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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7859
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My right eye will not open during the night when I wake up

Resolved Question:

My right eye will not open during the night when I wake up unless I widen my eyes or push it open with my finger. Then it is alright. This happen about 20 yrs ago and 5 years ago and went away. I much worse now and been going on for about 2 weeks.
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 :

Does it seem stuck together or just paralyzed?

Customer:

My eye will not open when I awaken during the night for about two weeks. When I widen the eye it opens and seems ok. This happened about 20 yrs. ago and a neurologist gave me magnmesius and it worked. Happened again 5 years ago Magnesium also worked Not working this time and has been going on worse than before for two weeks.

Customer:

It is not stuck together. Seems partilly paralyzed

Dr. Rick :

When you force open the eyelid, do you have double vision or notice your eye not pointing in the same direction as the other one?

Customer:

No. The eye appears and feels normal. Happens about two times a night Never in daytime. I looked in the mirror and it was about 2/3 closed until I used my facial muscles to oepn it. The eye looks normal.

Dr. Rick :

And you say that this has happened before and it has gotten better? How old are you? Male or female? Any medical problems or take any medicine?

Customer:

This happened before and completely went away as long as 20 years ago. I have dry macular degeneration in the eye and a large catarac but have 25/25 vision with correction. Eyes are very dry and I had been using Genteel ointment which irritated my eyes greatly. I am seeing a retinal specialist at Duke for six years with the macular and everything is great with that. Pressure is good and they test for leakage every 6 weeks and none has happened so far but they will not answer by questions about this condition. They think the eye is sticking but it is not. I am sure. After six year with wet macular in the other eye and still 25/30 vision in that eye I am very thankful but do not want to take any chances with this eye. What do you think? My husband was a surgeon and he would not have let me just let this problem go. Can you \help?

Dr. Rick :

Sorry to hear of your husbands passing. The nerve that runs the muscles that normally raise your upper eyelid also run a few of the muscles that move your eye. Usually if the problem with a temporary droopy eyelid is due a nerve problem the eye muscles are also affected...but not always.

Dr. Rick :

It is possible that you have a partial third nerve palsey, possibly MS (usually doesn't present at your age for the first time) and the differential list just kinda goes on.

Dr. Rick :

I would suggest starting with a complete eye exam, then possibly seeing your internal medicine MD and, if needed, visit with a nerologist.

Dr. Rick :

oops...misspelled that one :)

Dr. Rick :

Does this make sense to you?

Customer:

I am 73 but a very active and helthy and not on any medication other than pressurevision and calicum and vitamin D. and magnesium. but do feel it has kept the eye dry for this time. It does make sense but five years ago when I saw my opthamologist he brushed it off also. I am concerned though and I guess I will start with him. In your gut do you think this is a serious thing that my progress to my eye not opening during the day or drooping etc if the cause is third nerve palsy or ms. And is there any treatment for either. I do not fee that this is ms. Don't know anything about third nerve palsy. If it is that would you see a neurologist first or internist.

Customer:

sorry about the typos. I am a realtor and am on the phone at the same time.

Dr. Rick :

I don't think it is anything real serious or it would have got a lot worse by now

Dr. Rick :

third nerve palsies usually resolve on their own with time....MS does have treatments available, but I really don't think this is what you have...

Dr. Rick :

I'd see the eye doc, the internist and then a neurologist if needed, in that order. If your ophthalmologist blows you off, find another one.

Dr. Rick :

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


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Customer:

Thanks so much you have made me feel better and I will go ahead and see my ophthamologist who wants to remove the cataract now but I feel I should wait until I can not read as I have no assurance that I will not have a complication and now I need both eyes and am not sure what the research is saying about cataract surgery may cause bleeding with the macular degeneration. I am sure that is what happened when left eye became wet just a month after cataract surgery. One last question and then i will let you go. Is it your opinion now that cataract surgery may precipitate leakage when you have macular degeneration or not. What I have read keeps going back and forth.l

Dr. Rick :

As a retina specialist I do not believe that uncomplicated cataract surgery has any effect on either changing dry macular degeneration into wet or causing a normal macula to have macular degeneration.

Dr. Rick :

Does that make sense?

Customer:

Yes that makes sense and I hope you are right. What happened with me was immediately after the cataract surgery I had bright flashes and then a month later my vision became fuzzy and that is when he said the leakage started. It is basically the only retinal damage I have. I have had 30 injections of lucentius (Sp.)in that eye and the damage has not gotten any worse. I feel very blessed and that is why I want to do every thing I can to protect my vision. Thank you very much you have done a great job and saved me a lot of time that I do not have and have answered all my questions.

Dr. Rick :

My pleasure. Always a pleasure to help a family member of another FACS :)

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7859
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 3 years ago.
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Customer: replied 3 years ago.

Hi Dr. Rick,

 

I did give you the $5.00 bonus for a good job on the eye question and asked a second question because I thought I could ask a bonus question for free. Just making sure that I was not charge $38.00 for the Shingle question also. Thanks

 

Customer: replied 3 years ago.

 

Hi Dr. Rick,

 

I did give you the $5.00 bonus for a good job on the eye question and asked a second question because I thought I could ask a bonus question for free. Just making sure that I was not charge $38.00 for the Shingle question also. Thanks

 

Expert:  Dr. Rick replied 3 years ago.
I didn't know that the shingles question was you....but in any event, it came across as a second question..

I am just a worker bee and don't know how the billing thing works :)

I suggest you send a note to the customer service folks. That will be the best way to find out what happened with billing.

It was a pleasure to help you with both your questions. Take care and have a good day.

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