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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10582
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had a full eye exam at the Optometrists less than a month

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I had a full eye exam at the Optometrists less than a month ago. However, for a few weeks I've been having episodes of incredible stinging pain, eye redness and watering in either eye, randomly.

The pain seems to come in an arc. I notice it starting, it gets worse to the point where my eye is clamped shut and opening it is near impossible, and then tapers off. Lasts 10-20 minutes, the redness gets better for about an hour or two afterward.

It seems unlikely that these would be acute closed angle glaucoma attacks, since a narrow angle surely would have been discovered at my eye exam not long ago.

What could be going on?

Dr. Rick :

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

Dr. Rick :

Narrow angle glaucoma is a good thought, but a glaucoma attack doesn't usually cause a stinging pain; it causes horrible, deep pain, nausea, cloudy vision ect.

Dr. Rick :

Also, an optometrist is not trained well enough to rule out narrow angles which would put you at risk for an angle closure glaucoma attack. For this you would need a test called gonioscopy and only ophthalmologists are trained in how to do this exam, not optometrists.

Dr. Rick :

Rather then bouts of angle closure glaucoma attacks it sounds like you are suffering from an anterior segment/tear film issue. Many times, as we get older, and especially after eye surgery, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.


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 :

Does this make sense to you?

Dr. Rick :

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Customer: replied 4 years ago.
So, no emergency, just set up an appointment through my GP if possible with an Opthamologist.
That is correct. I would stress with your GP that since she really has no idea of what is going on with the eye that a referral is the right thing to do....
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
I did try that once. We'll see how it goes if I ask again..

You must not be in the USA.....

Thank you for the accept. Let me know if there is anything else I can do to help; maybe if you tell you GP that you chatted with an ophthalmologist she will be more willing to refer you.

You can print this out by right click, highlight all, hit copy, then paste into your word processing program....

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