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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7924
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi For the past 10 years I have been regularly using Naphon

Customer Question

Hi

For the past 10 years I have been regularly using Naphon (naphazoline hydrochloride) originally because it got the red out, but now because it made my eyes feel good, see clearer and of course, I am addicted because if I don't use it, my eyes turn red.

Yesterday I woke up and my eye was a bit tender when touched, especially in the far corner closest to the ear and close to the bone. I had to go to the ER for a follow-up blood tests for something else and the ER doctor examined my eye and looked into it with a machine and also tested pressure. Today the eye is much less tender, however its very twitchy, I am blinking alot- its almost like I am having eye lid spasms, but its probably not related to the eye lids.

Today I went out and bought Natural Tears, a lubricant and its temporarily releives when I put it in. When I say releive, I am not having any pain, its just a nuisance because my eye feels twitchy, odd, itchy..

I spoke very briefly to an opthamologist yesterday and he suspected dryness..

What does this sound like to you from what I have described?
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.

Customer:

Hi

Customer:

what is our take on my story

Dr. Rick :

I do agree -- I bet you are, at the very least, having an issue with dry eyes. I am also glad to hear that you have bought natural tears and, hopefully, will stop using the naphconA

Customer:

could that have made the eye tender yesterday>

Dr. Rick :

Those "get the red out" drops tend to be addicting in that you get a rebound hyperemia when the drops wear off and then you use more drops and round and round you go...

Dr. Rick :

Yes. They can.

Customer:

yesterday it was only tender today its slightly tender (marked improvement) but

Customer:

it feels just....strange

Customer:

not painful, but i keep wanting to cup my eye lid

Customer:

or take two fingers

Customer:

and pull my eyelid

Dr. Rick :

I'm glad that is is better...and I think since this is the case, everything will be OK.

Dr. Rick :

And you may feel strange after using the naphcon A for so long......

Dr. Rick :

This is not unusual.

Customer:

I have to go to orlando tuesday on business and I am a bit nervous- if I needed to, could an optometrist be helpful in diagnosing or treating this if it gets worse

Customer:

an optometrist would be much more accesible

Dr. Rick :

One thing that you might try is some home therapy to treat any underlying issues that you may have with dryness, allergies (it is that time of year you know :) and blepharitis. Now, I'm not saying that you have all these things, just that your eyes might feel better if you follow these instructions:

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.


 


Here is a good article on Blepharitis:


http://en.wikipedia.org/wiki/Blepharitis


 

Dr. Rick :

In a pinch an optometrist should be able to help you during your trip.

Customer:

ok.. lastly, what I am describing is not a symptom of anything terribly serious? I am not having vision loss. They even tested that in the hospital yesterday.

Dr. Rick :

But in an emergency, in Orlando, ophthalmologists are thick as ticks on a hound dog :-)

Customer:

lol... you see I am in Canada

Dr. Rick :

Nope. I don't think your symptoms are suggestive of anything serious or that would make me suggest that you postpone your trip.

Customer:

and I am used to the state of Canadian healthcare

Customer:

see when I sit here

Dr. Rick :

Canada, eh? I'm in Northern Wisconsin, just across Lake Superior from 'ya....

Customer:

right now

Customer:

my eye makes me want to touch it

Customer:

and pull the eye lid

Customer:

almost like an itch

Customer:

I am in Montreal

Dr. Rick :

Here in America you can just walk in the office and get care, especially in an emergency.

Dr. Rick :

Try the lid scrubs and natural tears...bring a small bottle with you on your trip.

Customer:

listen my dad is a doctor in NY he is shocked when I tell him what i go through

Dr. Rick :

Ya...and the foolish Americans think they want Obama care. Idiots.

Customer:

if i wanted an appointment with a gastroenteroilogst, its a 30 day wait

Dr. Rick :

I could make a phone call and get you into see any specialist you needed tomorrow....

Customer:

the wait for a colonoscopy in Quebec is 2 years

Dr. Rick :

When a physician calls me personally about a patient I see them that day. No questions asked.

Customer:

I needed one so I flew to NY and had one the next day

Dr. Rick :

You could have one here this week....if you were really wanting one. Yuk.

Customer:

Although I could see a dentist tommorow

Customer:

why? cash business. not under the system

Dr. Rick :

Great. Canadian corpses have the best teeth in the world ;)

Customer:

however... I will tell you something- when you have something serious

Customer:

you have 1st class treatment typically my McGill doctors

Dr. Rick :

No. I would see the patient and be able to bill insurance/medicare if I squeezed them in that day when the patients doctor calls me. No under the table or cash payment needed.

Customer:

my dermatoolgist told me he gets $38 per patient

Customer:

in the sytsem

Customer:

therefore, the game is to see volumes

Dr. Rick :

It would not be worth going to school until age 34, like I did, to be paid $38/patient

Customer:

well... his average patient is what... 7 minutes

Customer:

doc, can you look at this mole? doc, can you tell me what this rash is?

Customer:

he can see 10 patients an hour or $380 an hour

Dr. Rick :

Ya, but when I did cataract surgery back in the early 90's it took me 15 minutes and I got paid $2,000

Customer:

$380 an hour is not so bad

Customer:

lol my dad is a urolgost

Customer:

in the 90s he did a TURP and got $1500

Customer:

today $400

Dr. Rick :

It is in my field......but, of course, I don't make that here in justanswer. This I do for fun.....

Customer:

i am trying t coinvince my dad to do it

Customer:

he is retiring in december

Dr. Rick :

Same here. Cataracts pay $620 with 90 days free post op care.

Customer:

after 40 years

Customer:

answer this for me...

Customer:

I spend $29 a month for just answer

Customer:

and I ask 20 questions a month

Customer:

how can they be making money on me?

Dr. Rick :

I've been a retina surgeon for almost 20 years and I wouldn't recommend being a MD to my kids anymore...as your dad can attest to.

Customer:

yup... he hates it

Dr. Rick :

Ya...I'm not sure how justanswer makes money on that deal. It makes no sense to me.

Dr. Rick :

But, hey, I'm just one small Indian in a great big world full of Chief's lol!

Customer:

this is a candians dream

Customer:

becaus if i showed up to the ER right now

Customer:

its at least a 5 hrs wait

Customer:

there is NO such thing as the on call doctor in Montreal

Customer:

you cannot call your gastro doc and speak with the on call doc in the practice

Customer:

there is no such thing

Dr. Rick :

I can't imagine such a thing.......

Customer:

everything after hours is triaged through the ER

Dr. Rick :

Not very efficient way to give quality care. I know in the USA, when I applied to medical school decades ago, there were 7 applicants for every open spot.

Dr. Rick :

Now? There are two. Pretty soon the classes won't even fill. Then, I guess, Lawyers can start doing open heart surgery.....

Customer:

lol

Customer:

I am now overdosing on natural tears

Customer:

i use it... i feel good for 5 minutes

Customer:

then i need it again

Customer:

or I will want to pull my eye lid

Dr. Rick :

You can also use some refresh PM or lacrilube. It lasts longer but can blur your vision.

Customer:

this is what I keep doing

Dr. Rick :

Wife says it's time to eat dinner. Is there anything else I can do for you this evening? It has been a pleasure chatting with you. Give my best to your dad.

Customer:

pic coming..

Dr. Rick :

k

Customer:

Full Size Image

Customer:

this is what makes it feel better

Dr. Rick :

got it

Customer:

thats what I mean by cupping it

Customer:

squeezing the lids

Customer:

is that typical of what I described

Dr. Rick :

Don't do that. Your just irritating it more. Try gooping it up with lacrilube and rest for the evening......

Customer:

ok...it just satisfies the twiching reflect

Customer:

it makes it feel better temporarily

Dr. Rick :

It is possible that the twitching effect is from myokymia secondary to the chronic use of the naphcon A.....

Dr. Rick :

It should resolve on its own with time.

Dr. Rick :

Gotta go or my wife, of 32 years and 5 kids, is gonna chain me up in the basement again lol!

Customer:

thanks... Dr Rick Great talking to you! If I need surgery, I am coming to you.

Dr. Rick :

I'll keep my knives sharp for 'ya....take care.

Customer:

bye

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7924
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
Let me know if there is anything else you would like to discuss pertaining to this issue.

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