really. One day it pissed me off a little and I bought some pure marigold eye drops that I thought have helped me. Some time passed, my eyes were kinda red-ish and one day my eyes started to burn and feel sore after some hours on PC and I thought that my eyes are just exhausted from too much PC (it usually starts to happen after MANY hours of non-stop work, but it is not so bad) so I took a rest. Usually this would recover my eyes, but not this time and not anymore.

Sometimes this will begin happening only after 5-10 minutes working on PC, sometimes (if I slept a lot and my eyes are fresh) 30 minutes and at good days, but rarely if I don’t pay attention to them and the pain is mild for more. But this does not happen only on PC, but also during driving or playing the piano. I think I can fairly say that it happens when my eyes focus. It feels like it exponentially increases my dry eye symptoms. I’ve discovered that it is unrelated to blinking, despite that doctors say that I don’t blink. I experimented and blinking does not help, same thing happens. I even recorded myself to capture unconscious blinking rates. How far I can go? I can push through the pain a little, but it increases to the extent that I am no longer able to sustain it and have to forcefully sleep.. My eyes can turn very red at this point.

What doctors estimated
Intraocular pressure tonometry – Normal for both eyes
Visual Acuity Test (with numbers) – 110% vision
Schirmer test – 10mm one eye (a little reduced), 20mm on other eye (increased tear production)
The collected data + autorefractometry on dilated pupils concluded that I don’t have diopter (< 0.25~)
I also had UV look with Fluorescein eye drops where doctor said she could not see severe dryness at the moment
I am 22 years old male, 190cm tall, 85kg with no prominent and conclusive dryness in other glands so Sjorgen Disease is very unlikely, although I am collecting money to do the expensive test that will 100% confirm the absence of this disease.

Many times doctors would see conjunctivitis and prescribe me antibiotic eye drops. Once I also paid a lot to test my eye fluid for pathogens, they discovered streptococcus epidermidis and prescribed me eye drops again, but the doctor obviously did not know about it looking on the antibiogram saying: “Look on how much antibiotics you are resistant!” I googled this bacteria and found out it is naturally resistant on those antibiotics… and that it is normally found on human skin and especially face. The problem with the tests is that I visit those doctors when my eyes are fresh. I know that I can produce tears, I don’t need tests to confirm it. The inflammations and infections are typical for dry eyes though. So is the increased tear production. Perhaps what I need is osmolarity test / test tear composition. Or maybe I have other type of refractive error or muscle problem?

I tried all eye drops for dry eye I can find. When doctors prescribe me eye drops / anti-inflammation eye drops / antibiotic eye drops I take them exactly as prescribed. I tried stopping them, increasing their consumption. Every possible advice or model – I followed. They may help my underlying dry eye condition, but if I sit on PC again and try to work – same thing would happen just as if I did not take those drops at all. I also tried gels and ointments (which imo even worsened it), even during working and it did not help. If my eyes are watery the discomfort remains as usual just as if it has nothing to do with dryness.

What I’ve tried
Aside from the vast variety of eye drops, gels and ointments that did not work: Being in different environment did not work. I used a lot of “Analgin” before, I stopped it. It did not improve condition. I used to drink energy drinks every day for 7 years, stopping this did not work. Taking a longer break (at nature), with hands off PC and other things that require close focusing in general did not improve condition. I bought monitor with eye saver option, 3 reflection glasses, installed blue filter – none of this changed a thing. I even bought projector, which may actually ease focusing, but only if text is very large, but when the text is so large working on PC becomes pretty hard. Taking frequent breaks when working, even every 15 minutes, focusing distant objects did not work or maybe just slightly.

I suspect that me not drinking water (but other fluids) and eat too much salt probably eventually maybe have something to do with osmolarity and my problem, but I am saying this, not all those doctors.

Moreover, about 1 year after those problems started I had “ophthalmia electrica” from UV lamp exposure and I was immediately accepted and treated from it. Doctors are curious about this case, but do not connect it at all.

[JohnHaganMD]

Two things come to mind.  1) convergence insufficiency and/or latent hyperopia.  2. Ocular surface disorder.      The first is often over-looked and many eye doctors don't test for it.   You could need to have a Eye MD test your near point of convergence and do a 'cycloplegic refraction"    If positive you would likely need a trial of  near glasses  which do some of the focusing for you and have base in prism.  2) ocular surface disorder is the medical name for what people call dry eyes. Given all that you have tried, I would suggest you discuss a 12 month trial of either restasis or the newly released Cequa.
Over 4-6 months these drops improve the tear quality and reduce inflammation on the surface of the eye. Both my wife and I have been on restasis for over 6 years with great help after about 5-6 months therapy. Important to understand that restasis and Cequa take 4-6 months to work.