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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7364
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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insulin)..indicated blood pressure and sugar were satisfactory..eye

Resolved Question:

I am 77 years old, and diabetic (under control without using insulin), and my recent check up indicated blood pressure and sugar were satisfactory. However, in the last few days my left eye feels as if something is pressing behind it, and waters frequently. The lids are puffy, but there is no discolouration on the eye ball. I am a little more sensitive to light than normal. I had the same symptoms a couple of years ago, and saw an ophthamologist at my local hospital. She could find nothing wrong, except mild blepheritis, which cleared up following her advice. Please can you suggest any other causes for this pressure-feeling, as it gives me a headache
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

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

Dr. Rick :

Good morning.

Dr. Rick :

A very common cause of your symptoms is anterior segment problems such as dry eyes, allergies and blepharitis. Since you responded to treatment for blepharitis in the past I would bet that it has returned.

Customer:

Hello - I'm here

Dr. Rick :

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 :

Other causes for a feeling of pressure behind your eyes is sinus problems. These can, of course, be made worse by allergy issues, colds and infections. A visit to your internal medicine doc should be able to diagnose this condition should it be present.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

I see that you are typing and that could mean a couple of things: 1. you are actually typing or, 2, the chat system has frozen up. I'll give it a few more minutes and if I've not seen anything from you I'll switch over to the Q&A system. That system works a lot like 'text messaging' but, unlike the chat system, it almost never freezes up. We can continue to work on your question there. :o)


 

Customer:

Most of it, but your references to "puncta" in the first paragraph are Greek to me. Also, if my eyes are watering more, how can this be "dry eye"? But I will certainly try blepheritis treatment.

Dr. Rick :

the puncta are the little elevations on the edge of your eyelids, near your nose, where the drainage channels for your tears are located.

Dr. Rick :

When your eyes are "dry" and irritated they make more tears....this is the "something is in my eye" mode of tear production, not the "my eye feels fine and I'm making tears to keep things moist" mode. The use of natural tears will help your eye turn off the flood of "something in my eye" tears that comes from your eyes being dry. Does this make sense?


 

Customer:

Sorry if my typing is slowing you down

Dr. Rick :

No problem :)

Customer:

yes, and thank you for your help

Dr. Rick :

the chat system has been locking up lately and when it crashes it shows that the other person is "typing" even though the link is broken :(

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7364
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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