Is a dry eye condition the root cause of KC?

[Steven Williams]

The following copied from the Systane thread:-

At my consultation this Thursday (MREH Dr Cindy Troumans) the check up regarding a new type of rgp lens I am trying in one eye, the examination revealed crystalline deposits on the epitherium.

As I know I have dry eyes I did ask if I could use systane with the lens and was informed this was OK.

In the one month trial period I managed to get continuous wear time up to 11 hours but only managed this using the systane. Put a drop in eye every couple of hours when working in air con room and when using vdu.
Also drinking 2 litres of water during the working day.

Photographs were taken of the eye for record/further research purposes, with my permission as this has never been seen before at MREH.

I have been instructed not to use the systane anymore or wear the lens until its established was is causing the problem and the epitherium has healed itself and removed the crystals deposits. I have another appointment in two weeks time.

Initial optom thoughts , which to me seem the most likely is that it is the systane, the chemicals in it evaporating due to heat build up through the rubbing/friction caused. Like when salt crystal deposits remain when salt water evaporates.

Anyone else come across this?

The good news/positive development is that, at last, they are now looking at sorting out my dry eye problem.

I was provided with a tube of Viscotears liquid gel to try out to use for my dry eyes.

This leads me to raise the questions:-

1. Do KCers have dry eyes and could this be the cause of why eye rubbing predominates?

Could the the sequence of events which creates KC be:-

Dry eyes>eye rubbing>KC

I will put this KC cause/dry eye issue on another thread for discussion as this is a systane thread.

Is there a practical/medical test for the degree of dry eyes (like a PH test?)? Has anyone ever had one in connection with their KC?

[Andrew MacLean]

I did develop dry eyes, but not until I had suffered from advanced keratoconus for a number of years.

I never used Systane, preferring hypermelose during the day and carbomer gel at night. The problem with all artificial tears is that they lack the complex structure of natural tears.

I have heard of people with KC and dry eyes benefiting from surgery to plug the ducts that drain tears from the eye; it seems that dry eye may not be a result of a failure to produce sufficient tears, but a result rather of the natural drainage of tears from the eye being too efficient.

Andrew

[mike scott]

i dont believe that dry eyes causes KC, in fact my understanding of one of the causes of dry eyes is the prolonged wear of lenses that is necessary to correct KC, which can stop enough oxygen getting to the cornea which over time can make the eye drier.

as for the causes of KC , to my knowledge they are still unknown.

i'm sure if i've got this wrong someone will tell me
mike

[donna]

When I was at the hospital last week they told me that they still have no idea what causes KC and my eyes have been dryer since I started with KC

[Andrew MacLean]

donna and mike are, of course, right.

Here is a fairly accessible report on the etiology and epidemiolgy of jeratoconus. it begins with the immortal words

The cause of keratoconus is unknown. There have been many theories based on its association with other conditions but no theory explains any significant percentage of the keratoconus patients. Microscopic changes appear to occur first in a single cell layer of the epithelium (Teng). It is suggested that enzymes released by this degenerating cell layer cause a breakdown of other layers of the cornea. The degenerating cells become pale and swollen, and the cells become less organized (Leibowitz and Lawless). These cells eventually disappear, leaving one or two superficial epithelial cells (McPherson).

Causes of Keratoconus

[Steven Williams]

I never used Systane, preferring hypermelose during the day and carbomer gel at night. The problem with all artificial tears is that they lack the complex structure of natural tears.

I have heard of people with KC and dry eyes benefiting from surgery to plug the ducts that drain tears from the eye; it seems that dry eye may not be a result of a failure to produce sufficient tears, but a result rather of the natural drainage of tears from the eye being too efficient.

Thanx for that Andrew

Totally agree with you about natural tears being the best. Personally dont like using man made solutions, containing chemicals developed by the Pharmaceutical industry to maximise their huge profits, many of which have negative effects which are only confirmed when you discover them.

Dr Troumans mentioned about plugging the ducts as a solution. If anyone has had this done could you provide some info about the operation and the effects (positive and negative if any).

[Anne B]

Not had my tear ducts plugged but seemed to have had the opposite!!!!
my eyes used to water all the time they would really stream and if i bent over water would pour from my eyes.
i had a procedure which they called a three snip (i think) this is where they snipped my tear ducts in three places so that fluid can drain away better.
i have to say that it really has worked because my eyes just don't water any more!!!
Not sure if that is a good thing or not

Anne

[donna]

Sometimes if I blow my nose tears squirt out of my tear ducts!

[GarethB]

The test for dry eyes showed my tears were in the normal category but only just. This is why I have problems with lens wear.

It has been suggested at past AGM's that the movement in the corneas collegen causes irritation which leads us to rub our eyes and possibly do more damage.

Others have suggested it is the dry eyes causing the eye rubbing.

For me I have asthema and eczema, asthema I am deficient in a surfactant for the mucus to be removed effectivly so it is quite viscous. The type of eczema is due to a defeciency in a skin oil closely related to the surfactent in the lungs which is why my skins dries easily. These two apparently are linked to the surfactant in tears that prevents a lipid component flowing smothely in the watery component of tears. So although I have lots water flowing over my eyes, it is not soaking in to the cornea or have anything to help the cornea retain its moisture.

From old group surveys I think only a third of people had alergies or dry eyes. So this may be a link/cause for some, but not for others.