The Dry Eye Solution Can Sometimes Be the Problem

I’ve had dry eyes for a long time now (about 30 years). It got much worse recently, though. I have a condition called corneal ectasia, which means my corneas started bending out of shape (not amazing for a good vision!) I was lucky in that I got the diagnosis before I lost too much of my eyesight, and the surgeries I had stabilized my condition (touching wood that it lasts!)

Corneal ecstasia

Some of my corneal ectasia issues could be helped with special glasses, but not all, and usually the answer is to go with scleral lenses.

Scleral lenses are those rigid contact lenses that are bigger than regular contacts, resting directly on the sclera (the white part of the eyes). They are usually molded precisely to your cornea’s measurements, and it helps correct the aberrations thanks to the effect of the tears being trapped between your eye and the lens.

Scleral lenses are also, coincidentally, a tool to help severe dry eyes! Because they trap those tears underneath, it keeps the eye surface moist. So I was expecting my vision to be so much better with those lenses. I couldn’t wait to say goodbye to blurry vision and halos, while having less dry eye symptoms to boot!

Adjusting to scleral lenses

It sadly wasn’t the way my story would go…I adjusted quite well to the lenses, starting slowly and eventually being OK wearing them all day. But my severe dry eyes complicated things. My eyes didn’t seem to get the “it keeps eyes moist” memo. I had to put drops in every 20 or 30 minutes and often had to remove the lenses to rinse them and add more drops before popping them back in. I tried adding eye gel inside the lenses before putting them in, which usually helps… but it didn’t.

I eventually noticed the dryness wasn’t between the lens and my cornea, but between the exterior part of the lens and my eyelids! If I didn’t put drops often enough, I ended up with my eyelid rubbing against the scleral lens.

I had no other options, so I wore them, enduring a lot of pain and discomfort.

Corneal erosion

On a beautiful summer day in 2021, I drove for a few hours… with the A/C on. And I didn’t put as many drops as I usually would, because I didn’t even think of stopping to do so. I maybe put drops in 6 times in the whole afternoon.

That evening when I removed my sclerals the pain in my right eye was unbearable, with crazy burning. I almost lost my mind the pain was so bad! Light increased the pain, as did opening or closing the eye. Eventually, with cold compresses (with sterile water!) and keeping my eyes closed, it got to “only” a feeling of having sand in my eye…my left eye was bugging me too, but nothing comparable.

Luckily, I had an appointment with my ophthalmologist the next day! He told me I had corneal erosion. My corneas, fragile due to my hypermobile Ehlers-Danlos syndrome, and very thin and even more fragile following my surgeries 2 years prior, were easily injured. He explained that this issue was the cornea literally having a layer scraped off, by my own eyelids or by the lenses.

He prescribed anti-inflammatory drops, antibiotic ointment, rest from screens and a few weeks without my lenses.

Switching from lenses to glasses

When I started wearing the lenses again, I had to go at it slowly, like I had when I first got them. But I don’t know if it’s because I knew what symptoms to look for, or just bad luck… or maybe my corneas got more fragile after that first time. But even though my lenses were a good fit (both the optometrist and ophtalmologist agreed on that), I had that corneal erosion pain very often, would need to stop wearing the sclerals and use the anti-inflammatory drops for a few days. Since I didn't have any other option, it meant living in a blur for days, each time.

I even had to run and remove the lenses in the middle of a meeting!

I eventually decided I had enough, and got glasses. To my surprise, my vision is as good with them as it had been with the sclerals. I’m guessing it’s because with the sclerals, I always had drops in (which made things blurry), or my eyes were too dry… which also made things blurry!

Now I only wear glasses, and no, my higher-order aberrations are not corrected, so I have a somewhat blurry vision, halos, and all… but at least my eyes don’t hurt!