Keeping a diary can be really useful

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GarethB
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Keeping a diary can be really useful

Postby GarethB » Tue 17 Jan 2006 8:40 pm

Had a fun filled day at the hospitle, that I think he optomotrist ws ready to cry at the end of it :oops:

As many will know I have been visiting on a monthly bases due to uncomfortable lenses, poor vision and reduced lens wear. Well after my visit on 20th December the lens would be in place, all comfortable and we would adjust the vision so that I was getting 6/6. Then I would blink and couold not even see the eye chart. :o

We went through the whole procedure again and again, but the vision would suddenly go. After each attempt he would look at the lens position and check where the little dot was. Little do sat rigidly at 30 degrees despite my KC being at 20 degrees. We would put the rest of the sight correction on which showed an axis of 40 degrees each time, but vision would disappear again. :o

After second, third, fourth and fifth opinions and seeing the opthalmologist all concluded the cornea was healthy, the topography had not changed, the rest of the eye was healthy, but they all could see for some reason vision would just go. Concluded the lens needed to be tighter on the eye so we went with the best we could.

Here is where I started my KC diary again, recording every little thing and I searched the net for Exzema. We all know many with KC have exzema and asthma, exzema is dry skin and asthma can be in the form the airways feel constricted because of mucus build up.

In exzema the body can not maintain the skins natural oils so it drys quickly. Some types of asthema is due to the lack of a surfactant to make the mucus mobile, so the ciliia (hair type protrusions) in the upper airway can not move the mucus to the back of the throat where we swallow it or cough it up if we have a chesty cold.

This made me look more at the tears as I rememberd some of what one of the confrence guest speakers said about the tears having three components, water, oil and I forget the third. Well my tearproduction is fine and I do not feel like I have dry eyes and the visit to the hospital thought all was well. So I posed myself the question, if my skin lacks oil hence the exzema and my lungs lack a surfactant hence asthema, perhaps an oil/surfactant is deficient in my tears. I also remembered some people reported goo across there lenses after a few hours wear, I never had this but would sometimes get a very small amount at the tear duct. This got me thinking further and that the problem had been there infront of my eye all the time :)

The searched for eye drops that rather than wet the eye surface actually encourage the water to stay in. Well Systane was one that came up and I happened to have some. Decided to use it four times a day, morning before lenses in, afternoon when lenses come out for half hour break, before lenses go in after half hour break and finaly in the evening when my lenses came out.

Soon used my eye drops, but I did notice that after lunch the lens was more comfortable than first thing in the morning.

Regime changed in that when drops were used when the lenses were removed in the evening drops used, but I would put them in again last thing at night.

Initially no change, but after three days, the lens comfort first thing was really good, but before luch things were uncomfortable and again early evenig when lenses were removed. So I calculated that I was wearing lenses comfortably for 2 out of 6 hours in the morning and 4 out of 6 hours in the evening.

As I had already started to find an accumulative effect with the drops I though I would continue this regime for longer when I was working over Christmas. Here everything fell apart as after a couple hours lens wear was really uncomfortable. Why?

The labs I was in was differnet so I measure the humidity and it was well low and the temperature I recorded change throughout the day. Borrowed the meter and found at home humidity was variable but a lot higher than work, but the temperature was steady. Concluded humidity was perhaps the major factor and temperature secondary. Before changing anything, went to my old lab for the day and temperature is completely steady, but humidity is low and had exactly the same eye problems at work so concluded hunidity is the issue. Experimented further with humidity using the aircon in the car and varying amounts of watre in airfreshners you get that plug in the cigarette lighter and clip over the heater events. A very crude way of controlling humidity in the car. Higher humidity, higher comfort.

So now to experiment with how to lock the moisture in my eye even more and cope with these conditions. Every four hours removed lenses, put drops in and back go the lenses. After 4 days, no joy, cut back to three hours and after a couple of days lens comfort, vision and eveything is good. Did this for 4 days and everything is brillient again.

Now go for 4 hours and I am at home for the new year and an extra 2 days off work. Brillient I am getting good comfort, lets go back to work and see how well that works.

Day 1, after 1 hour right lens is really uncomfortable so take lens out sue drops and all is well againg. 2 hours later same problem. It would appear that the humidity is really low and my yes are loosing a lot of moisture and lab work is hard. This happens day after day and is agrevated by pc work.

Start over, I know what it feels like when the lens starts to move, so as soon as I get this feeling, lens out use drops and lens in again. How to aleviate the pc problem, set timer to 30 minutes and take a break.

So far so good, at work in the office I am going 2 - 4 hours comfort and excellent vision. Laboratory work is still variable which can be difficult for collegues when I have to duck out at inconvenient times. I am also going through my lunch without lenses but things are managable.

I regulary achieve a total wear time in the day of 14 hours with about 1.5 hours spent removing lenses, using drops etc. At work I loose an hour to lens stuff!

This is inconvenient but worth it as I can now wear my lenses at the weekend if I want without paying the price the next day by following the same regime and I have been doing this for about a week now.

The result of my eye test when I first walked in was 6/5 in each eye, something I have never achieved before and I had been wearing the enses for 2.5 hours before the consultation. The optomotrist was gob smaked :shock: . He checked my reasoning with dermatology and they backed up my theory and reasoning.

I never thought that my KC, exzema and asthema would be so intrinsicly linked, but they are.

For the hell of it we tried the tighter fitting lens which was just as comfortable as my old, but my vision with that lens was worse than my eye unaided :shock:

Could get good stable vision, even if the lens was sitting at 60 degrees now and the extra correction would add 15 degrees to it he decided there was more dignity to loose this battle but to survive and fight another.

KC is unchanged over the last 18 months, but my sight is better than it was when I got the lenses 16 months ago. I go back in three months to see how things are then.

Will tell my boss that I really need ot give up routine lab work and stick to tinkering here and there where I can take a break when I need to without causing problems.

I will have to become far more stringent in planning my day if I want to maintain long accumulative lens wear, comfort and excellent vision.

This is a long post, but a six month slog, I though I would post it as it may proove to be of help to others.

Regards

Gareth
Gareth

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Louise Pembroke
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Postby Louise Pembroke » Tue 17 Jan 2006 9:10 pm

I think you deserve an award for working that out. How about KC'er of the Year!

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Postby jayuk » Tue 17 Jan 2006 9:43 pm

That is some exhaustive process! But good on you!!....its amazing what we do and want to achieve when we want to take things on ourselves!.....this is an amazing example of this!
KC is about facing the challenges it creates rather than accepting the problems it generates -
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Rob Armstrong
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Postby Rob Armstrong » Tue 17 Jan 2006 9:59 pm

I reckon you could really be onto something here..

I've too noticed problems due to dry air/low humidity - although my eyes are dry so I have always put it mainly down to that fact.

When I worked in the local supermarket, everyone used to complain about the dry air causing dry/sore throats - I tried wearing my lenses but had to give up (luckily could cope without them at that stage) as I'd be lucky to go much more than an hour without them going all dry and cloudy, which was totally impractical as I worked a 12 hour shift on Saturdays. (I didn't know about refresh drops and such at the time). This was in stark contrast to through the week at uni when at the time I would regularly wear them for over 12 hours continuously with reasonable comfort.

Windy days could be just as bad, as again it would dry the eyes - (not to mention grit, although the fact it made your eyes water could actually provide some relief.)

Even now (with no lenses) my eyes quickly feel red raw when the blowers are on in the car - doesn't matter whether they're on cool in the summer (doctors suggested it was the pollen) or hot in the winter (been told they get people complaining about increased contact lens discomfort once the central heating gets turned on in people's homes).

Guess this affects everybody to varying degrees, not just KCers - it's just that for us it's more than an inconvenience.

So once the problem is identified, progress towards a solution can be made - obviously there are drops such as Systane (brilliant stuff), and I have seen people on here recommend wrap around shades to combat the wind burn on the eyes, and as for the heating at home - I remember my Mum used to place a small bowl of water in front of the gas fire to stop the air getting too dry - (we stopped doing that though, dunno why). Also important is not to get dehydrated - I'm a bit parched now actually, better go.....

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John Smith
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Postby John Smith » Tue 17 Jan 2006 10:24 pm

Hi Rob,

If your mum stopped putting water in front of the gas fire in the early-mid 70s, then it was probably because of the conversion to natural gas.

The old town gas was very dry, but one of the by-products of burning natural gas is actually water vapour!

Now we seldom use an open flame though for heating, and use dry central heating instead, we certainly have drier homes. I vaguely remember seeing a trough that you could mount on a radiator and fill with water; the heat from the rad evaporating the water. Never tried it though, has anyone else?
John

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Sweet
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Postby Sweet » Tue 17 Jan 2006 11:47 pm

Gareth gee that was one hell of a long post, i tihnk you even beat me!! LMAO!! :wink:

I do understand and relate very well to changes in humidity. I have terrible trouble in resus at work as it is air conditioned and my lenses get really cloudy pretty quickly and i need to take them out to rinse them.

I have found though that systane is brilliant if used regularly so it is the first thing i do when i wake up and last thing to be done before bed! You get into a pattern pretty dam quickly when you need to!

I also have asthma but not that bad at all, although it is interesting that my twin sister suffers with much worse asthma yet her KC is quite mild, hhmm maybe that needs some thinking?

Well done on your findings!!

Sweet X x X
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GarethB
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Postby GarethB » Wed 18 Jan 2006 8:25 am

Thanks for all the replies.

I never made the link with asthma initially as I have not had to use an inhaler for 18 years now. Although on the few occasions I get a bad cold on my chest I do exhibit the symptoms ad put this down to the cold when really it may be that my lungs are finding things harder than they should. So although we think we have grown out of soemthing, it can still be hiding.

I tried the lens rewetting, but that would only give short term releif as it treated the lens, not the eye.

Just had to find what to re-wet and how, for me it was the cornea. Still have the irregular surface astigmatism characteristic of KC, but it is slighly reduced which I put down to the cells in surface of the cornea being better hydrated so stretching the cell surface to reduce the urregualrities.
Gareth

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Postby Dipesh » Wed 18 Jan 2006 8:45 am

Gareth,

Think I may have to call you Sherlock from now on. It just goes to show keeping a diary is a good thing.

I started one after my op in April 05, but soon got complacent and never looked at it again. Think that will change after today.

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Andrew MacLean
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Postby Andrew MacLean » Wed 18 Jan 2006 9:00 am

Gareth

You are wonderful. You have quantified an effect that many of us have experienced, and tracked it down to low humidity. It must be hard in an air conditioned lab where the air is scrubbed and stripped of humidity.

All the best

Andrew
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GarethB
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Postby GarethB » Wed 18 Jan 2006 1:47 pm

I was feeling a bit flipant today when I updated my boss on yesterdays succes.

She asked what could be done to improve humidity around my desk and I suggested a small tree and bringing my dog to work. :)

She asked how that would help and I said he would pee against the tree at regular intervals! :D

Probably ruined my protional prospects again :)
Gareth


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