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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8067
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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First time, it was my left upper eyelid swollen..my right eye pain

Resolved Question:

I have seen doctor twice. First time, it was my left upper eyelid swollen. Second time, it was my right eye pain. Doctor gave me this eye drop : Sodium chloride 0.9% , chloramphenicol 0.5% and Chlortetracycline 1% eye ointment 3.5G. Now this is the third time, I feel pain in my right eye corner. I apply this eyedrop as it has not expired. What is the problem with my eyes ? Sth serious ? do I need to go to see eye specialist ?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Are you available to chat?

Dr. Rick :

Sounds like you are being treated by an optometrist :o)

Dr. Rick :

Sodium chloride drops would only be indicated if you can corneal edema from endothelial dysfunction, such as Fuch's corneal dystrophy or after intraocular surgery/trauma. The others are for bacterial infections.

Customer :

my doctor told me it was infection

Dr. Rick :

So. Lets start by stopping the chloroamphenicol and the tetracycline ointment. If you don't have any of the above endothelial dysfunction/corneal edema problems -- which I bet you don't -- let's ditch the salt drops.

Customer :

but after I apply the eyedrop it is better

Dr. Rick :

ok. We can keep the natural tear drops.

Dr. Rick :

:)

Customer :

I always have tears out when I keep yawning in the morning.......is this normal

Customer :

it will last for about 20 mins during I take underground train to work

Customer :

I need to use tissue or handkerchief

Dr. Rick :

I think you may have a mixed bag of issues causing your ongoing symptoms. You may not have all three, but let's try this for at least 3 to 4 weeks:

Dr. Rick :

Wow...you are on the other side of the world from Wisconsin....this therapy should still work in Singapro though ;)

Dr. Rick :

Tearing in the morning with yawning is normal and not a problem. Now, back to what I was saying....

Dr. Rick :

It sounds like you have a couple of things going on. First is allergies, second dry eyes and third blepharitis.


 


When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. 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-reversible) 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. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.


 


Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.

Dr. Rick :

Use baby shampoo. I don't know if you can get Johnson's & Johnson's No More Tears baby shampoo in Singapore, but anything like it should work.

Customer :

that means it may be my shampoo cause it

Dr. Rick :

no. Use this baby shampoo on your fingers to clean your eyelashes every day. This should solve your blepharitis (infection) issue. But it may take up to 4 weeks of daily cleaning to work.

Customer :

so should I stop to use all these eyedrops and eye oitment ?

Dr. Rick :

Yes. Just continue with the sodium chloride drops. Use them 4-6x/day and as needed.

Dr. Rick :

stop the other drops and ointment.

Customer :

and use baby shampoo to wash my eyelashes..........?

Customer :

do it daily ?

Dr. Rick :

yes. Every day.

Customer :

the Johnson & Johnson baby shampoo ? Yellow or red colour one ?

Dr. Rick :

They both seem to work, but patients tell me they like the yellow one better. I, myself, use the yellow one to keep my blepharitis in check....

Customer :

how long do I need to continue using baby shampoo to clean eyelashes ? permanently ?

Customer :

or as and when there is infection ?

Dr. Rick :

start doing it every day for at least a month. If things are better you can do it 2x/week or so to maintain the effect.

Customer :

ok

Customer :

but now it is my right eye corner got pain

Customer :

how ?

Customer :

a bit only

Customer :

after the eyedrop and oitment

Dr. Rick :

this should help with the right eye corner pain. The ointment is not really the correct treatment

Customer :

ok I will start using Johnson & johnson baby shampoo to clean my eyelashes daily........thanks.

Dr. Rick :

Your welcome. Have a great day...all the way on the other side of the world!

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8067
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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