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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7761
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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my 18 son has pain in eye, above eye and below eye (sinus area).

Resolved Question:

my 18 son has pain in eye, above eye and below eye (sinus area). the eye watered terribly. He wears contacts which he has removed and that decrease the pain. When I use a pen flash light and look at his eye, the black part of the pupil looks different from other eye. It's not cloudy but doesn't look as clear.
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 :

The most likely cause of the pain your son is having is a corneal ulcer. This is an infection of the actual meat (corneal stroma) of his eyeball.

Dr. Rick :

I think you should take him to the ER for an evaluation tonight. While it would be best if he could be examined by an ophthalmologist tonight -- and some ERs do have eye doctors on call and available -- even a regular ER doctor is better then waiting until morning.

Dr. Rick :

The ER doc will at least be able to get him started on antibiotic drops now until he can be seen by an eye surgeon tomorrow.

Dr. Rick :

Delaying treatment of a possible bacterial ulcer overnight can cause significant damage and make things a lot harder to fix.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Hi. I see you have entered the chat room. Can you see my chat? Please let me know if you are there......

Dr. Rick :

My system shows that you are typing......are you there?

Customer:

I am here. The pain started suddening today. He was not doing anything that could have resulted in something unusualy getting into his eye.( like sawing wood or sanding)

Dr. Rick :

Hi.

Dr. Rick :

That is not necessary for a corneal ulcer to start. Just the fact that he wears contact lenses puts him at a higher risk of getting one.

Dr. Rick :

In two decades of ophthalmology I have learned, the hard way, not to wait for a convenient time to start treating a corneal ulcer. I had one ER nurse who tried to treat it herself for a day....after two months of almost daily therapy we had to remove her eyeball....I only need to have that happen once in my medical practice to be biased against not waiting to check things like your son's eye out.

Dr. Rick :

If he were my son I'd pack him up and go to the ER.

Dr. Rick :

Does that make sense?

Customer:

Our eye doctor will be open tomorrow morning at 8. But you said above to go to ER. I will take him if necessary, but my fear is that there wont be an eye doctor at the hospital and we will endo up just going to eye doctor in am. We live in a small town outside Athens GA. The hospital in Athens is not a huge metro hospital.

Dr. Rick :

It is much better, you are correct, for him to see an ophthalmologist. But any ER doc can look for a corneal abrasion with a black light and start him on some vigmox eye drops.

Customer:

I know you only have one set of eyes... but it is already 11:15pm - that's only 9 hours away....


 

Dr. Rick :

If you wait, will he be OK? Probably. But if the bacteria that is growing on his eye is pseudomonus (the one the RN had) it can be orders of magnitude worse by 8 am

Dr. Rick :

In nine hours I've seen some corneal ulcers go from a pinpoint small white spot to a totally opaque, soupy mess of a cornea with bare light perception vision.

Dr. Rick :

Will this happen to your son? If it is a gram positive bacteria, no. You can see him and I can't. I can only go on what I've learned over the last 20 years and,I must admit, I've been seriously biased by the few terriable cases I'

Dr. Rick :

I've treated....

Customer:

I understand, but you're giving worse case senerio. I'm going to go look at his eye again and ask him how it is feeling now without the contact and now that an hour has passed and it has calmed down.


 

Dr. Rick :

If he stays home tonight cold compresses on the eye and, of course, no contacts. Try to get him in to an ophthalmologist (not an optometrist) first thing in the morning.

Dr. Rick :

Ok. That sounds like a good plan.

Dr. Rick :

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Let me know if you have further questions.

Dr. Rick :

Also, as an aside, he should dispose of the pair of contacts he was wearing and start with a fresh pair once his eye is back to normal

Customer:

Thank you very much for your medical advice. And I just realized our eye doctor is optometrist (as well as a person friend - small town...) but he can recomend the ophthalmologist in Athens.


Thank you - have a nice night

Customer:

yes I will give excellence service response


 

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7761
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.
Hi Charlotte,

I finished a retina surgery where we had to scrape the skin off the entire cornea to see well enough to finish the case and I found myself thinking about your son.

What did the ophthalmologist find on Monday? Was it a corneal ulcer as we discussed? I hope your son is doing better?

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