Question: I am a 60yo male from Brisbane Australia with diabetes and Psoriatic Arthritis.

At the moment I am very worried because I have Bell's Pausy on my left side. The Bells is getting better but I goofed and used the ordinary liquid tears to protect my eyes and it wasn't good enough. I also thought my eyes were closing at night and they really weren't. Because of this my eye got very red so I went to see my GP. He prescribed FML drops which got rid of the redness but after two weeks my vision didn't improve so I went back. He was worried and sent me to my regular ophthalmologist urgently who examined me and found a small corneal ulcer.

I now know I should have gone to my ophthalmologist from the start as I now had Exposure Keratitis which could have been prevented if I used lubricating ointment from the start. He switched me to lubricating ointment instead and told me to stop using the FML. He wrote to my GP and said he was very confident of being able to fix my Exposure Keratitis. The ulcer resolved in a week but he said there is now some thinning where the ulcer was. I asked was it left over from the ulcer - he wouldn't give me a straight answer - literally going hmm, hmm. He kept on mumbling but what if we lubricate it. I was told to continue using the ointment and to ensure it doesn't get dry or it may perforate. He wanted to see me in 4 weeks time. Perforate - this worried the hell out of me. That was nearly 4 weeks ago and I am seeing him on Thursday but I really am worried. I saw my GP for the write-up he got and all the ophthalmologist says is my ulcer resolved but there was some thinning. My GP says ophthalmologists are generally cautious and if he thought it was likely would have seen you much sooner.

The symptom I have in my left eye is blurriness and changing in vision when I blink which I believe is typical dry eye stuff. When I saw the Ophthalmologist last my vision certainly had improved - I could read much further down the eye chart and he said everything looked good in the eye except for the comment about the thinning.

Still I am so worried I went to see a neuro-psychiatrist who is going to do some Cognitive Behaviour Therapy to try and combat it - I am seeing him Wednesday. He explained a lot about Bells and thought it was from reactivation of mononucleosis I had when young but since its idiopathic you cant say for sure. I personally thought it was from my diabetes.

I know I only have to wait to Thursday to see my Ophthalmologist but I have been reading about all these things like corneal melts with immune diseases (I have psoriatic arthritis) and diabetic neuropathy which can make your cornea insensitive. I don't think I have that because when I close my eyelid and touch it I certainly feel it but of course don't know if that's a proper test.

I also asked my physiotherapist to check if my eyes were closing when I lied down. He shone a torch in and thought it was. I have also started wearing a contoured sleep mask at night to protect my eye while asleep after I have put in the lubricating ointment. I also tend to really put a lot in because I want to ensure it definitely doesn't become dry.

As you an see this has got me really worried and I would like an ophthalmologist to respond. I asked about it a few weeks ago an an internist responded the thinning was likely left over from the ulcer. But what I have read since then has really got me in a bad state.

I realise this is tied up with the my psychiatric worry issues the neuro-psychiatrist is working on but I think it would really help to get an expert opinion.

Thanks so much for your reply. Just to double check you think the risk of perforation has now passed and everything will keep healing? Was the ophthalmologists concern simply for the period when he observed the thinning and wants to see me next Thursday? Since nothing happened everything is OK now?