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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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carer and did not want the hassle of having to wait and be unable

Resolved Question:

Two years ago I had both cataracts done privately - mainly because I am a carer and did not want the hassle of having to wait and be unable to care for my husband.
I am also using Timolol, morning and evening for tension. This is working and keeps the pressures to about 15 now.
Also I am told I have blepharitis since the operations- though to me it is only noticeable in the left eye. This is under control by use of shampoo (No more tears) and occasionally the use of Lacrilube.
About 5 days ago I became aware of a couple of "floaters" in my right eye which come and go along with a veil which seems to pass over the eye at various times making it very slightly blurred. This does not last for long.
I was warned that I many get some later effects following the cataract operations - is this possibly one?

Any suggestions please.
Pauline Worley
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.

Customer:

Having looked at my question, what would you advise me to do? I can see fine with just the occasional awareness when the "veil" passes over my eye.

Dr. Rick :

Hi. Sorry. Had to start getting ready to go to the office.....I'm back.

Dr. Rick :

It sounds like you have a couple of things going on. The floaters are, most likely, from a posterior vitreous detachment.

Dr. Rick :

You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), or a shadow/veil in the periphery of your vision, this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.


 

Dr. Rick :

the veil that comes and goes may be related to your blepharitis and, possibly, some component of dry eyes. I'd continue to do the baby shampoo lid scrubs and natural tears. Here is some information on how I like to do the lid scrubs.....don't pay attention to all the diseases discussed, it is just part of the handout :o)

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. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.


 


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.


 

Dr. Rick :

When you eyes are dry and the tear film is "messed up" it is like getting oil on your windshield in the rain -- a blurry view comes and goes, which sounds like what is happening to you. The above therapy will help with this....

Dr. Rick :

I do not believe that these issues are due to your prior cataract surgery alone. I feel confident that you will get better with the above treatment.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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


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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
Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
Let me know if there are there any other concerns or issues you would like to discuss on this topic.

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