How dry eyes helped me embrace MS uncertainty
As a physician and patient, I've learned that medicine is rarely black and white
As a physician, I hang my hat on certainty, where a certain medical issue can be solved with a certain medication. But when it comes to real life, especially as a parent and a person living with multiple sclerosis (MS), I know there’s little certainty in everyday living. My recent battle with dry eyes reminded me that there is also little certainty in the practice of medicine.
The first ophthalmologist who examined me prescribed steroid and antibiotic ointments. I diligently went along with the plan for three months, but was, at best, 10% percent better in the end.
For my follow-up, I saw a different ophthalmologist who took one look at me and said, “I wouldn’t treat this with steroids and antibiotics at all!” She explained that I didn’t have much oil in my tears and needed to use ointments, tape my eyes shut, and wear a moisture chamber sleep mask at night (which, oddly enough, has become one of my favorite things).
So off I went in a completely different direction. A month later, I’m still not much better, but I do appreciate this gentler, more practical approach.
Learning to live in the gray
Maybe my dry eyes will never fully resolve. But the experience reminded me how much variation there is in how we, as physicians, practice medicine. The lens of each practitioner shapes their recommendations. I’ve noticed it in myself: When I read a new study, it inevitably colors the conversations I have with patients for the next few days and the treatments I recommend.
It’s not different in MS care, either. While there’s the standard of care, I have seen the same patient treated three different ways by three different neurologists. The contrast grows sharper when I talk to MS patients abroad, where limited access to MRIs, spinal taps, and disease-modifying therapies forces clinicians to rely on entirely different tools and perspectives.
Uncertainty isn’t necessarily a bad thing.
When MS entered my life, I had to leave the black-and-white world of anesthesiology where outcomes were predictable and immediate: You push a drug, you see an effect within seconds.
Now, as an integrative and functional medicine doctor, I live in the gray. I take a look at the human sitting in front of me, gauge what may work and what they might be open to, and give it my best shot. If it doesn’t work, I go back to the drawing board.
For me as a physician, acknowledging uncertainty keeps me humble and adaptable. It’s even more relevant in holistic and lifestyle medicine, where people can have very different reactions to the same foods, herbs, or complementary therapies, such as acupuncture.
In my personal life as a parent and patient, uncertainty has helped me stay flexible and open-minded. If something doesn’t work, I pivot. It’s not failure; it’s feedback. This is in stark contrast to who I used to be as an anesthesiologist who thrived on control and predictability.
I have MS to thank for this shift in perspective. Embracing uncertainty is freeing and allows room for error. This new approach to living has taken me on a series of experiments, unexpected detours, and surprising destinations I never would have reached without a healthy dose of uncertainty.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
About the Author
Steve Hards
For many years my 79 year-old wife has managed her MS dry eyes simply with preservative-free eye drops containing sodium hyaluronate 0.18 % lubricant (brand name, Vismed), which she can get on prescription here in the UK. She uses them as and when she needs to.
On the wider point of the article, which is the variation in treatment owing to different physicians' experience and expectations, she suffered for many years with worsening lower limb weakness and pain which ALL the doctors and physical therapists she saw assumed were due to her MS.
It took a visit (in desperation) to an osteopath for the actual cause to be recognised... compression of the nerves from an extruded lumbar spine vertebral disk owing to the collapse of the bones, probably due to her osteoporosis. An MRI confirmed this and also showed an associated cyst of fragmented bony material. The solution was spinal lumbar decompression micro-surgery by an excellent neurosurgeon who cleaned it all out, taking pressure of the nerves. It took a month for the inflammation to reduce and the pain to disappear, allowing her to stop taking the tramadol which was all the doctors had offered for the pain. Three months after the operation her left foot drop, previously ascribed to the MS, also disappeared.
Eight months on her walking is still difficult but we are now recognising that there are different elements to her remaining walking problems: her affected balance may be MS-related; the leg muscles are weak due to de-conditioning because for many years her pain was only relieved when sitting and, of course, over the years she has lost confidence in her ability to walk without an aid.
To my mind it seems that her MS diagnosis blinded her physicians and we were fortunate to chance upon an osteopath who looked at her with fresh eyes!
Donna Kidd
Dear Susan,
I have had MS for over 30 years.
Recently I suffered with dry eyes. My carer suggested I try organic cold pressed Castor Oil. I gently rubbed this on my eyelids at night before sleep. After about 3 days they started to improve. I now do this a couple of times a week. The result is terrific, and so simple. No doctors visits!
Good luck. Regards, Donna Kidd - Australia
Judith Hillock
I have had MS for 30 years and extreme dry eye for the past 10 years. Nothing worked until I discovered MIEBO.
My eyes were dry because my tears evaporated.
Azmeh Dawood
Thank you for this insightful article. It echoes my own feelings that MS is actually a blessing rather than a curse. It allows one perspectives and avenues that would’ve remained unexplored. More power to you, both as physician and parent.