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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2280
Experience:  Eye Physician and Surgeon
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I was told I had pink eye. I was put on Tobradex for a month.

Resolved Question:

I was told I had pink eye. I was put on Tobradex for a month. It did not clear up the problem. Dr. #2 put me on Azasite 3 weeks and Lotemax so far that has not cured it. Dr. #3 says I do not have an infection, I have ocular rosacea and map dot fingerprint dystrophy use Mura 128 creme. I tried that it burned terribly, stopping the Azasite made the redness much worse, I had to lay down and put ice on my eye. Dr. #2 says continue with the Azasite and use artificial tears. I had a chalazion in the other eye before this all started. I am incapacitated each week for at least a couple of days due to the burning. Dr. #3 is supposedly a specialist in dry eyes and rosacea but all he thought I needed was the Mura 128. What is the best treatment for this so I can manage this disease and clear up the burning and redness?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. James replied 2 years ago.

Dr. James :

Hello.

Customer:

Hi Doc. I realize rosacea is an autoimmune disease, I do have it dermatologically, but that has been controlled with Clindamycin if a flare up occurs. I don't understand how a Dr. cannot know an infection from an inflammation. I think there is both. I also don't know how long I should stay on a topical antibiotic that does not seem to be working. Shouldn't I see some improvement in a week or so? I haven't. Yet Dr. #2 tells me my cornea looks better than 2 weeks ago. I don't know what to do, I do not want to go blind or have corneal ulcers. If you can refer me to someone on Long Island or in NYC, or anywhere who can help me that would be great too.

Dr. James :

It appears you do have dry eyes and blepharitis.

Dr. James :

Usually, the chronicity of the symptoms will tell you if it is an acute infection such as pink versus dry eyes/blepharitis.

Dr. James :

Unfortunately, there is not easy fix.

Dr. James :

Treatment is a combination of lid hygiene with warm compresses and eyelid scrubs with baby shampoo.

Dr. James :

You need to use artificial tears regularly as well, preferably the preservative free ones.

Dr. James :

The goal is to keep you eyes comfortable off the steroid and antibiotic eye drops.

Dr. James :

Once your eyes are better, then you should be able to not need those medicine.

Dr. James :

You may also consider punctal plugs if you have dry eyes.

Dr. James :

Please remember to press the accept button so I can receive credit for assisting you today.

Customer:

I just don't want to have a lingering infection that does damage. Last week when I cut back the Azasite to once a day on the recommendation of the dry eye specialist (who even wrote a book on dry eyes), the redness got worse. That is why I think there is an underlying infection. If it was just inflammation, then there should be anti-inflammation drugs that can help me. I know the cortisone is not good it increases the the pressure in the eyes, but what can I do to reduce the inflammation, the lubricant drops do not seem to be enough.

Customer:

My eye gets so bad it looks like the eye in this article, well maybe a little less red, yet these Dr.'s do not seem to be as worried about it as I am.

Customer:

?www.ophmanagement.com/printarticle.aspx?article=86533

Dr. James :

What are you worried about specifically?
When did you start treatment?

Customer:

That the redness will cause hemorraghing and can lead to blindness, also Dr. #2 told me that with the dystrophy the cornea foundation can separate, so I know I don't want pressure, inflammation or infection in the eye. The whole thing with the redness and infection started April 22. I had had a chalazion removed in the other eye on March 28 and was put palliatively on Tobradex in that eye for a month till that healed.

Customer:

Is there anyone who can tell me what, in their opinion is the best treatment to stop the inflammation from the rosacea with potentially a low level infection underlying it? Any help will be appreciated.

Dr. James :

I believe you are already on good treatment.

Dr. James :

You may consider doxycycline for the rosacea.

Customer:

What is a normal length of time for resolution to the inflammatory aspect of this? I have stopped spices and started Omega 3 supplements and will make the dietary modifications I read may help.

Dr. James :

It sometimes takes months for the inflammation to resolve.

Customer:

Should I continue with the Mura 128, will it do damage since it burns if I use the drops?

Dr. James :

If it burns, you may consider stopping it for now to see if it helps lessen the inflammation.

Customer:

Okay, thank you for your help. I will ask the Dr. about the doxycline. The Azasite just does not do much of anything.

Dr. James :

You're welcome.

Please remember to press the accept button so I can receive credit for assisting you today.

Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2280
Experience: Eye Physician and Surgeon
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