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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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My eyes are dry and at night my eyelid stuck to my eyeball

Resolved Question:

My eyes are dry and at night my eyelid stuck to my eyeball . During a day they not so bad. Went to two eye doctors and they both said it nothing wrong with my eyes. But they said it can be bacteria, so I need to wash my eyes with warm water (???). If it is bacteria I should use medication of some sort to kill it, yes? So I have no help from doctors, you are my only hope. Thanks.
Alla K.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 5 years ago.
Hello and thanks for your question. I think what your doctor is referring to is an entity called blepharitis which very commonly leads to dry eye symptoms like you are having.

Blepharitis is inflammation of the eyelids and glands in the eyelids. The eyelids are key players in making a layer of tears that coats the surface of your eyes called a tear film. The inflammation that is blepharitis keeps the eyelids from making that tear film as healthy as it needs to be and so the eyes dry out. Also because there is inflammation in the tears because of the blepharitis, there are bacteria pooling in your tear film. Often times an antibiotic +/- steroid drop or ointment is used to help kill the bacteria, but if your eye doctor does not feel there is a large bacteria load or excessive inflammation, an antibiotic may not need to be given because the therapy itself may help to limit this smaller bacteria load. This therapy, if it is used, is l usually only used in a pulse fashion, to start out the treatment and then only used when there are flare-ups, not on a regular basis for most people. However, treating this with a antibiotic/steroid drop for a few days is not enough to treat this entire problem, it is usually just an adjunctive measure combined with the baseline treatment as I state below.
 
The baseline treatment for blepharitis and what I think you should start doing, is everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations (Sterilid or Ocusoft) or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water): you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.
 
It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working; often times combining this with the topical steroid helps to bring relief sooner. Also the eyes are still significantly dry during this 3-4 weeks so use artificial tears one drop in each eye, 4x/day. After 4 weeks you should be able to start tapering off of the tears to as you need them.
 
Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working. Also you may need an antibiotic/steroid combination medicine to help augment the therapy. If after 3 weeks of diligent treatment you are better, but not completely normal, you may need to see your eye doctor to assess for other causes of dry eyes, as blepharitis is only one cause of dry eye. Many times dry eye patients have more than one cause of dry eyes (Restasis is an excellent treatment for those people with dry eyes because they don't make enough of their own tears). Each cause of dry eyes needs to be appropriately treated for your symptoms to resolve.

If, after 2-3 weeks of doing this you see no improvement in your symptoms or there is worsening prior to that time then I would suggest seeing your eye doctor as there may be inflammation that needs a steroid or antibiotic treatment to resolve.

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?
 
I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.
 
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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.
Customer: replied 5 years ago.
Thanks, XXXXX XXXXX I do not understend why only at night when my eyes'r closed, my eyelid stuck to eyball and it's very painfull to open them. It seems like I tear the serface off the eyball. Now I'm scare to fell asleap 'cause of that! And teardrops feel uncomfortable to use during the night. What can I do to prevent stucking?
Expert:  Dr. Dan B. replied 5 years ago.
It is possible that you may have some inherent deficiency in the ability of the outermost layer of the cornea to anchor itself to the underlying substance of the cornea. This can lead to thus morningtime sensation that feels skin to having your eyeball ripped off when you first awake.

I would recommend getting an ointment at the drug store called Muro 128. Squirt a small bead in the lower eyelid pocket you can create by pulling your lower lid down. Do this right before you go to bed. If thus is a problem with your cornea then this will help to treat that problem.

Does that make sense?
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