Reta and Laser eye surgery

[thelaststatistician]

So I had PRK done on both of my eyes on March 31, and that happened before I decided to go ahead with reta. Then on May 26 I began reta at 2 mg/week.

By June 24 I was done with my last ophthalmologist appointment, and for all intents and purposes my vision came in at 20/20 in both eyes.

Over the months that followed I kept titrating, and my vision stayed stable the whole time. As the dose went up, I didn't pick up on any real changes in visual acuity.

Then late September rolled around and I began to notice occasional blurriness, plus sensations like there was “something in my eye.” This showed up after I got back from Mexico with a fairly rough flu, and it lined up with me being far less consistent about using my lubricating eye drops. Some of the time it seems to be the left eye, other times the right.

As of now, nothing gives me a reason to say the reta was the cause. There are a number of other fairly clear variables at play... dry eye after PRK, being sick, environmental exposure during travel, and not staying consistent with drops.

Really, the reason I'm posting is that the timing scared me at first, since reports about glp-related optic nerve infarction were starting to hit the news, but when I look at the timeline objectively, I'm not convinced there's a causal link between the reta and the visual symptoms.

My current theory is that the metabolic shift is leading to fluctuations in the tear film of the eyes. Or maybe some bouts of mild dehydration are affecting how many tears I produce (I had to set several alarms to remind myself to drink water and electrolytes ). I've got a check-up next week, so I'll be sure to update y'all.

Meanwhile, has anyone come across similar cases? Any thoughts, educated or otherwise, on my theory? I'd really like to hear what you all think.

 

[woundcarping]

NAION isn’t typically something that comes and goes. What it involves is the death of the optic nerve.

If I had to point to a way Reta might have played a role, it would be the dehydration angle you brought up, rather than Reta acting directly. The same goes for being sick, especially when drops weren’t being used.

 

[lessthanhalf]

From what I understand, NAION typically brings on sudden loss of sight in a single eye, so this really doesn't sound like that. It seems closer to a localized dry eye problem, or possibly even viral conjunctivitis. Still, whenever there's any shift in vision — or even a possibility of one — it's always worth having it looked at.

 

[NeiNei]

My eyes have been giving me trouble, and Reta is 100% to blame. As I see it, this comes down to shifts in glycemia. Any time my vision goes blurry, it tends to happen after going a long stretch with no food. Eating clears it up.

That said, my eyes now react to eveyrthing more than they used to. ANd that's 100% since tkaing reta.

 

[HouseCat]

I don’t know a ton about this topic, but here’s what I’d do

A) Ring up my eye doctor and get a follow-up appointment on the books (because it can be hard to get one) — then be upfront about reta. Trust me, they’ve heard stranger things, and vision isn’t something to gamble with. If telling them about reta feels too awkward, you can simply mention a GLP-1.

B) Stay consistent with your eye care routine (drops, fluids, electrolytes) as much as possible, and watch whether the sensation improves.

Dry eyes are something I’m prone to, and my eye doctor never stops reminding me to drink more water! I’ve also noticed that what I eat affects my blepharitis (clogged meibomian glands, which normally release oils onto the eye to stop tears from evaporating), and that gives me the sensation of having something in my eye. For me, a cleaner diet means less eye irritation.

 

[5byfive]

I deal with those same symptoms because of dry eye problems, and I use prescription drops to manage them. You also mentioned that around the time your symptoms showed up, you got less consistent with your eye drops. The simplest explanation is probably the right one.

 

[bamagirl26]

thelaststatistician said:


So, before pulling the trigger on reta, I had PRK surgery on both eyes (March 31). I then started reta at 2 mg/week on May 26.

Had my final ophthalmologist check-up by June 24 and my vision was --for all intents and purposes-- 20/20 in both eyes.

I continued titrating over the following months, and my vision remained stable throughout. I didn't notice any meaningful changes in visual acuity while increasing the dose.

Then, around late September, I started noticing some intermittent blurriness/“something in my eye” type sensations. This happened after I came back from Mexico with a pretty nasty flu, and coincided with me being much less consistent with my lubricating eye drops. Sometimes it feels like the left eye, sometimes the right.

So far, I don't have any reason to conclude that the reta caused it. There are several other pretty obvious variables in the mix... post-PRK dry eye, getting sick, environmental exposure while traveling, and being inconsistent with drops.

I'm basically posting this because the timing initially freaked me out as reports of glp-related optic nerve infarction started making the news, but looking at the timeline objectively, I'm not sure there's a causal connection between the reta and the visual symptoms.

My theory right now is that the metabolic change is causing fluctuations in the tear film of the eyes. That or some episodes of mild dehydration might be affecting my tear production (I had to set up several alarms to remind myself to drink water and electrolytes ). I will have a check-up by next week, so I'll make sure to update y'all.

In the meantime, do you know any similar cases? Do you have any thoughts or educated/non-educated guesses on my theory? I'd love to hear your opinions.

Click to expand...

Since I began GLP, dry eyes have been ONE side effect I've really noticed. My lasik was 25 years ago; during recovery (roughly that first week) my eyes were dry, but after that they were fine. Once I started GLP (tirz), I began noticing more dryness, though it wasn't a big deal - no drops needed, it just reminded me to drink more water. However, a few weeks into Reta, the dryness has definitely gotten worse. The other day I felt like something was in my eye, and it was quite irritated and seemed swollen. I picked up drops and they gave some relief, but my left eye took a good two days to feel normal again. (There may have actually been a slight environmental abrasion.) Everything is fine now, and I keep mineral oil lubricating drops in my purse. I already drink plenty of water, but I believe adding electrolytes has helped.

I really do think the metabolic shifts, plus the increased hydration demand, are behind the dryness. I wouldn't stress too much about the LASIK being the culprit, but do check with your doc if it worries you. Naturally, my first thought was also, oh no, is this the nerve thing people mention, but no, I believe that's mostly a side effect for those with very high blood sugar/obesity. That said, glucagon apparently does raise blood sugar, but I doubt it would push a healthy blood sugar up THAT much and cause eye problems. Bottom line, I'm not a doctor, just someone who enjoys reading, and I wanted to share my experience.

 

[bamagirl26]

HouseCat said:

I don’t know a ton about this topic, but here’s what I’d do

A) Ring up my eye doctor and get a follow-up appointment on the books (because it can be hard to get one) — then be upfront about reta. Trust me, they’ve heard stranger things, and vision isn’t something to gamble with. If telling them about reta feels too awkward, you can simply mention a GLP-1.

B) Stay consistent with your eye care routine (drops, fluids, electrolytes) as much as possible, and watch whether the sensation improves.

Dry eyes are something I’m prone to, and my eye doctor never stops reminding me to drink more water! I’ve also noticed that what I eat affects my blepharitis (clogged meibomian glands, which normally release oils onto the eye to stop tears from evaporating), and that gives me the sensation of having something in my eye. For me, a cleaner diet means less eye irritation.

The Blepharitis! That's probably what set off the eye irritation I had a few days back — I woke up that morning feeling like there was a ton of sand in my eyes, so maybe the meibomian got gunked up. Everything's fine now

 

[RetCurious]

bamagirl26 said:

The Blepharitis! That's probably what set off the eye irritation I had a few days back — I woke up that morning feeling like there was a ton of sand in my eyes, so maybe the meibomian got gunked up. Everything's fine now

I'm putting the blame on the ragweed here.

 

[Bruce Campbell]

thelaststatistician said:


In the meantime, do you know any similar cases? Do you have any thoughts or educated/non-educated guesses on my theory? I'd love to hear your opinions.

Click to expand...

I went through LASIK a few years back, and during that first year afterward I felt something quite similar. After several follow-up visits (roughly 12 months in), it turned out my right eye needed a second procedure. Not a huge issue — it's a known possibility, and I wasn't charged since they handled it. Since then, the right eye has been gradually recovering from dry eye that shows up now and then, mild to moderate, and every so often I still notice that "something in my eye" feeling.

Even so, I'd go through it again 100x over — a bit of odd eye sensation now and then is nothing compared to having perfect vision.

Anyway, to me this sounds like the usual quirks people get after eye surgery! I'm on Reta too, and nothing unusual has happened with my eyes.