September 10, 2011
The absurd level of pain associated with dry eyes
"until you’ve experienced dry eye, you can’t understand how unspeakably painful it is" [Source]
It is like "living in hell" [Source]
"I was ready to jump out the window" [Source]
"I felt like I had shards of glass cutting into my eyes. The only relief I got was when I was asleep; my time awake was torture." [Source]
Dry eye pain – description
I've tried to classify the levels of pain I've experienced here. But a further discussion would be useful, since it is the most absurdly painful experience, well beyond any possible description .
This greatest problem with this pain is that it is located DIRECTLY ON the "window" to one's world – the eyes and forebrain. The entire area inside and around the eyes gets SEVERELY affected.
A throbbing, tight pain is experienced in the eyebrow area. Severe headache can arise. But basically it feels that the brain is experiencing the pain (although that is not possible since the brain doesn't have pain receptors). Basically therefore, the experience is one of continuous soreness inside and around the eyes – almost as if it inside the frontal lobe.
This background soreness (quite bad) can get aggravated badly once the eyes get dry enough to start burning (note that this dryness is NOT alleviated by eye drops).
Without such burning what is experienced is a tight pulling sensation inside the eye and around the eyelids. But this sensation can get astonishingly bad when the eye starts burning. At that point there is an acute burning sensation inside the eye – as well as throbbing headache.
Somewhere between the burning and the headache is an ugly sensation where the eye is feel as if there is some astringent filled inside the eyes. It is not a gritty sensation, but feels as if the entire eyelids are filled with something that is pulling at the pores and causing a weird irritating experience.
Somewhere around this level of dryness is associated the inability to move the eyeballs flexibly within the eyelids. Moving them around the eyeball (such as rotating the eye in a circle) becomes impossible, sticky, and painful. So essentially one is forced to look ahead, and narrow the eye.
The worst sensation of all is when the headache and burning reach the acute stage, and to that is added most unbelievable sensation of a "layer" or "film" of pain that fills the entire eye in the front.
This "layery" sensation has been well described here
: "menthol sensation," like a cold, mint wind is blowing right in to your eyes, even if you're just standing still, indoors, in a perfectly calm-aired room." "Nasty, nasty sensation". "as if I was "sticking my head in a freezer with my eyes wide open"
If you pour isopropyl alcohol over the back of your hand, it evaporates very, very quickly. What you feel is a "severe" cooling sensation that surely could be described as a "menthol moment." That sure sounds like severe evaporative dry eye (very short tear breakup time) to me … and mine's usually less than two seconds. [Source
This kind of sensation generally arises when one is reading the computer screen after a long day of work. At that point one knows that is simply not possible to continue. [Note: this apparently is fixed best by moisture chamber glasses]
There is NO relief for the entire day the moment one gets up. The only time one doesn't experience pain is during sleep.
WHY THE PAIN?
The opthalmalogist/neurologist that I see told me that the cornea is linked to the trigeminal nerve and if the cornea gets dry and starts burning, it sends those signals to the trigeminal nerve and that is when all that other stuff kicks in. He put me on Trileptal, which is an anti-seizure medicine and that has helped tremendously. It is just a small dose, but the results are amazing. [Source
he tried the Trileptal 300 mg per day 1 hour before bedtime and it shuts that nerve irritation down for the next 24 hours. For me it truly was a miracle. He told me that there are so many of these drugs and there is no right one for everyone. You kind of just have to try a few until you find the one that works. I had thought I was going crazy too, because no one knew what I was going through and though it sounded a little weird. My original doctor (who I have dumped) basically told me it was all in my head. But my G.P. listened to me and referred me to the Opthalmalogist/Neurologist who told me that my case was classic – not as severe as some people, but very definitely Trigeminal Neuralgia – caused by the irritation of the dry eye. [Source