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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
20222826
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Hi Doctor, I went to see an optometrist in 2009. He used drops

Resolved Question:

Hi Doctor, I went to see an optometrist in 2009. He used drops to dilate my pupils and have them examined (I suspect he also used cortisone to calm down my eyes ). Because I have dry eye problems, he gave me a sample eye drop and covered it with a label that said "use it twice daily." I used it without suspicion only to find that there is increased redness in my eyes. After I removed the label, I found that it already expired in 2006. Shortly after I used the eye drop, there are new dark spots/pigmented spots in the white part of my eyes.

Unfortunately, I lost that piece of evidence and do not know its name (the only thing I remember is that it was made by Novartis). My question is can the expired eye drop contribute to the increased redness and new pigmented spots? Thank you.
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. James replied 2 years ago.

Dr. James :

Hello.

Customer:

Hi Dr. James, thank you for taking your time to answer my question

Dr. James :

How long did you use the eye drops?

Dr. James :

When did you notice the new pigment?

Customer:

Which one did you refer to?

Customer:

I mean the eye drops

Customer:

the expired eye drops

Customer:

?

Customer:

I went to see that doctor in February 2009.

Customer:

At first, I just noticed that there is increased redness, but I did not pay attention to the pigmented spots.

Customer:

I cannot remember exactly when I noticed that I have increased pigmented spots, but that should be in 2009. Is there a link between the use of expired eye drop and this?

Dr. James :

Very unlikely.

Customer:

Also, during that session when he dilated my pupils, he probably also used steroid or cortisone to calm down my eyes (I have dry eye problems).

Dr. James :

The caution with using expired medicines is that it can lose its effectiveness.

Customer:

it is also unlikely that cortisone or steroid may cause the pigmented spots?

Dr. James :

No, during the dilation session he used a numbing eye drop.

Dr. James :

Steroid eye drops are not used during examinations. They are usually prescribed.

Customer:

He probably also used something else such as steroid/ cortisone because my eyes are always slightly red but after that visit, for the rest of the day, they appeared to be so white. Since I used cortisone before, I suspect that is the effect of steroid or cortisone.

Customer:

However, starting from the next day, my eyes appeared to be even more red than they were before the doctor visit

Customer:

Suppose that he did use cortisone/steroid, is it possible that they cause pigmented spots?

Dr. James :

One of the dilating eye drops also constricts the blood vessels, which makes the appear whiter.

Dr. James :

No, steroid drops are not known to cause pigmented spots.

Dr. James :

Have you been back to the eye doctor since that visit?

Customer:

I see, but the dilating eye drop that constricts blood vessles also is not known to cause pigmented spots?

Dr. James :

Correct.

Customer:

I have been back, but he had such a bad attitude. It makes me feel sad

Dr. James :

bad attitude about what?

Customer:

He was impatient as if he did nothing wrong by giving me expired eye drop.

Dr. James :

the expired eye drops are a different story. true that he should not have given you expired eye drops, but it likely didn't cause any problems.

Dr. James :

He probably gave you a sample of an eye allergy medicine.

Dr. James :

That doesn't cause pigment.

Customer:

Also, doctor, does it matter that the length of time the drop expired-it expired in 2006, but I used it in 2009. So it expired 3 years by that time. Sorry, I may ask you circular questions, but I have been paranoid .

Dr. James :

The pigment was likely present for a long time, but has since grown, making it more noticeable. It is best to see an ophthalmologist for a second opinion.

Dr. James :

The length of time likely did not matter.

Dr. James :

Going to another doctor is likely the best thing right now since 2009 was a while back.

Customer:

I see. Then, what would be the cause of pigmented spots? the sun damage?

Customer:

I actually went back to another doctor, and he basically said the same thing that the expired eye drop did not cause pigmented spot. He also said that they are probably due to sun damage.

Customer:

But I have been very careful with protecting my eyes under the sun.

Customer:

So I really cannot figure out what is the real cause.

Dr. James :

People can have pigmented spots anywhere in the body. They can grow with time. Sun can stimulate growth and dry eyes as well.

Customer:

OK. Also, doctor, I want to explore the efficacy of using plugs to treat my dry eye problems (I have been using eye drops without much effect), are there any side effects of plugs? They are quite invasive, right?

Dr. James :

Pigmented spots can frequently grow during adolescence and early adult hood as well due to effects of normal hormones.

Customer:

Plugs are foreign bodies into the eyes.

Customer:

Thanks regarding your answer to my pigmented spots question

Customer:

Oh, I am an Asian, I heard that Asians are prone to have the pigmented spots, is it true?

Dr. James :

Plugs are not every invasive. There is risk of infection and irritation. Sometimes the plug can migrate down deeper than intended and cause problems. Generally they are very safe.

Dr. James :

Yes, asian can have pigmented spots since they are naturally pigmented. Similar to hispanics, african americans.

Customer:

I want to try temporary plugs (dissolvable) first and if they work, I want to try permanent plugs. Which brand of plugs do you recommend?

Customer:

I want them easy to be removed.

Dr. James :

I don't have a particular preference to a brand.

Dr. James :

Likely, your doctor will use the brand he has available which should be fine.

Customer:

Have you tried plugs on your patients? Generally, have they found relief to their dry eye problems?

Dr. James :

Even the permanent silicone plugs are easy to remove.

Customer:

Also, with plugs, can I continue to exercise? Like playing basketball?

Dr. James :

I would recommend avoiding the "smart plugs" however, as I have seen problems with them.

Customer:

Regarding the smart plugs, that is exactly I had in my mind because there were bad reviews about them.

Customer:

Have you tried "Oasis" plug on your patients? Are there any complaints on the plug?

Dr. James :

I use EagleVision silicone plugs. The Oasis is very similar to those. I have not had problems with them.

Customer:

Do your patients generally find relief to their dry eye problems?

Customer:

with the plugs?

Customer:

Also, sorry if it is a silly question. Do you have patients who have red, irritated eyes due to dry eye problems, but with the use of plugs, the redness has been subdued?

Dr. James :

For people with dry eyes, they are helpful and can relieve the redness.

Dr. James :

You are young to have such dry eyes however, so I would be suspicious if it is truly dry eyes. Ocular allergies are a possibility as well, in which case plugs are not as effective.

Customer:

Have YOUR patients found relief with the plugs?

Dr. James :

Yes, my dry eye patients have found relief and I put them in regularly.

Customer:

With plugs, can I still exercise such as playing basketball?

Dr. James :

yes

Dr. James :

you do not need to alter your lifestyle.

Customer:

I see. I know I am too young to have dry eye problems. That is why I have been so depressed. I used to be a very happy person.

Customer:

If it is due to occular allergy,

Customer:

I tried pataday, but it did not seem to help me other than making my eyes seem whiter. The dryness was still there.

Customer:

For occular allergy, other than using eye drops, what can I do to relieve the dryness?

Dr. James :

You may have both dry eyes and allergies.

Dr. James :

in which case you need to treat both.

Dr. James :

the dry eyes with artificial tears or plugs.

Customer:

Can dry eye problems themselves cause pigmented spots?

Dr. James :

yes.

Customer:

Really?

Customer:

But if the dry eye problems are under control, then ?

Dr. James :

because the irritation from the dry eye can make the pigmented spots grow.

Dr. James :

if you can control the dry eye, you lessen that risk.

Customer:

So suppose if the plugs can really help dry eye problems, the risk is certainly lessend?

Customer:

Thank you for your time, doctor.

Dr. James :

yes.

Customer:

I did not realize there is a link between dry eye and pigmented spots. Thank you. I will try plugs. Thank you again.

Dr. James :

You're welcome.

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

Customer:

Where is the accept button?

Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
Dr. James and other Eye Specialists are ready to help you

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