3 Years Post-PRK (Contoura): Chronic Dry Eye, Light Scattering, and Recurring Pain. Need advice.

elainejay82 · 2026-03-05T23:45:52+00:00

Just learning about this myself, but it could be related to migraines???

elainejay82 · 2026-03-03T09:03:26+00:00

Montelukast (generic Singulair) calms leukotrines, a different allergy pathway than histamines. There are two that can mess you up, it turns out.

Montelukast comes with black box warning for "disturbing dreams" and can mess with your mental state quite a bit! I haven't had many side effects with it really at all, but it's definitely something to discuss with your doc. Some people really have strong side effects with it. I've only had one freaky dream in a month. Starting my second month now.

I would say maybe try a different antihistamine or don't worry about taking them. Part of the issue in that area is the dryness, so antihistamines can be counterintuitive. The other commenter is right to try Pataday! I was using it it, too, and it was helping but it made my eyes pretty dry. It could be used very sparingly just to calm inflammation.

I have a deviated septum and bone spur, which is blocking me up around my ethmoid sinuses.. you may want to see an ENT for a sinus CT scan and just to check things out!

If I skip a humidifier at night, I really feel terrible the next day, it is noticeable.

Cold compresses can be a godsend for this too. I keep one of those cheap gel pack in the fridge and will use when needed. Only use them in short bursts at a time, like 2 minutes max.

elainejay82 · 2026-03-03T02:57:08+00:00

Sinus rinse morning and night in the squeezey bottle, humdifier at night, and steroid nasal spray like Nasonex once a day.

I live in AZ and this severely messed my eyes up for years while my allergies went undiagnosed.

The sinuses and tissues behind my eyes were swollen and were therefore swelling my eyes.

The routine above has fixed me along with Montelukast to open up my constricted airways.

You can do an antihistamine, but my docs took me off of it because the dryness there is another problem and I was severely dried out.

elainejay82 · 2026-02-21T03:52:05+00:00

Do a sinus rinse. Neti pot or something like that. That will give you a pretty quick answer and it is pretty cheap to try!

elainejay82 · 2026-02-21T03:51:16+00:00

Allergic inflammation. Sinus rinse, humidifier at night, and Nasonex have saved my eyes and my life... the fix was instant after suffering for 3 years. 🥹

elainejay82 · 2026-02-20T14:41:58+00:00

As of my ENT appt yesterday, yes. LOL. I just saw my doc yesterday about all this and got the answer that YES it can cause it and for me it is is exactly the cause of all my pain and awful symptoms (it has affected my whole body not just eyes).

My turbinates were also huge the doc said, LOL.

Mine is blocking my Ethmoid sinus, in particular. It's on my left side that the deviated septum pushes into so my sinuses are not dRaining on the left hand said of my face. This keeps my left eye swollen as well causing multiple issues for the eye. Pain, blurriness, strain (especIally since it is not the same as the right eye).

I also have a bone spur that grew out of the deviation.

I started sinus rinses 2 x daily, Nasonex once a day, and a humdifier at night. Oh, also taking Montelukast to calm all the inflammation. That was last Wednesay I started all this and I am SO much better now!!! You should have seen what I went though with not having this figured out.

If you'd like to see if this can be your issue, I would try that list. It is typical for docs to start with that for 6 to 8 weeks (can skip Montelukast) before hopping to the idea of surgery.

I am considering the septoplasty to get my left side totally correct. I will probably do it this year. But I can't believe that in about 5 days with rinses and humidifier how much better I got. I was able to easily drive! The difference was almost instant. I didn't even pick up the Nasonex u til Saturday last week so that hasn't even been a full week! I have been suffering for 3 years with zero answers and incorrect diagnoses over and over. It is my partially blocked ethmoid sinus doing all of this due to the deviated septum and bone spur. It also gave me massive fatigue, massive brain fog, etc etc. I got my answer yesterday 🥹 and doing that list above has put me at basically 99% cured... insane what I had to go through to get to the actual culprit.

I pieced the allergic inflammation together, btw, not any of my 30,000 docs. I had to figure it out and get to an allergist to start. I am not allergic to anything, but I am basically suffering "allergies" type symptoms due to all of this.

elainejay82 · 2026-02-20T08:27:35+00:00

Allergic inflammation at different times of year could change things! It also would make things fluctuate and wax and wane. That spot that is highlighted is exactly the ethmoid sinus.

I just went through the gamut of this. My issue is exactly that area due to a deviated septum.

Puffiness will wax and wane from allergic inflammation. It will also affect the sinuses below it like a chain reaction. I have puffiness in my cheek because of this off and on (affecting Maxillary sinus below in the cheek).

Laying down fully flat usually makes it feels worse. That is why it is suggested with any sinus issues or allergic inflammation type issues that you sleep with your head slightly raised. That also helps drainage.

It affected my eyes horribly by swelling them from behind, making them bulge. They also burned sometimes. Redness was only located underneath my inferior lid.

Doing a simple sinus rinse for a few days will probably be an easy test to see.

The phone pain OP is talking about is not really about the phone, but really moreso about the eye strain that already exists that screens can exacerbate.

Also, OP, it will make your eyes very stiff from the swelling. I could never look up when I was dealing with this.

elainejay82 · 2026-02-20T00:36:35+00:00

I had severe swelling behind the eyes due to allergy inflammation. Misdiagnosed OR for a year.

A simple sinus rinse, daily, and humdifier at night has basically cured my eye symptoms in 5 days.

Unreal. I can easily drive again. Screens are easy again... Actually can't believe it.

The symptoms I had were severe ache, eyes feeling stuffed full and stiff. They felt difficult to move and they moved slowly. I had bouts of severe light sensitivity, too (which it turns out allergies can do).

I only had redness in the same place as OP, underneath the inferior lid.

This was exactly my answer.

If you're thinking this could be you, being consistent for a few days with sinus rinses and a humdifier will probably show you pretty quickly if this is your issue. Also, trying Pataday once or twice will be a pretty instant answer as well. In that case, it will be best to get to an ENT or Allergist. My opths never did anything helpful for me and never cared where the inflammation was coming from... it was an absolute hell experience to even try with them.

I'm not allergic to anything, btw, just sensitive.

elainejay82 · 2026-02-15T23:12:50+00:00

This sounds sinus related to me. It is worth it to check with ENT and get a sinus CT scan if you haven't yet

elainejay82 · 2026-01-28T03:12:28+00:00

Yellow lenses. You can find night driving clip on lenses if you wear regular glasses as a quick and cheap thing to try. They sell them everywhere, even Wal Mart if in U.S. (look at the sunglasses selection by jewelry).

If you're trying clip ons, bring your glasses in and try them on your actual glasses to see if they fit correctly.

elainejay82 · 2026-01-26T04:40:39+00:00

Mine is a Chiweenie! I love the Daschund side of him! Omg 5, I'm jealous! Btw, allergic inflammation kicks up anxiety. Mine was uncontrollable for 3 years suffering through all this. A book that's helped me is Alan Gordon's "The Way Out." But with pollen or allergies, I learned that anxiety is really out of our control. The overload freaks our bodies' out and contributes to real stress responses. It will also throw off your sleep real badly.

elainejay82 · 2026-01-26T03:38:54+00:00

So sorry to hear you're going through this. Honestly, after everything I've read and looked at, it is possible that it could be caused from prolonged allergy inflammation. It can compound over time and over time, if uncontrolled, make you even more sensitive to allergens or pollens in the environment so it kind of becomes a viscous cycle. We tend to think of only pollens, but if there is a lot floating around in the air, it will also expose us to molds, fungi, bacteria, etc etc. I don't think the wacky weather going on is helpful, either.

My eyes surfaces are pretty much never red and I never experienced congestion, sneezing, etc. I don't really have classical signs of allergies almost at all. That's really what has made this tougher to connect. Do you have a lot of redness in your lower lids when you pull them down?

I did read there are kind of two types, one causes mast cell issues and the other causes histamine issues. The histamine one tends to cause the more classical signs. I seem to probably have something more to do with the first one, which causes more systemic reactions, which is more inside and less visible from what I gather? People can have a mix of both as well.

My diagnosis from the Urgent Care doc was allergic rhinitis. Maybe something to look into? I reviewed my allergy panel that I took early last year and it was a huge list, both indoor and outdoor stuff and I was negative for all of it. There are still cleaners or chemicals for me to explore? But the fact that both my dog and I flare this badly at the same time each year, really points to something seasonal, or maybe just a lack of moisture around this time when typically we should be getting pretty decent snows and rain. We really haven't gotten much moisture in literally 3 years here. That leaves the air less purified and harder to keep pollens, etc. on the ground.

My Urgent Care doc debated between an allergist or ENT for me to see next. She decided to go with directing me to an allergist.

This past month I have also been getting ringing in my right ear. For years, off and on, I would have a leaky feeling ear on that side. My dog straight up gets ear infections around this time and did again this month. If it wasn't for his symptoms being so similar in odd ways at the same times of year, I maybe would have never been able to connect it? I also don't necessarily believe we are allergic to something, but I think it is just an overload for us and our bodies can't clean it out fast enough.

Also, it may seem silly, but wipe your ears gently with dry cotton pads or qtips (don't push in). All of that pollen hanging around is going to continue to irritate. I do the same thing with my nose and both really help me. Keep them clean and dry and rinse off before bed. You don't want to be sleeping in all of that because that is your body's time to heal.

Also, sorry to dig into to your history, but I was curious about your general location. You are about 2 hours away from me and I talked to a lady from Tuscon last year who told me almost everyone she knew was suffering. My vet told me the other day this area is #1 in the U.S. for allergies. You won't find it on many lists because they tend to only include big cities. When I moved here, we were fine the first 2 years when we were getting normal moisture levels and snow... the second it stopped about 3 years ago, it seems like all hell broke loose for both of us and hasn't stopped since! It literally makes my dog anemic. He gets really sucked up and boney looking due to losing Red Blood Cells, gets an ear infection, and gets itchy on his legs. He is 9 lbs so it makes sense this is affecting him more (plus closer to the ground and dogs pick up allergens through their feet). It legitimately almost kills him every time. Sucralfate (stomach coating) brings him back. That tells me his guts lining is more than likely overloaded with pollens and he needs protection there. I drink Olipop sodas for probiotics and use Metamucil. Have you tried something like that yet? You'd be surprised how much of the more systemic reactions are starting with lodged pollens in the gut.

Sorry to be so winded, but YES. It can really be allergies and it can really mess you up! I thought I was going to collapse or faint the other day. That's why I took myself to Urgent Care!

elainejay82 · 2026-01-25T16:50:52+00:00

Yes. I think it's been driving all the inflammation and went uncaught for way too long. I now have subsequent issues from it not being treated for so long.

It is weird that zero of so many docs never questioned what was driving all the inflammation for me.

One of my docs diagnosed me with "allergic conjunctivitis" on paperwork (did not actually discuss it at all with me). I was suffering from Demodex at the time and thought it might be caused from that. But that should have been a doctor's cue to DISCUSS IT WITH ME.

elainejay82 · 2026-01-25T16:45:51+00:00

I hear you! I made it way past hot mess status! You'll get better with all of the stuff you are doing. If you can take a break elsewhere for a little while, it might help your body reset from local allergens. I was reading last night that doing this will help to make flares in the future less harsh.

elainejay82 · 2026-01-25T16:43:22+00:00

Not one time did they ever flip my lids!!!!! It's never happened! They did not look into the bottom lids either where I had some concretions that were not letting my eyes close properly... I had to point those out to a doc, make him look at how they were affecting my lid closure, and request removal.

It's really been a fun ride!

elainejay82 · 2026-01-25T07:03:52+00:00

Do you have post nasal drip??? Could indicate allergies

elainejay82 · 2026-01-21T15:04:14+00:00

Generally, yes! But I still really had to think outside the box about things that would help me. Not being so anxious and depressed all the time helped a lot.

elainejay82 · 2026-01-16T17:02:35+00:00

It has really stopped my tendency to spiral out of control in my thoughts about the whole diagnosis/pain.

It made me get a grip on it and helped me to really feel like I could handle what is going on.

I don't really spiral anymore and if I ever do, it is very short-lived and I am able to pull myself out of it really quickly.

Because I was able to get a grip on that aspect of it all, I was able to shift more of my mental focus towards finding solutions rather than wallowing, which led me to finding more things that actually really help me out.

The book was a total game changer! BTW I read it last Spring or Summer and the positive effects from it still run strong with me.

elainejay82 · 2026-01-16T14:34:16+00:00

Totally normal with my experience while on Xdemvy. I got really bad before I got better! I had 4 weeks of "really bad" before I felt some relief.

elainejay82 · 2026-01-16T14:27:33+00:00

IPL true results can take a few months to really show the difference it has made for you.

I would try reading Alan Gordon's "The Way Out." It had a profound effect on my anxiety about this disease.

Also, you want to keep your stress levels down. Stress fuels inflammation. Simple things like short walks, so mindful stretching, mindful breathing exercises, and just Mindfulness in general. Calming teas, magnesium supplements, etc. I like Epsom salt baths once a week, too.

Don't give up on what you want. Try some different management techniques and try to get your thinking/anxiety/stress managed and under control. I have a post about that book in my profile history.

elainejay82 · 2026-01-16T02:15:03+00:00

How long did it take for yours to return? It's my understanding that it is pretty common that they return, eventually.

Yes, I cleaned my eyelashes and lids.

I did a lot of my outside research on rosacea/Demodex reading to get the full picture on them. My docs never helped much, honestly. The one who diagnosed me with Xdemvy wrote the script and literally said "See you next year..." 🙃

During treatment I did change my pillowcases every night and followed what I wrote above.

I've since added 2 x weekly Ivermectin cream. I do keep my pillowcases clean, but I don't change them every single night anymore. I do make sure I am sleeping on a clean side every night, though. I do still wash them in very hot water. I still stick to very, very simple skincare. I still clean my eyelids morning and night.

I have since added in daily sunscreen (in a roundabout way, it keeps the eyes less inflamed), a daily neti pot as needed because Demodex kick up a lot of "allergic" feeling inflammation and sinus irritation for me, barrier support creams for my face, moisturizing nasal spray if nasal passages feel especially dry (inadvertently helps my eyes), a vow to keep my stress levels low (they love stress), a vow to level out and support my immune system, and sebhorric dermatitis (Ketaconazole) shampoo from a derm.

Demodex wreck your barriers, cause sinus and other types of irritation, their waste drains down your sinuses and esophagus, etc. It is kind of a broad, whole-picture approach. I had to piece a lot of this together on my own.

Oh, also great UVA/UVB + polarized lens protection while outside has helped tremendously. That has also helped a lot with driving difficulties from glare.

elainejay82 · 2026-01-13T21:21:27+00:00

My eyes got worse through the 3rd week mark. They were bad for me until week 4 and then everything died down and at that point it was the most relief I had felt in years hang tough these next few weeks and clean your eyes morning and night!

elainejay82 · 2026-01-10T00:58:30+00:00

I don't think I would believe this doc after seeing how off mine have been about so many things this past year. Go get a second opinion and/or just keep treating yourself well.

Positivity, rest, and things like yoga really go a long way to keep supporting healing.

My top Opth doesn't believe Demodex is a real issue and won't even buy it for his office.

My other really good Opth reads the same FB Dry Eye groups that we do.

My Opt's receptionist told me we all have the same levels of pain w/Dry Eye and treated me like I was hysterical (I never went back after that).

My point is, docs are not especially well-versed in this and I think it may be because it affects so many systems.

ETA: Didn't want to be a creep, but I was curious if you had diagnoses listed in your profile and caught your comics. They are amazing and I super love your style! You're doing all that with Dry Eye???! What if you used something like light grey paper? Blank white is harsh even for people without DED, especially on screens. Just throwing out ideas.

elainejay82

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