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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7844
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My eye lids, particularly right eye lid..your eyes, blurred vision

Customer Question

My eye lids, particularly right eye lid, remains swollen all day. Basically, it is a similar feeling as when you first wake up and rub your eyes, blurred vision, etc. I have tried the hot compress for blepheritis with only subtle relief resulting. Co-workers are making comments that I look very tired (i am a 60 hr a week civil engineer and a full time doctoral student). But, i still have the swollen/ tired eyes even when i take a break and sleep in on weekends...

It is worse at times than at others. Twice in the past year, i have had episodes that woke me up from a sleep with a feeling of sand in my eyes. In both of those cases, the hot compress brought relief within a few hours of repeating the soak of 5 minutes, every hour.
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 :

Is it your upper or lower lids that seem swollen, or both? Is the entire lid involved or just kinda one area?

Dr. Rick :

Would you say that you are a heavy person, for example 5 foot tall and 300 lbs?

Dr. Rick :

Or have you recently lost a large amount of weight?

Customer:

I am available.

Dr. Rick :

Welcome to chat.

Customer:

neither is so swollen that it is visibly protruding. I belive it is the lower lid. I have a tendancy to want to rub the lower lid and "wipe out of the corner"

Customer:

I am 5'10", 168#, coudl stand to loose about 8-10#, still in decent shape

Customer:

Thanks for the "welcome"

Customer:

one important paramter i have failed to disclose is a life long history of allergies

Dr. Rick :

5ft10 and 168 is not obese in anyones book....I only asked as obesity can lead to certain eyelid problems

Customer:

understood

Dr. Rick :

Well 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 are 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, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.


 


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 your 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.


 


 

Customer:

in the past, seasonal allergy eye irritation was not like this. I had red eyelids

Customer:

let me digest these...

Dr. Rick :

I know you have already tried this treatment......it may be necessary for you to have a complete exam to make sure that there is not some type of anatomical problems with your lower lid from rubbing it so much

Dr. Rick :

It is possible, especially with the nocturnal dry eye feelings, that your have lid laxity from your allergies/rubbing and that your eyes are coming open on the pillow at night and causing exposure. This could contribute to many of the issues you are discussing....and the lid scrubs etc would only give marginal relief

Dr. Rick :

Could your significant other/bed partner (we are sooo PC here at justanswer :) check to see if your eyes are cracked open a little when you are sleeping?

Customer:

Thanks! sounds like it is more related to the blepharitis. I do have a thick, gunk type drainage in the morning (more than normal). I may have failed to use the eyelid wash/compress on an consistant enough basis to fully relieve symptoms

Dr. Rick :

that is entirely possible......

Dr. Rick :

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


I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

Positive Feedback and/or Bonus is welcomed and appreciated.


 

Customer:

LOL. Yes, i can have my wife check it while I am slppeing

Dr. Rick :

ok. That should help.

Customer:

will definitely leave positive feedback and go to a local doc after trying a few weeks of consistant treatment

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7844
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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