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Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience:  Board Certified Ophthalmologist
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My eyes have been running for four weeks. One optomistsrist

Resolved Question:

My eyes have been running for four weeks. One optomistsrist said it was infection and treated my eyes with steriod and antibiotics..that did not work. Yesterday I went to an opthamologist who said that this was a combo of dry eyes, a slightly clogs duct and something else. After he poked by ducts with something that he did not call a needle and would not let me call a needle..and flushed out my eyes. I am now putting drops every hour but he told me that this might be permanent. I am freaked out, reading is blurry and this is something I did not anticipate.
Customer
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Stevens replied 5 years ago.

Hello there

since your visit yesterday, what has changed? what is concerning you since yesterday? by the way, it sounds like he used an irrigating cannula to irrigate the ducts, did you get the fluid in the back of your nose, or throat when he flushed?

Customer: replied 5 years ago.
Nothing change. I am putting in systane every hour (actually I did it until 4 am), and have done it all day. He says it could take a week and yes it was a cannual and I felt more fluid on my right side than my left, but there was fluid in my left side. That by itself was horrifying by the way..after 12 weeks of chemo..I am still feeling it. What I am most concerned about is the chance that this could be permanent. I am a very public person and water running down face might not be the best for my work.
Expert:  Dr. Stevens replied 5 years ago.

I understand. The first thing we want to be sure when folks have tearing is that they dont have a blockage and it seems you dont. Now, why would using lubricants all day help?? I assume he told you that you have a dry eye syndrome of sorts and lubricants will help. Dry eye is very complex. Lets talk a bit about this now so you know what is happening. You may or may not know, the tears that help lubricate the eye are made of 3 different components. One is the actual watery component made in the lacrimal gland under your brow. It is where the water is made and if you get something in your eye or your eye is irritated, this gland goes in to overdrive and causes tears to be produced excessively. Second, is the mucous component and rarely do patients have a deficiency of this (short of chemical burns to eye, as in lye or acid burns). Third is the oily component of the tears and this comes from the glands at the base of the lashes, called meibomian glands. Those glands are often the culprit in someone with tearing..... folks with meibomian gland dysfunction (which is easily overlooked) have lots of tearing and here is why.

 

When your hands are dry, you dont put water on them although it makes sense to do so if you think about it in the most basic sense. However, you go get lotion which is oil and water mixed in a precise mixture. Same with your eyes, if you have meibomitis or posterior lid margin disease, oil glands become boggy and they dont drain and it contributes to a tear that is more mucousy, but less oily and the tear evaporates quickly (doc sees a thing called decreased tear breakup time) and the surface of the eye becomes irritated as there is no continuous lubrication. Instead the surface becomes irritated and it causes running of the eyes because the eye things there is something stuck in there, and tries to flush it out. Unfortunately, unless the glands become more functional, the situation never gets better. So the best treatment for this situation is the faithful and consistent application of heat packs which help the oils get moving. We are not talking a warm washcloth, that gets cold quickly, rather a heat pack that applies constant heat for at least 3-5 minutes at a time. If this does not provide good relief, your doc may consider an antibiotic like doxicycline, tetracycline or minocycline for 6-8 weeks or longer. These help the glands drain better. Also, use lubricants as you are doing, and even a nighttime ointment may be used, such as Refresh PM.

Take care and let me know if there is any more questions or concerns.

Sincerely XXXXX XXXXX

Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience: Board Certified Ophthalmologist
Dr. Stevens and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
How would you suggest the heat be applied. I have tried the wash closh and you are right that does not work...so what a heat pad? And what kind of night time lubricant. Thank you this was helpful
Expert:  Dr. Stevens replied 5 years ago.
You can purchase reuseable heat packs and just warm them up, or you can make your own using uncooked rice in a thick cotton tube sock, just tie off the end and you have a cheap and wonderful heat pack. Refresh PM is a very good night time lubricant, and is readily available at most pharmacies and drug stores, walmarts, etc. Regards
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience: Board Certified Ophthalmologist
Dr. Stevens and other Eye Specialists are ready to help you

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