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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7923
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Please, please help. My mother is 66 years old and has had

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Please, please help. My mother is 66 years old and has had several left eye surgeries: botched cataract removal (we later determined she had Fuch's dystrophy), full corneal transplant, two laser treatments to relieve eye pressure, then an Ahmed implant to resolve her secondary glaucoma. She consistently remains on pressure drops, Muro 128 to soothe the irritation as well as gentel ointment. The question is she has been complaining for about a year now about what she describes as 'parasites' in her eyes. She is certain that there is a needle-like irritant that 'attacks' her eyes especially at night. We have seen the red, swollen eye area and know that she feels 'something'. I am at a total los for a real solution or even a band-aid solution as no one is taking her pain/irritation seriously since they cannot 'see' anuthing that would cause this pain. It never goes fully away but there are times when its tolerable. Now, she feels that 'parasite' has fianally penetrated and now she's decribing this feeling as PAIN. What could this be??
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 :

Given her ocular history there are a number of things that could be causing her pain/localized redness and feelings that a parasite is after her.

Dr. Rick :

Has she been examined by her corneal specialist during one of these episodes and has her ophthalmologist been able to actually see on of these red areas?

Dr. Rick :

Are you available to chat?

Dr. Rick :

We have been experiencing problems with the chat system for the last few days. Our engineers are working on it. However, 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.
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Expert:  Dr. Rick replied 2 years ago.
I could not see anything you were typing on the chat system.....we might be having problems. Just to make sure you are able to read what I type earlier please allow me to copy it here for your review:

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

Dr. Rick : Given her ocular history there are a number of things that could be causing her pain/localized redness and feelings that a parasite is after her.

Dr. Rick : Has she been examined by her corneal specialist during one of these episodes and has her ophthalmologist been able to actually see on of these red areas?

Dr. Rick : Are you available to chat?

Dr. Rick : We have been experiencing problems with the chat system for the last few days. Our engineers are working on it. However, 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..... :)
Customer: replied 2 years ago.
Her corneal specialist has seen the obvious swelling and irritation once. This is when we were advised to slather both eye areas with Muro ointment and use Genteal drops as needed. This course did alleviate some of the redness within a couple of days as well as stop the constant complaints. But, again the issue has never resolved.
Expert:  Dr. Rick replied 2 years ago.
well, first of all I very much doubt that the issue is with a parasite that is burrowing into her eye as your mother thinks......

My first thought was a loose stitch or, if her intraocular lens was sewn in place, an exposed proline suture tail.

I have to admit that the most likely problem is, as you have already mentioned, dryness of her eye from all the surgery.

I do not get the impression that your mother is going to accept this diagnosis right now, would you say that is a correct statement?
Customer: replied 2 years ago.
No,she definitely will NOT accept that. I know its not a parasite, but she insists. What is true is that whatever she feels, feels the way you would imagine a foreign body burrowing into your eye area and now your eye, would feel. But this is for certain more than 'dry eyes'. Needle-like pain, and the definite redness beg for an alternate suggestion.

When sutures on the implant were an issue, she always described this as 'pain' and e would go to the doc to cut it.

This ongoing problem is definitely something more as it involves both eyes and only the left has had the snumerous surgeries.
Expert:  Dr. Rick replied 2 years ago.
Ok. Thought so :)

Since her corneal specialist has already look at it I think it might be time for her to take a very difficult, and bold, step to see if she can get some relief. It seems obvious to me that her current doctor has reached the bottom of his bag of tricks and, yet, she is still having these problems. Perhaps she will feel better with a evaluation by a set of "super sub-specialists" and be more willing to accept their treatment plan and assurance that is is not a parasite that is causing her issues.


At this point I think the best thing you can do for her would be to gather up copies of all her medical records and travel to a large University Teaching hospital. At an institution like that she could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near your mother.

If you could tell me what large city she lives near and how far it would be possible for her to travel in seeking treatment I would be happy to give you some names. Of course, you could also ask friends and associates or check the internet yourself. Let me know what you would like to do.

When it is all said and done she may end up with the same diagnosis and treatment plan but I think, even if that were the case, she would feel much better about everything. Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you at no additional charge :-)

Let me know if there is anything else you would like to discuss pertaining to this issue.
Customer: replied 2 years ago.
I live in the Chicago suburbs, so I'm certain there is someplace near here to go.

The eye most irritated is actually the one 'good eye'. Any other ideas as to why this would happen and what it could be?
Expert:  Dr. Rick replied 2 years ago.
Cook County hospital is the major teaching facility for the medical school. Here is their webpage:

http://www.cchil.org/dom/cook.html

As to what is the cause of her issue, from what you have posted, I would think that the primary issue is an anterior segment/dry eye problem. Many times this is from a combination of dry eyes, allergies and blepharitis.

If you think your mother would be interested in trying some home therapy and, I must say, it doesn't seem like she is -- and most likely won't be until she believes that it is not due to a parasite drilling in her eye -- then here is some information on what she can do at home: (Let me say, however, that if a trip to an expert for a second opinion accomplishes nothing other then to give your mom the piece of mind to try other treatments, it will be in my opinion time and effort well spent.

In any event, here is the information on home therapy for your consideration:


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.

I wish your mom the very best.


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.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7923
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 2 years ago.
I 'loved' your response above (not sure that it registered). Monday night we had a face-to-face heart to heart and for the first time since this first came up a year or so ago, entertained the possibility that it might NOT be parasites. I begged her to help me, help her. I had to level with her as to how she lacks credibility when she presents her symptoms and possible diagnosis to a doctor. They know enough to know that a parasite, something micrscopic, does not function in the way she describes.

So, I need to research the conditions that you mention above aand will start there. She did say before I even read your response that it could be allergies. I know these 'attacks' typically only occur at night. And, I failed to mention that she has two cats. We have had them checked at a vet and one has ear mites, but that's it.
Expert:  Dr. Rick replied 2 years ago.
I'm glad to be of help and very happy to hear of the positive steps you have been able to take with your mother. It sounds like she is on a much better path now.

I do not believe there is any need to worry about ear mites from the cats and, if she has had the cats for a while, it is most likely not allergies to them.

See if you can get her to try the home therapy we discussed and see how things go.

Let me know if there is anything else I can do to assist you. Have a good evening.
Expert:  Dr. Rick replied 2 years ago.
I was just thinking about your mom and wondering how she was doing. Did she decide to go to the University for a second opinion or is she giving the home treatment a try?

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