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Ask Dr. Rick Your Own Question

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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for approximtely 6 months I have experienced recurring eye infections

Customer Question

for approximtely 6 months I have experienced recurring eye infections. i treat each episode with sulfacetamide NA 10% , two drops per eye, twice dailyfor 7 to 10 days. The infection returns anywhere from 2 to 4 weeks later. i know it is not my eye make-up since i do no use the same products on a consistent basis. i do not wear contact lenses or glasses. I am 52 years old. Any information you could share is very appreciated. Thank you!_
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I can help you today.

Dr. Rick :

Are you available to chat?

Customer :

yes

Dr. Rick :

Do your eyes itch at all or feel dry?

Customer :

right eye has been getting dry occasionally before I retire in the evening. itching is not really a problem. mosty redness and discharge

Dr. Rick :

who has been treating your eye infections? A primary care MD or do you just have the drops on your own?

Customer :

I got the drops through my husband, who is a radiologist but ordered these for me one time a while ago when I had an infection and needed treatment immediately. it is extremely rare that he will do this since this is not his area of expertise

Dr. Rick :

That's OK....I've been known to order birth control pills for my adult daughter -- and that is a long way away from the retina :o)

Dr. Rick :

It sounds like you have a couple of things going on. First, mild dry eyes and also Blepharitis. Dry eyes is very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, then temporary punctal occlusion of the lower puncta, then temporary occlusion of all 4 puncta then surgical ( non-reversable) closure of the puncta.


 


Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk.


 


The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on you eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


 


Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix.

Dr. Rick :

Antibiotic drops can make the blepharitis better in the short term, but it does nothing to treat the underlying issues. The lid scrubs and warm soaks, as low tech as they might seem, really do work best.

Customer :

lol. i know how it is, but you docs have to be careful. You don't want any problems with the medical board. He prescribed what the pharmacist recommended

Dr. Rick :

If needed you could also go on a course of doxycycline 100 mg PO qd. This has a dual effect of helping with the bacteria issue and it, for some unknown reason, also helps the meibomium glands to start working better.....

Dr. Rick :

Ya, the board can really hold our feet to the fire for that...but I bet almost every physician in the US has been guilty of the same thing at least once.....

Dr. Rick :

but, as you know, the tetracycline like drugs can be very hard on the tummy.....

Dr. Rick :

I would hold off on the PO meds for now and give the lid scrubs at least 3 weeks to kick in

Dr. Rick :

Also, sulfa drugs are bacteriostatic not bacteriocidal.....never really clears things up..

Customer :

thank you for the information. I will try all the above. Pepto bismal can help with the stomach upset of some medications. i am willing to do what it takes. it's hard enough to try to be a "hot babe" at age 52 without red yucky eyes! LOL

Dr. Rick :

Ya, my wife tells me the same thing all the time....but after 31 years I still think she looks pretty good. Take care and have a great holiday season.

Customer :

the pharmacist did not have his first drug of choice in stock so that"s how I ended up with that one. But that is good to know for next time someone has an eye infection. I want to keep my eyes healthy. I think I am one of the few people at my age who is not in glasses yet!

Dr. Rick :

Ya, but I bet you are using "cheaters" for reading ;o)

Dr. Rick :

Let me know if I can do anything else to help. Have a good day.

Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
k
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
thank you for all of your help!!! Have an incredible holiday season with the "hot babe" you have been blessed to be married to for 31 years. It sounds like she got a good deal when she married you too!
Expert:  Dr. Rick replied 3 years ago.
No. I got the good deal....but I'll never say that around her!

Thanks for the bonus....it was not necessary, but is appreciated. Now maybe I can get my kids some shoes this winter ;)

Careful not to hit the accept button again....I've heard how difficult it can be to survive on a radiologist income nowadays....
Customer: replied 3 years ago.
you are a hoot! i love your sense of humor. It very much reminds me of my husband's sharp wit. i think in order to survive what it takes to become a doctor and survive in that profession, you HAVE to have a super-charged comedic outlook on life. Let's hope Obama care is defeated by our new Congress. After all, like you said, you have to buy your kids those shoes! c:
Expert:  Dr. Rick replied 3 years ago.
Obama care, and the decreasing pay for physicians is why there is currently only 2 applicants for every Medical School seat nowadays....there was almost 10 per when I applied.

Something needs to be done, but I don't know what. I was thinking of letting the Wife get a second job and just living off of her for a bit ;o)
Customer: replied 3 years ago.

I feel that we are living Atlas Shrugged now! A nation of poorly educated people who have no business voting and use that vote to continue their moocher lifestyle at the expense of people like you and my husband who have worked their butts off to acheive what they have. I am a big supporter of the Fair Tax. It would turn this country around economically like nothing else could. But this "entitlement" moocher class saw fit to elect an economic illiterate whom I wouldn"t even trust to run a lemonade stand. There are a lot of other things I could say about this "community organizer"sitting in the White House. "Poser" would be one of the more mild terms that comes to mind. Most of us learn growning up that you can't spend money you don't have, many of the rest become politicians and President. i have to be careful though, I don't want the liberals going after me like they did Joe the Plumber! haha Oh well, I guess I had better get off my soapbox and stop pontificating. Good luck getting your wife to get that second job so you can take it easy. haha Not a bad idea though for all the "producers" to call it quicks and see who the moochers live off of then! Personally,though,I have no room to talk. I consider myself a career parasite - i live off of husbands. i am currently on husband #2. Working out so far. hahaha Seriously, I have nothing but respect for anyone who has what it takes to become an MD. I have definitley been enlightened since I have been with my present husband. You guys& gals go through hell to reach that goal. you put up with even more once you go into practice too - hospital politics, government interference and red tape, difficult clients, Medicare/Medicaid reimbursements continually being lowered, etc. you really have to be one tough cookie to stay in this profession. i think doctors DESERVE every dollar they get and then some. the average person has no clue what level of responsibility you deal with and the crap you have to put up with. Just filling out paperwork to be credentialed at a hospital is like a full time job. so kudos to all of you!!!!!!! i could tell from the time difference on IM that you are somewhere on the West Coast or Just Answer is. i hope you are not living in about-to-be-bankrupt California. i lived there briefly about ten years ago and loved it. anyway... I am too long-winded. you are a peach! wish you could talk to my hubby, i am sure you would have things in common! the laundry room calls.....take care of yourself and your family. merry christmas!

Expert:  Dr. Rick replied 3 years ago.
Talking to the choir here....

I'm in northern Wisconsin. Go to geocaching dot com and post a note to geocacher copperpeak

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