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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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contacts w/ no problems until L eye got red so stopped

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21 YOF. L eye a nuisance for 3 yrs. was able to wear contacts w/ no problems until L eye got red so stopped. double vision no more than a week. 3 months eye was extremely dry and infected.Cleared with antiobiotic ggts. no tear production. 6 months later,upper eye lid swelled, minimally, never went away and got worse. always sore and makes me feel tired and is no longer red. acutane (for 7 month two yrs ago) may be cause of dryness.sum it up,eye is currently swollen and sore, dry, no redness and very minimal exudate. one of my cervial nodes is swollen on the Lside of my face by my ear. If on the my L side, my eye tears and swells worse, if lying down on bed and hang over, all the pressure from gravity makes it hurt.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. James replied 7 years ago.

Are you still needing help?
Please reply with any changes.
Customer: replied 7 years ago.

Yes I do still need help. My eye is always swollen and sore! and i dont know why or how to make it better. I think there is something weird going on with it. Like i said, it kinda acts like an infection but not really (its only my left eye for crying out loud) and then there is the whole weird issue about the pressure behind it. When i lay on my left side, tears fall out even though my eyes are really dry and when i go upside down, gravity puts so much pressure on my eye that it hurts. It has been doing this for so long. Help!

Expert:  Dr. James replied 7 years ago.

Do you ear contact lenses?
Are the whites of your eyes red?
Any change in vision?
When was your last visit to the eye doctor?
Customer: replied 7 years ago.
I use to wear contact lenses. From 7th grade through high school with zero problems. Then almost a year after i graduated i had to stop cause it hurt my eye. Now if i want to wear contacts, i just put it in my right eye only. My eyes are white, no more redness. When my right eye first started having problems, it was really red. My vision hasnt changed a whole ton. Just gotten a little worse over the years, but thats how its always been since i started wearing contacts. I did start seeing double in my right eye when i first had problems but that hasnt happened for two years. I last went to an eye doctor in the spring because i wanted to wear contacts when i got married. He didnt see any sign of infection. I dont have glaucoma or any of those types of things. He gave me great contacts for dry eyes. But it still hurts too much to wear in my left eye. My upper eye lid is so swollen sometimes that i can feel it everytime i blink. Like it rubs harder against my eye
Expert:  Dr. James replied 7 years ago.
Your symptoms are suggestive of dry eyes. Patients can have all or some of the following symptoms:
  • foreign body sensation
  • mucous discharge
  • heaviness of the eyelids
  • sorness/dull ache
  • swollen eyelids
  • reflex tearing
  • light sensitivty.

It can sometimes mimic an infection, but since you have a pattern and history of symptoms, it is more suggestive a chronic dry eye problem. For the acute symptoms, I recommend chilled artificial tears and cool compresses to help with the swelling. You are very young to have typical dry eyes and makes me think there may be an underlying medical condition. I recommend your doctor check for autoimmune diseases such as lupus, Graves' disease, Sjogrens, rheumatoid. Accutane as you mention can cause problems with dry eyes, but less likely now with use almost 3 years ago.

You doctor can also check the level of your tear production with a Schrimer test. If low, then punctal plugs and restasis may be of help. Smile

Remember to press the green ACCEPT button. It was a pleasure helping you with your question. Best wishes to you. Feel free to ask any additional questions. Smile

Edited by Dr. James on 10/2/2009 at 5:59 PM EST
Customer: replied 7 years ago.

I actually have take that test and it showed I have practically no tear production. One of the doctors I have seen put me on restasis and I wasnt very good at keeping up with it so I stopped. So you think the dryness is causing the swelling? I have had a doctor suggest plugs. It just worries me because im afraid there is something else going on here and dont want to do something that might not work. I have had thyroid problem in the past. It was hyper for about six months and then cleared all on its own. But that was a little over a year before i had any problems.

One more question, what is reflex tearing? does that explain the pressure I feel behind my eye when gravity is against it?


Expert:  Dr. James replied 7 years ago.
Your current symptoms are due to the deficient tear prodction. Restasis is a medication used twice a day and designed to increase tear production. It is not an artificial tear and may takes a few months to see the effects. Punctal plugs are also recommended, but may have limited benefit if you have no tear production. It can help the artificial tears stay longer.

It is important for you to use artificial tears. If you are using them more than 4-6 times a day, you should switch to the non-preservative ones in the tear away ampules. Another option may be Lacrisert which slowly releases moisture into your eyes. I have not prescribed it myself to patients, but may be worth a try in your case.

Reflex tearing is when your eyes are irritated and tear in response. It is a sign of dry eyes, but is confusing to the patient because they actually tear in response to the dryness. The pressure feeling is related to the dryness. Often times, it can give you a heavy sensation of your eyelids.

Please remember to accept if my answers has been helpful. Smile
Dr. James and other Eye Specialists are ready to help you
Customer: replied 7 years ago.
sorry i was worried i wouldnt be able to keep asking questions! I could not live with out my eye drops. The only ones that give me relief are refresh but only the liquigel.. super expensive though. Depending on the climate, sometimes i do use up to eight drops a day. The doctor gave me some non preservative drops but for some reason they dont give me the same relief so I dont use them. Is that bad that i have been using these drops at least four times a day for the last two years? my left eye tears when i accidently poke it yes, but does that really count as irritation when im laying down on my left side and it starts to tear and swell worse? Why would it do that? both of my eyes are dry, my left is worse and is the only one that swells, when i lay on my right side it doesnt tear up and swell. what is that all about?
Expert:  Dr. James replied 7 years ago.
Thank you for the accept. Don't worry, you can continue to post questions.

If you use the regular artificial tears too frequently, the perservatives in them can sometimes buildup. So instead of providing relief, it may be a cause irritation in the long-term. The non-preservative tears should work in a similar fashion as the others, but different brands can be more comfortable. Try the one that works best for you. Since you are using them that frequently, punctal plugs will help minimize the frequency of the artificial tears by limiting the drainage into the nose.

Though you have dry eyes in both eyes, it can be worse in one eye than the other. By laying upside down, you are limiting the drainage of the fluid in your eyelids. I suspect that is why it gets worse. By laying on the side, you may be helping the drainage away from the swollen lids.
Customer: replied 7 years ago.

I understand how laying upside down limits the fluid from draining and creates pressure, but that isnt normal right? That never use to happen. So you are saying the swollen lids have something to do with the drainage and thats why when i lay to the side they can escape? I dont really get how i have fluid... Because i thought i wasnt producing tears to begin with? Should I be worried about something like this? which leads me to the fact that my cervical lymph node near my ear is swollen, is it collecting all of this drainage? I dont understand why all of this is happening and how it relates to dry eyes.


After this response from you i will accept and then i have to stop. Thanks for all your help. I wish I could afford to give you money. I no longer have insurance to see a doctor so I saw this online and thought id give it a try.

Expert:  Dr. James replied 7 years ago.
Every tissue in our body makes fluid and then it is drained through the lymphatics. Lymphnodes are apart of the drainage system (like pit-stops along the highway). With irritation, you can get more fluid buildup. So your underlying dry eye can cause swelling of your eyelids.

Often swollen lymph nodes are a sign of infection. I would not expected for you to have this with dry eyes alone. I would recommend you talk to you ophthalmologist or primary care doctor about this specifically.

I will be offline for the next few hours, but you are welcome to post more questions and I'll respond when I am back online.