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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8509
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi - I am experiencing a problem when waking where my left

Customer Question

Hi - I am experiencing a problem when waking where my left eyelid feels paralysed and takes a few seconds to get it to open and when it finally does open, I have double vision for a few seconds. A friend who saw me wake (who I hadn't mentioned it to) said my eyes were looking in different directions. I am worried and hope you can clarify the cause?
Thanks you
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 :

This could be due to a systemic issue like MS. Or it could also be from a tear film/anterior segment issue, although this would not cause your eyes to point in different directions as witnessed by your friend.

Dr. Rick :

I suggest that you have a complete eye exam by an ophthalmologist. Also, if your friend can take a photograph of your eyes not working together, or better yet, short movie of you trying to look in different directions while this is going on, that would be very helpful. In today's world where every cell phone can take high quality pictures and movies this shouldn't be too difficult to do.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Are you available to chat?

Customer:

MS?? That would seem like an extreme end of the possible diagnosies -

Customer:

I am otherwise healthy and on no medications, don't have any other symptoms. I have recently got reading glasses, and the technician who tested my eyes did not find any abnormalities. This was a month and a half ago and as the paralysis thing had only happened once or twice back then I didn't think to mention it to him

Customer:

Are you still there?

Dr. Rick :

yes

Dr. Rick :

This really needs more then a technician to work on it. An ophthalmologist is your best bet. Might it just be nothing? Perhaps, but I don't think you should continue to ignore it.

Dr. Rick :

Hi. Did I loose you?

Dr. Rick :

It looks like you have stepped away from your computer. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)


 

Expert:  Dr. Rick replied 2 years ago.
It was a pleasure to assist you with your question. Please let me know if I can do anything else to help you in the future. Positive Feedback and/or Bonus is welcomed and appreciated.

Let me know if there is anything else you would like to discuss pertaining to this issue.
Customer: replied 2 years ago.
Hi - could you elaborate on the tear film / anterior segment issue suggestions. I have a child with a severe illness who has undergone experimental gene therapy in Germany and we have to travel there every 10 weeks so my being sick would be exceptionally inconvenient and difficult. Any suggestions for milder, manageable issues would be appreciated as I am fearful of it being something serious. I realize you can't make it be something it is not but I can't call a Dr for 10 hours and need to be able to sleep




































Expert:  Dr. Rick replied 2 years ago.
I understand completely. Usually anterior segment/tear issues are caused by a combination of a few things such as dry eyes, allergies and blepharitis.


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.

You can give this home treatment a try and see if things improve but if you get a chance try to get a movie or picture or your eyes when they are acting up.

I wish the best for you and your child. As a father of 5 kids I understand what you must be going through....
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8509
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
I was just thinking about you and wondering if you have had a chance to see and ophthalmologist and, if so, what she found.
Customer: replied 2 years ago.
Hi Dr Rick,
I went and saw my GP (we are in Australia and you have to get a referral from a GP to see any kind of specialist). He was concerned about an auto-immune condition called Myasthenia Gravis (as I am a carrier for Wiskott-Aldrich and they are starting to think carriers might be more at risk too for auto-immune diseases and cancers)So I had bloods collected on Friday morning and will get the results in 48 more hours from now. This may be definitively yes or else will be a "keep looking" scenario, as MG is not always easy to confirm. He is also saying he will send me to see a Neurologist. It has not been as bad for the last week but strangely it is now more my right eye than my left being paralyzed. Hard to keep hoping it is nothing but I'm doing my best - maybe just some bizarre virus she says hopefully?
Thanks for asking,
Sue
Expert:  Dr. Rick replied 2 years ago.
Sue,

It is a pleasure to hear from you. Yes, I agree MG was another condition that entered my mind although with MG the weakness is usually worse at the end of the day and better in the AM.

In any event, it sounds like you are on the right track and answers will be forthcoming soon. I would like to add my vote for it all to be do to a bizarre virus as well ;-)

Take care, let me know how things turn out and do your best to stay out of trouble. :) I'd be happy to assist you again should the need arise in the future.

Enjoy winter, Mate. Summer is coming fast here in Wisconsin.

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Dr. Rick
Dr. Rick
Ophthalmologist & Retina Specialist
5455 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest