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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I HAVE HAD CONTINOUS EYE PROBLEMS SINCE I WAS ON DULOXETINE

Resolved Question:

I HAVE HAD CONTINOUS EYE PROBLEMS SINCE I WAS ON DULOXETINE FOR DEPRESSION APRIL 2009. IT IS A MEDICATION ALSO USED FOR URINARY INCONTINENCE AND AM TOLD IT WORKS ON THE MUSCLES. i CAME OFF THE MEDICATION AFTER THE PROBLEM OCCURED BUT IT HAS NOT RECTIFIED ITSELF.eXCESSIVE BLINKING ESPECIALLY WHEN DRIVING OR TALKING FACE TO FACE.aLSO SORENESS OF THE EYES AND DISCOMFORT. hAVE TRIED EVERYTHING. tOLD NOT DRY EYES, BUT GIVEN DROPS, TOLD BLEPHARITIS BUT TREATMENT WITH SHAMPOO MADE NO DIFFERENCE.pRESENT ON OCUSAN DROPS WHICH HELP MOMENTARILY.sEEN 4 OPYHALMIC BODS BUT GETTING NO JOY AND FEEL THEY ARE NOT LISTENING. aLL DIAGNOSE A DIFFERENT PROBLEM AND FEEL NONE OF THEM GETTING NEAR TO IT.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.
Chat Conversation Started
Dr. Rick :

Hi. I'll be happy to help you with you question.

Dr. Rick :

Has your vision been affected?

Dr. Rick :

Are you available to chat?

Customer :

I find I am squinting more and more. However an eye test showed no change in my vision yet I feel it has been affected

Customer :

yes, able to chat.

Dr. Rick :

Ok, so the major ongoing issue is excessive blinking, especially when driving or involved in face to face conversations. There is no decrease in vision that can be shown during a vision test but your vision seems to be affected to you? Am I getting this correct?

Customer :

yes

Dr. Rick :

Ok. There is a condition called tardive dyskinesia that can be a side effect of some medications. SSRI's (which duloxetine is in this class) are not part of this class of drugs. Therefore I don't think the medicine caused your issues. So then the question remains: Why?

Dr. Rick :

Dry eye and blepharitis are great thoughts, but you've tried Rx for this with no relief. Has any ocular abnormality been found at all during your exams?

Customer :

I am monitored for

Dr. Rick :

I didn't get that entire message. What are you monitored for?

Customer :

Iam monitored for glaucoma as have family history.However pressures are ok.I have slight cataracts in both eyes.These have been checked a few times..also have some floaters.but this checked too.

Dr. Rick :

Another condition that can cause soreness of eyes/ blinking is neuralgia after shingles. Have you have facial shingles or viral herpes of the periorbital area?

Dr. Rick :

Cataracts wouldn't do it; nor should being a glaucoma suspect. I see you are in the UK. It is possible for you to travel to Moorfields Eye Hospital or one of their branches?

Dr. Rick :

Moorfields is one of the best eye care institutions in the world and would leave no stone unturned in geting to the root of your problems. Sounds like you have been through the gamit of the other ophthalmologists and it is time to turn to the University. Does this make sense?

Customer :

No shingles or viral herpes.Moorfields is in London think the branches are all in the london area.There is a manchester eye hospital where I thought my referral was going but went to a more local hospital....which was no help whatever. WAITING FOR FOLLOW UP APPOINTMENT...nOVEMBER.

Dr. Rick :

Ya, the medical system in the UK is different then what we have here in the US, although it is changing here too. I believe you would be best served by seeing a fellowship-trained corneal specialist who has access to all your past medical charts. It would be best if you could get into a place like Moorfields where an entire team would be involved in your very intersting (and I know it no fun to be an "interesting" medical case :) ) case. I think you need some doc's who will think outside the box for you.

Dr. Rick :

Can you travel outside the UK for care?

Customer :

no wouldn't travel outside Uk. Also would need referral from GP to access service. I am on other medications but none co incide with the time of the Duloxetine to make a difference.

Dr. Rick :

I understand. Perhaps you can show this chat to your GP with my suggestion that she refer you to the specialists I suggested above. There has to be an reason for your continued symptoms, we just have to look at the whole picture from the correct angle. I'm sorry I don't have a magic answer for you today. Is there anything I can do to help you encourage your GP to refer you on to a corneal specialist or to the folks at Moorfields?

Dr. Rick :

Are you still in the chat room?I hope I was able to be of assistance in some way today. Please, allow me to get credit for my time and effort in assisting you and press the 'accept' button. I will be glad to answer additional questions until you are satisfied. Positive feedback and/or Bonus is welcomed and appreciated.

Customer :

will print out the 'chat' and seek another referral. Any ideas for the problem whilst driving? it is very tiresome.Literally makes me tired. Blinking can ease if I use other facial muscles but you can't staypulling faces all your life. Chewing helps at times but not a solution.watching tv is the same.....unless I eat (use other facial muscles.

Dr. Rick :

It sounds like using other facial muscles, while it may be tiring, may be the best way to make things livable until we can get to the root of the problem. I'd suggest using soothing natural tears (preservative free) but you've already tried that will little improvement. Guess the best thing to do is try to impress your "gatekeeper" GP to move up the referral date to a corneal specialist.

Customer :

ok thanks for your help. That is all for today.will think on what you have said.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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