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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7761
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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eye..cataract..pain, he was going to do it back in august..my vision

Resolved Question:

I have asked eye doctors here before, so yet another question!!! now i have got to have a lems implant, as the one i have has gone cloudy, i had the cataract op in 2003, it didnt seem right to my from the very beginning, so here we are nearly 2011, still waiting for op (and its private) i told my surgeon I have a lot of eye pain, have been told to have acupuncture, as he want do it if i have this pain, he was going to do it back in august. But i`m so fed up, i dont know what to do, i know its got to be done as my vision is bad......have you answers to this very bad eye pain...its not posterior sclritous, i did have that and they said it had calmed down, but i still have bad eye pain, would you suggest acupuncture????? HELP
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 :

hi

Customer :

yes

Dr. Rick :

So, let me get this straight. They said your actual artificial lens inside your eye is cloudy? Not just the posterior capsule? (we'll deal with the pain next)

Customer :

yes, i did go to see him about 3-4 yrs ago now, with very bad eye inflammation, still got that, no drops seem to work, after mri scan, and other test over these years, they said my eye has now gone cloudy, which took them a very long time to see, he told me i would see it before he would?

Dr. Rick :

Ok. I understand. uveitis can cause precipitate to form on your intraocular lens and make it cloudy. Do you know if your lens is in front of your iris (the colored part of your eye; this would be an anterior chamber lens) or if it is in the capsular bag (posterior chamber intraocular lens)? Also, did they ever find out why you are having so much inflammation?

Customer :

They said the cataract op had failed, and said the inflammation was because i have very dry eyes.

Customer :

i cannot touch my eyes with out them going red

Dr. Rick :

That is very possible and not good. Are you interested in having the lens exchange done and, if so, does the doctor think this will address the pain you have been experiencing? Are you using a lot of natural tears for your dry eyes?

Customer :

no i am scared of having the op as its under a general anasetic, none of the natural tears work! he has told me to look on the internet for others, as he does not know what to use now. All this has taken my confidence away, i dont go out much because of my vision, as i`m also light sensative, and my eye is very blurred.

Dr. Rick :

Let's address the dry eyes for a bit. First of all, continue using the natural tears as often as you can during the day. Add a tear replacement ointment at night. A brand name in the USA is refresh PM, but a chemist can point you in the right direction. Then I think we should start some treatment for possible blepharitis

Dr. Rick :

. 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.

Customer :

I could not do that my eye would be very red and painful after.

Customer :

eys its in both

Dr. Rick :

Give these lid scrubs at least 3 weeks to "kick in" If you are still having problems, I would start you on a 30 day course of doxycyclene by mouth. This drug has been shown to improve the function of the meibomium glands in addition to it's antibiotic properties. You might also want to talk with your eye doctor about plugging your tear drainage channels.

Dr. Rick :

ok, well then skip the lid scrubs and try gentle warm compresses.

Customer :

ive had plugs they didnt work

Dr. Rick :

It is also possible that some of your pain is coming from the intraocular lens itself. This is rare but I have seen it on occasion. I wouldn't be too afraid of general anesthesia for a lens exchange. It is a very quick surgery and the risks of the anesthesia are very small.

Dr. Rick :

You doctor may want to pre treat you with steroids before surgery to keep your inflammation from coming back post op.

Dr. Rick :

did you try Rev-eyes drops?

Customer :

he is going to do that i`m on vexol 1% at night, no never heard of rev-eye drops

Dr. Rick :

Vexol is better...

Customer :

would you suggest acupunture

Dr. Rick :

Since you have done so many of the things suggested to decrease your pain, I believe that, if you can find a practitioner of acupuncture who is comfortable around the eye and orbit, and thinks he can help you, why not? I've read articles about folks who have had surgery with nothing but acupuncture as anesthesia.....

Customer :

why did it take him so long before he saw the lens was cloudy

Dr. Rick :

I also would try to get to an emotional place where you are comfortable having the cloudy lens replaced so you can see well again. Acupuncture may very well be something that can assist you in reaching this mindset.

Dr. Rick :

That is a very good question. The cloudy lens should be fairly obvious on slit lamp examination, especially if he dilated your eyes.....

Customer :

its was after 3yrs of seeing him, on one visit he said the lens is cloudy, i was shocked

Dr. Rick :

I could understand that if it was the posterior capsule that was cloudy; that can take years to happen. Unless, of course, you inflammation was just worse between visit and the lens became more cloudy since the last time he saw you. Weird.

Customer :

i would be in a good place with all this, if had not taken 4yrs to get here

Dr. Rick :

I can understand that!

Customer :

shame he cant (sorry)

Dr. Rick :

Ya. Have you had a chance to get a second complete eye examination by someone else, such as at Moorfields Eye Hospital?

Customer :

maybe i will do that, thanks for your help bye

Dr. Rick :

my pleasure

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7761
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you

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