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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Everyday when I am at work the computer screen and the florescent

Resolved Question:

Everyday when I am at work the computer screen and the florescent lights at the hospital hurt my eyes. I start to see rainbows around the lights and by 1pm I cannot see the keyboard or even read the screen. After that I develop the worst headache of my life. I went to a neurologist for ocular migraines and none of the medications worked. I had a MRI of the brain with no findings. I don't want to take medication since it only happens with the computer screen and the lights at work, never at home... and I do not have a stressful job. I have been wearing polarized glasses with no help, and I even tried polarized sunglasses with no help. What do you suggest? It is to the point where it is debilitating because it happens everyday.
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 :

It is possible that you are suffering from an anterior segment/tear film issue. Many times problems like yours are not from one thing alone but rather can be the culmination of a few issues such as dry eyes, allergies and blepharitis.

Dr. Rick :

The good news? There is a therapy that I have had excellent results with and you can do it at home :-)

Customer:

No eye problems, I went to an optomitrist and have perfect vision.

Customer:

The neurologist wants to put me on Keppra, but it only happens at work, and I don't want to be on medication if I know the cause...

Dr. Rick :

Ya. An optometrist could easily miss these types of problems......even busy ophthalmologists have been know to look right at the problem under the slit lamp and miss it.....

Dr. Rick :

I can understand not wanting to start medications. Let me tell you about this home therapy you can try at home......

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.

Dr. Rick :

I suggest that you give this at least 4 weeks of at least daily treatment. If after that time you are still having problems I'd suggest, in your case, that you have a complete eye exam by an corneal/external disease specialist before starting on Keppra.

Dr. Rick :

Does this make sense to you?

Customer:

No... I have occular migraines that are triggered by the computer screen and flourescent lights... I need a solution to screen my eyes...

Customer:

My eyes are not dry

Dr. Rick :

Yes. I can understand that your eyes do not feel dry and that you may not even feel that you have allergies. It is possible to have these types of anterior segment issues and not have the "classic" symptoms.....

Dr. Rick :

Given what you have posted, all the suffering you have gone through and your strong desire not to go on daily medication I, truely, believe that this simple and inexpensive treatment -- as low tech and silly as it may seem -- has an excellent chance of helping you.

Customer:

This never happened to me until I became a vascular specialist and used the ultrasound screen all day... I am light sensitive... Are you saying that antierior segment issues can be triggered by the computer screen and lights?

Customer:

This has been going on for 1 year now.

Customer:

If I am not at work... I can go two weeks without it happening. IT is only at work..

Dr. Rick :

No. The doppler ultrasound did not cause this problem.....but it sounds like it is bringing out your symptoms. I have seen this time and time again over the last two decades of practice with people who work on computer screens all day long and I've had many people (not all of course) become much less symptomatic.

Customer:

Dr. Rick,

Dr. Rick :

What do you think is causing it?

Customer:

Why wouldn't this happen at home?

Dr. Rick :

That is an excellent question and my only answer is because people are complex and disease processes, as you well know, rarely play out the same in every patient.

Customer:

I think it is clearly the light... I don't understand why, but even now, the screen hurts my eyes... I have even turned the brightness down to zero and it still burns my eyes...

Dr. Rick :

The good news? There is no side effects to this treatment and baby shampoo is dirt cheap. Since this has been going on for a year why not try this therapy for a month? What have you go to loose?

Customer:

Do you recommend any type of glasses to protect my eyes??

Dr. Rick :

In my professional opinion it is not the light.

Customer:

I will try that treatment, but you are saying that Baby Shampoo treats ocular migranes?

Dr. Rick :

No. The light of the ultrasound screen is not damaging your eyes and you do not need protection from the rays.....

Customer:

Not the rays, the brightness

Customer:

even when I am driving home at night , the on coming cars lights blind me...

Dr. Rick :

Nope. Just your anterior segment issues. I've had ocular migraines for over 30 years and we can discuss those that disease and it's treatment at length if you want. But right now we are dealing with the problems you are having with your eyes hurting at work

Dr. Rick :

Tear film/anterior segment issues can cause that problem with night time driving...see, it is happening at places other then work.

Dr. Rick :

Nor do you need protection from the brightness of the screen.....think about it. The screen is a miniscule fraction of the brightness of the outside sunlight.....

Customer:

I am sorry dr... I am not tying to argue with you... I have been diagnosed with ocular migraines... I am trying to understand how to treat my ocular migraines since I have found the trigger to be the light of the screen or flourescnet lights or headlights...

Dr. Rick :

This entire discussion we have had is about the discomfort you get when your are working and how you can't even see the keyboard etc. I think that this treatment will help.

Customer:

Alright. Once a day? 3-5 minutes with baby shampoo... but no eye drops or anything like that?

Dr. Rick :

As far as the migraines, it is entirely possible that the ultrasound screen is triggering them......and if that is the case and you don't want to quit this job, then you may need to go on medical therapy. And for this I would agree on the use of keppra.

Dr. Rick :

I'm sorry about the confusion on my part :(

Dr. Rick :

Yes, artificial tears 3 to 4x/day and as need at work are helpful. Antibiotics are of no value.....

Dr. Rick :

This therapy is a simple solution to a complex problem....

Dr. Rick :

Does this make sense to you?

Customer:

I will give it a try...

Customer:

Is there a way that I can follow up with you or at least let you know if it worked?

Dr. Rick :

Ok. That sounds like a good plan.

Dr. Rick :

Yes. You can post back to this screen and, if you don't mind, I'll check back with you via email in about 3 weeks and see how you are doing.

Dr. Rick :

Please remember the top 3 ratings are positives [Excellent service is my goal] and this is how we are compensated. Rate my answer when you are satisfied. If you feel the need to rate low, please stop and reply to me via the REPLY TO EXPERT button with the issue you have. I will be happy to continue further and do everything I can to provide you with the service you seek.


Otherwise, a high positive rating is very much appreciated, bonuses are great, and find me anytime for follow up.


 


Let me know if you have further questions.

Customer:

would you mind just briefly explaining how my eyes are getting dry all of the sudden and only when I am working?

Dr. Rick :

I do not believe that your primary issue is dry eyes but rather an abnormal tear film that is causing your cornea to become stressed and loose optical quality during your long work hours. This can be one of the reasons that your are unable to see clearly by 1 pm.

Customer:

Last question...

Dr. Rick :

The replacement tears will keep your corneal hydrated and help things to be better until the lid scrubs start to work and get your meibomian gland back online

Dr. Rick :

Sure.....

Customer:

And it makes sense to you that it only happens at work???

Customer:

and driving at night

Dr. Rick :

It makes sense that you may be just on the edge of having symptoms and stressors like work or glare at night (where you tend not to blink as much) make you symptomatic.

Dr. Rick :

Trust me. I'm a Doctor. :-)

Customer:

I would like to thank you for your time. I am willing to try anything at this point because I have to pretend that I can see while I am walking around the hospital or working at the computer.. and worse, it is so very dangerous when I am driving home at night... YOUR LAST COMMENT MAKES SENSE... I DON'T BLINK AT WORK WITH THE ULTRASOUND OR THE COMPUTER :)

Customer:

THANK YOU

Dr. Rick :

That is correct as you are paying close attention to the screen so you can better delineate the pathology.

Customer:

Now can you find me a babysitter so I can sneak out to the store? :)

Dr. Rick :

lol! Actually, I have five kids and 3 of them are old enough to babysit....my oldest daughter is cooking a Grandbaby for us at the moment :-)

Dr. Rick :

It has been a pleasure chatting with you tonight. Good luck on the trip to the store ;)

Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
I'll talk to you in a month or so and see how you are doing....
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
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.
Hi Matt,

I was just thinking of you and wondering if the lid scrubs ended up helping you at all. Did you decide to start taking Keppra for your migraines or did that become unnecessary?

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