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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
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My moms eyes constant tear; she constantly blinks which has

Resolved Question:

My mom's eyes constant tear; she constantly blinks which has impacted her doing normal everyday activities; her vision is severely impacted; please help!
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. James replied 2 years ago.

Dr. James :

Hello.

Dr. James :

When was her last eye exam?
What have the other doctors recommended?

Customer:

She went to the Eye Institute in Philadelphia, PA about two weeks ago. They haven't recommended anything. She will be going to Wills Eye Institute this week.

Dr. James :

Is she using any eye drops?

Customer:

One doctor recommended that she use more tears or use something called "linguin" which I could be spelling wrong. someone stated that it could be an eye spasm which results in the contant blinking

Dr. James :

Is it both eyes or one eye that constantly blinks?

Customer:

someone else stated that it could be yes

Customer:

she is constantly tearing...why would she have dry eyes as stated by a doctor>

Customer:

Another doctor stated that her eye ducts which catch the tear have expanded through the aging process

Customer:

they need to be made smaller to absorb the constant tears...

Dr. James :

it is common for people with dry eyes to sometimes have tearing. The problem is not so much that the eyes are dry, it is that the tears are of poor quality and do not adequately protect the eyes.

Dr. James :

In response to the irritation, the eyes cry and constantly tears.

Customer:

yes, she can not drive or watch television any longer

Dr. James :

This irritation can also cause spasm of the eyelids, i.e. blepharospasm.

Customer:

it is becoming depressing for her

Dr. James :

Treatment for the tearing can be improved with regular use of artificial tears. This sounds counter-intuitive, but helps to keep the eyes from getting irritated.

Customer:

she mentions that first thing in the AM when she awakes her eyes are fine..then the tearing begins

Dr. James :

Treatment of the dry eyes will help with the blinking.

Dr. James :

She should also washing her eyelids with baby shampoo and use warm compresses.

Dr. James :

If the eyelid spasms are very bothersome, then botox injection can help.

Customer:

Wow, sounds like a lot to do... will this decrease the blinking

Customer:

so this is not enlarged eye ducts that collect normal tears

Customer:

as in the case of yarning

Dr. James :

this problem has likely been going on for sometime. As such, it will take time for things to improve. The key is to find a good doctor and take the treatment in an incremental fashion.

Dr. James :

yarning?

Customer:

Yes it has and has gotten worst.

Customer:

Yes, my physician told me that the eyes, have eye ducts that accept/absorb our tears such as in the case of yarning

Customer:

but as we age these eye ducts enlarge which causes them to no longer accept our normal "yarning" tearing which is what Ithought could be the case here

Dr. James :

I'm sorry, I am not familiar with the term "yarning". Can you please explain?

Customer:

When we wake up in the morning, we yarn....when we are sleepy we "yarn"

Customer:

does that help...sorry for the misunderstanding

Dr. James :

yawn?

Customer:

Ooops...

Customer:

Yes

Customer:

sorry

Customer:

She has been working with one doctor for two years with no success.

Customer:

Her doctor is not recommending her to another eye institute

Dr. James :

Hmm... I don't think yawning is related to tearing.

What your doctor could be talking about are the tear ducts that drain away the tears. They are located in the inside corner of the eyelids and drain into the nose. In older people, these ducts can get blocked and cause tearing because of insufficient drainage.

Customer:

Yes, that is correct

Customer:

Yes...correct!

Dr. James :

What is your mom currently doing to help her eyes?

Customer:

Eye drops,

Dr. James :

how many times a day?

Customer:

called pleo, muc

Customer:

2

Customer:

times per day

Dr. James :

what is the brand of those eyedrops again?

Customer:

in the corner of the eyes twice per day

Customer:

sanum bran remedy

Customer:

brand remedy...

Customer:

this was prescribed by an herbalist

Customer:

she has tried everything and this is just another option

Customer:

we are becoming distressed with worry....

Dr. James :

what else does she do for her eyes?

Customer:

She takes a pill called bilberry ginkgo

Customer:

eyebright complex

Customer:

it has lutein

Customer:

this herbalist states that she should see changes in 30 days

Dr. James :

anything else?

Customer:

That's all for now

Dr. James :

it seems her symptoms are mostly related to dry eyes.

Dr. James :

She should be using artificial tears 4-6 times daily, brands such as systane or refresh.

Customer:

She has been using all types of dry eye tearing drops...such as hydrate

Dr. James :

The eye vitamins with lutein may help, but i disagree with the herbalist in that it will help in 30 days. I believe that is giving you false hope.

Customer:

She is no longer using the hydrate....

Customer:

I agree...we are desperate

Dr. James :

A second opinion at Wills Eye Institute will be helpful.

Customer:

yes she will be doing this on January 5, 2012

Dr. James :

topical steroids and possibly botox injections may help break the cycle.

Customer:

Hopefully this will help...she's a cornea specialist

Dr. James :

Yes, a cornea specialist is the appropriate specialist.

Customer:

she has tried the botox which helped a week or so

Dr. James :

if she needs botox, she may be referred to an oculplastics surgeon.

Dr. James :

how many times did she have the botox?

Customer:

she did the botox about three times

Customer:

it lasted for only 4 days

Customer:

it's very expensive and her medicare will not pay

Dr. James :

botox usually lasts about 3 months. she may need higher doses.

Customer:

she doesn't know the dosage...

Dr. James :

Yes, unfortunately botox is expensive. for essential blepharospasm, medicare may pay for it.

Customer:

maybe the specialist will recommend a higher dosage

Dr. James :

if it only lasted 4 days, then it may be too low a dose. you should let the doctor know so she can increase the dose incrementally.

Customer:

So if she is diagnosed for blepharospasm medicare may pay for the botox

Dr. James :

yes, the doctor should be the one to determine if she needs a higher dose or not depending on the response.

Customer:

Ok,

Dr. James :

it can be covered but prior authorization may be needed.

Customer:

I guess we will go with the specialist in January

Customer:

Ok, I will have the specialist look into this

Customer:

Is there anything else?

Dr. James :

the cornea specialist should also check for the blocked tear ducts.

Customer:

Ok, sounds terrific.

Dr. James :

this is done by injecting fluid into the tear ducts to see if it will go into the nose.

Dr. James :

Do you have any other questions?

Customer:

ok, this is a test that will be done in the office setting

Customer:

No that's it....

Dr. James :

yes.

Customer:

we will remain hopeful

Dr. James :

Definitely.

Customer:

Can I print this page or can it be emailed to me for future reference

Dr. James :

keep the emails you receive and click on the links provided.

Dr. James :

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

Dr. James :

Do you have any other questions for me?

Customer:

Yes I will, thanks so much!

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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