What's wrong with my eyes?
January 4, 2013 10:04 AM   Subscribe

When I take a hot shower, or am around any kind of steam, my left eye steams up like a mirror. It's like this for about 20-30 minutes. I have Keratocunus. More details inside...

Yes, I know you are not my doctor. I've seen them and they are stumped. I can only guess that there is someone else with this condition.

I have Keratoconus in both eyes and have had a Super K on my left eye 2 years ago (they removed part of my cornea so it could regenerate without scars). I wear NovaKone soft contacts for Keratoconus and they are scleral contacts. This started happening in August and I have yet to find anything that solves it other than making my showers almost chilly.

I've seen 2 different ophthalmologists who, once I explain that I'm NOT wearing glasses when this happens, have had no explanation nor a resolution. It's not bothering me but I'm still concerned because now it's happening to my right eye as well. It's not as frequent as the left.

Has anyone else had this happen? If so what is it? Should I be worried?
posted by bodgy to Health & Fitness (7 answers total)
Some types of contact can fog up if they're not immaculately clean. Try removing the contacts before you shower, and putting them back on afterwards - if that works, you may need to modify your cleaning regimin, or you may have a defective set of contacts.
posted by Slap*Happy at 10:43 AM on January 4, 2013

How long of an exposure to steam is needed? Could you bring it about with a vaporizer or other portable "steam" source? If so I would setup the appointment then apply steam at the office and let the doctor see exactly what is going on.

If it were the contacts I would have suspected that blinking would fix most fogging but I would definitely do the experiments of contacts in / out to see if you can localize the problem...
posted by NoDef at 10:47 AM on January 4, 2013

I also have Kera in both eyes, I have no info or experience with what you are describing but did want to put in a shout for PRK-CCL surgery, I am in the middle of the process now and am extremely happy with the results so far, memail me if you want more details.
posted by Cosine at 10:48 AM on January 4, 2013

A possible reason blinking does not resolve this is that the condensation is forming on the inside surface of your contacts in an airgap between your lens and cornea-- an airgap which communicates with the outside air.

I don't know whether scleral lenses are designed with an airgap to allow the corneas to breathe or whether such a gap could have gotten too big because of increasingly poor fit-- or opened to the outside air because of poor fit-- or what.
posted by jamjam at 1:01 PM on January 4, 2013

I am not wearing contacts when this happens. It's my eyes. Nothing in them.
posted by bodgy at 3:01 PM on January 4, 2013

I don't have keratoconus but I have aphakic bullous keratopathy, bullae on my cornea in my right eye. I wear a bandage contact lens for pain relief.

I get the steamed up thing too, but it doesn't really bother me sight-wise, because I have really low vision in that eye anyway. But it is a funny sensation. None of my doctors or optometrists know what it is either.

I thought myself that something in the corneal cells might retain water, because I used to get corneal edema that had similar symptoms (but not just in the shower) when my cornea was more compromised than it is now, and they treated it with strong saline drops, to remove fluid from the cornea through osmosis (if that's the word I mean).

No idea if our symptoms are caused by the same thing, but I thought I'd chip in to say you're not alone.
posted by mgrrl at 3:35 PM on January 4, 2013

Thanks for that very illuminating comment mgrrl; I think it is the same thing.

bodgy, upon further reflection, I think what's happening to you and mgrrl is corneal turgesence, or edema, brought on by insuffiency of the corneal endotheliar layer:
Endothelial cell loss, if sufficiently severe, can cause endothelial cell density to fall below the threshold level needed to maintain corneal deturgescence.
Corneal edema can also occur as the result of compromised endothelial function due to intraocular inflammation or other causes. Excess hydration of the corneal stroma disrupts the normally uniform periodic spacing of Type I collagen fibrils, creating light scatter. In addition, excessive corneal hydration can result in edema of the corneal epithelial layer, which creates irregularity at the optically critical tear film-air interface. Both stromal light scatter and surface epithelial irregularity contribute to degraded optical performance of the cornea and can compromise visual acuity. [my emphasis]
Leading causes of endothelial failure include inadvertent endothelial trauma from intraocular surgery (such as cataract surgery) and Fuchs' dystrophy. Surgical causes of endothelial failure include both acute intraoperative trauma as well as chronic postoperative trauma, such as from a malpositioned intraocular lens or retained nuclear fragment in the anterior chamber. Other risk factors include narrow-angle glaucoma, aging, and iritis.
In short, I'd say your corneas are absorbing water from the condensation deposited on your eyeball from steamy air, and producing light scatter of the sort described above.

It (the cloudiness) resolves when the endothelial cells have time to pump the absorbed water away again.

Since your condition seems to be progressing, I think you should go back to your doctor, or better yet find a doctor who specializes in issues stemming from problems in the endothelial layer of the cornea.
posted by jamjam at 4:49 PM on January 4, 2013

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