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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11232
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Is FML a recomened treatment for someone with swollen eyelid

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Is FML a recomened treatment for someone with swollen eyelid margins. And if a person was perscribed FML as a treatment, should they not been seen again within a week of that treatment?

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

FML is a steroid and it could be used in some eyelid problems. It can have long term side effects and, in a small segment of the population, cause a form of glaucoma.

Customer:

Hi

Dr. Rick :

It would not be my first choice for the majority of eyelid conditions.

Customer:

Can I explain what happened? BUt I have to worn you I'm noot a fast typer

Dr. Rick :

Sure. Don't worry about typos then I'll figure it out.

Customer:

ok, so I went to an eye doctor after visiting my family doctor for swollen eye lids

Customer:

but when I say swollen eye lids I mean my eyelids were swollen only around the eyelashes does that make a difference?

Dr. Rick :

was the eye doctor an optometrist or an ophthalmologist (MD)?

Customer:

when explaining to a professional

Customer:

optometrist

Customer:

I told him that my family doc perscribed me a coicsteroid ointment and it wasn't working

Dr. Rick :

It is sounding like a bad case of blepharitis.

Customer:

He did his yearly eye exam and I don't recall him doing any other special test to see if I had an infecion, is there a test to let a doctor know if there is infecion or possibly an algery?

Dr. Rick :

No. There is really no test for an allergy, infection such as blepharits etc other then a good exam at the slit lamp.

Customer:

He at the end gave me a sample bottle of FML and told me to use it for 5 days, well it took care of the symptoms as he was presomably treating me for an algery, so a week later the symptoms came back and I used them again keep in mind that I did not know what I was putting in my eyes at the time, I was just under the impression that I was treating an algery, my symptoms went away again and then came back so I used them again. Anyway I ended up ripping open the cornia and got a fungal infection and have suffered great losses. Shoud he not have had me come back in a week to reexamin?

Customer:

He also told me that I have cateracts in which I do not and did not.

Dr. Rick :

An optometrist should not play with steroids.

Dr. Rick :

And you shouldn't have used it so much without going back....so I guess, if you are looking from a legal point of view (of which I am NOT an expert) the there was error on both sides.

Customer:

Well he said he could because he works under an ophomologist who does laser eye surgery and he perscribes them regularly

Dr. Rick :

I would not have, personally, used steroids to treat your issue......just because they are powerful and have serious risks as you, unfortunately have learned.

Customer:

well he perscries to post op patients and I was not a post op patient

Dr. Rick :

As a retina specialist I see many things that have been treated by people without the training to do so....any, as is true in your case, it can be very difficult to fix the mess they leave behind.

Dr. Rick :

Do you know what type of fungus you have in your cornea and if it has gone into your eye?

Customer:

I guess I shouldnt have used them so much but I didn't know what they were until after the fact

Dr. Rick :

True....but now you have to deal with the fungus. Are you seeing a corneal specialist or does your ophthalmologist feel comfortable treating you?

Customer:

well it destroyed my vision the name of it was Paeiomyces Lilacinus

Customer:

I ended up with a conial transplant and the fungus seems to be gone

Dr. Rick :

good that the fungus is gone...sorry that you needed a corneal transplant.

Dr. Rick :

I'm not familiar with that particular fungus....but I am only a lowly retina surgeon

Dr. Rick :

Hopefully when you can start having some of the astigmatism in the graft minimized you will end up with good vision.

Customer:

Do you think its possible that the fungus was there before he treated me given what I know about steroid eyedrops now and that they mask symptoms and come back worse?

Customer:

yes I get headachs everyday and I extreemly sensitive to light

Customer:

my pupil doesnt work the way its suppost to anymore

Dr. Rick :

That can happen with a cornea transplant or even a serious infection like you had.

Customer:

really my iris is sqished together

Customer:

there for i now have glacoma in my eye

Dr. Rick :

hmm...maybe if you get a cataract it can be worked on when the cataract is removed.

Customer:

sorry about the spellling

Customer:

already been done

Dr. Rick :

I was wondering if you have glaucoma..........

Dr. Rick :

don't worry about the spelling.... :)

Customer:

can they shave this graft

Dr. Rick :

Not sure what you mean by shave the graft.......

Customer:

I am so fustreated because I think that if he would have had me come back in a week the the other doctors I would not be in this predicument

Customer:

I mean thin it out so that I can see better

Dr. Rick :

It is always hard to predict what may or may not have happened. I guess you could try to sue the optometrist but that really won't change where you are now....

Customer:

I use to wear contacts and now I`m stuck wearing glasses and I hate it

Customer:

Are you an

Customer:

Are you an American Doctor or Canadian?

Dr. Rick :

I can understand how difficult this is for you.

Customer:

My transplant was done at the University of Michigan

Dr. Rick :

Trained in NY and Tx; currently in Wisconsin as only retina specialist for over an hours drive in any direction.

Customer:

I am Canadian

Customer:

wow

Dr. Rick :

canadian, eh?

Customer:

yep

Dr. Rick :

Anyway, it sound like you are on the correct road now.

Customer:

Canadian optomitrists up until now this year were not allowed to perscribe seriod eyedrops an my thing happened in 2007

Dr. Rick :

In the USA they have the right given state by state.......varies all over.

Customer:

yes,but I feel like my life has been taken away from me. and I have really no one to talk to about this.

Dr. Rick :

You don't type with an accent lol!

Dr. Rick :

The good news is that you still have your other eye, you are young(ish) and otherwise healthy.

Customer:

My now opthimologist thinks the fungus was there when he treated me but won't speak to anyone on my behalf

Customer:

youngish

Dr. Rick :

Any maybe you can find a good Canadian guy who has three, maybe even 4! good teeth to love :)

Dr. Rick :

Sorry to hear that.

Dr. Rick :

No way to prove when the fungus showed up at this point anyway.....

Dr. Rick :

My wife always tells me how lucky she felt to find me here in Northern Wisconsin among the vast National Forests.....and I even have all my teeth!

Dr. Rick :

lol!

Customer:

yes, I suppose, I know I don't type with an accent! and nor do you

Dr. Rick :

thanks, eh. ;)

Customer:

Well I still have all my teeth and my husband doen't even have a cavity

Customer:

your welcome! eh

Dr. Rick :

Me neither. Never had a cavity in my life....of course my entire family is full of dentists and I as tortured with fluoride from an early age.

Customer: what's with that anyway? we always talk like that but it seems funny when someone make fun of it
Customer:

Discusting, makes my mouth water

Dr. Rick :

I don't know....I lived in the UP of Michigan, just across Lake Superior from Canada, and after a few years people gave me grief 'cuz I said "eh" a lot.....I don't do it much anymore...

Customer:

It's probably better that way. Now that its been brought to my attention I will try to refrain from saying that word

Dr. Rick :

good luck with that :)

Customer:

One more question, if a person has dry eye should they have been more closly monitored when using those FML eyedrops?

Customer:

you can be sure that I will try

Dr. Rick :

I would not use FML for dry eyes. I would use tear replacement drops and/or restasis.

Dr. Rick :

And yes, I'd check someone on steroid drops after about 2 weeks.

Dr. Rick :

depending on why they were on the steroids......

Customer:

so if they had been treated for alergies?

Customer:

Cause I never had that happen to my eyes before and It has not happened since

Dr. Rick :

I would use oral anti allergy meds if needed and baby shampoo lid scrubs with warm compresses for allergies. Also there are excellent, non steroid, drops that can be used for topical ocular allergies.

Dr. Rick :

hard to tell what you had going back on then but, obviously, "nuclear weapons" such as steroids were not the best choice even though they made you quickly better.

Customer:

I just wanted to go back to one thing that I asked earlier, when I explain to someone that my eyelids were swollen should I be saying that it was only swelling aroung my eyelashes? Does it make a difference?

Dr. Rick :

Not really. It sounds like you had blepharitis. This commonly causes swelling around the lashes.

Customer:

Would you perscribe FML for that?

Dr. Rick :

Never have. Can't think of why I would.

Customer:

would it take the swelling and inflamation away?

Customer:

and after using it could the symptomes come back?

Dr. Rick :

Yes. Very quickly and effectively. Just like the Atom Bomb brought a quick end to WWII....but it was later found to have unwanted side effects....

Customer:

really, thats very intresting!!!!!

Dr. Rick :

yes, symptoms would be expected to return as the underlying problem had not been solved....only the symptoms were treated.

Customer:

the problem is that knowone will probably ever know!

Customer:

especially because its never happened again

Dr. Rick :

that's correct. All that can be done at this point is to move forward.

Customer:

I guess so, anyway thank you for taking the time to chat with me I really appreciate it and I hope you have a good night.

Dr. Rick :

My pleasure. I hope that you end up with good vision when this is all said and done. Good night.

Dr. Rick :

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