Around 15 years ago I had redness and pain in my eye. It got bad enough, that although after-hours, I went to a Cigna Urgent Care center. I was examined by a non-specialist who didn't know what the problem was, but guessed it was probably a bacterial infection. So he sent me home with antibiotics, and told me to come back in "about a week" if things did not clear up. Well, a week later it was only worse, so he told me I needed to see a specialist "immediately".

I was in terrible pain. Redness, photosensitivity, etc. I get an appointment with a real opthamologist, and he said I have a viral infection in the cornea, and its serious. I had already permanently lost vision (from 20/20 to 20/50). Antivirals + steroids cleared it up, but it created a dynamic that is difficult to manage to this day.

Now with corneal ulcers, the surface of the cornea is uneven. This prevents the tear film from distributing evenly.

With poor tear film (tear break up time, TBUT) the eye becomes inflamed.

With inflammation, comes neo-vascularization, nerve destruction, and more epithelial defects. All these conspire against proper tearing, and the cycle repeats.

So - its very important to get whatever dynamic you have under control. 'Dry eyes' is actually pretty serious, but most opthamologists agree we don't have good weapons for it.

Some people have dry eyes, even though they produce too many tears. Its because their tears are defective. Like some people having high HDL, but their HDL is defective.

Almost all the OTC stuff is crap. All I can do is recommend

1) Find the best specialist in your area, and see them. I saw a cornea specialist at the Mayo Clinic for a while; they were "OK". But I was surprised they had an even more famous individual there - and she never once said "hmm, what we've been trying for the last 2 years hasn't been working, lets see what my (famous) colleague X thinks". So you have to manage your doctors with great attention. Also, my suspicion - is that cornea MDs like to operate (in my case - cornea replacement), not treat. Operating is probably more profitable.

2) For dry-eyes, you should consider a few things. I use Systane Gel Drops going to sleep. Friction between cornea and eye lids is a problem. The various PM oil formulations are too goopy; but this is the thickest liquid that seems to protect me through the night. I don't wake up with red eyes.

3) For the office, consider moisture being wicked away from your cornea by ventilation. I wear a hat and glasses. Try things that make a full seal, like something Ridick would wear, or a motorcycler. Try Wiley-X Climate control stuff. Since the seal needs to be perfect, try them on first.

4) I love my Oakley M-Frame Heater lenses. Huge, wrap around the face. I wear clear even at night if I'm not wearing goggles to protect that micro-climate around the eyes.

5) You can try the 'dry eye forums' at http://www.dryeyezone.com/talk/ .. YMMV.

I hope things get better.