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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7807
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I was recently diagnosed with episceritis about 6 days ago.

Customer Question

I was recently diagnosed with episceritis about 6 days ago. I was perscribed a maxitrol steroid eye drops for 10 days. my question is that I have this bubble on the sclera and it first popped up about 2 weeks ago after swimming in a chlorine pool with my eyes open. I used napcon A allergy eye drops and the bubble and redness went away in a few hours and my eye was fine for a week. Then it came back and the allergy eye drops were not as affective and I noticed some swelling on my upper and lower eye lid. This prompted me to go and see an eye doctor. He told me it was episcleritis and gave me a script for the maxitrol and ive been using it for 6 days now and it burns a bit but does not seem to be clearing up and when i wake up every morning my eye lids are extremely swollen in that eye. I cant afford to see the Dr again as they told me I will be charged again to see him and im worried about a possible missdiagnosis.
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 :

Were you seen by an ophthalmologist or an optometrist?

Customer:

opthalmologist


 

Dr. Rick :

ok.

Dr. Rick :

Ok. Well, from what you have posted this may not be episcleritis and in any event maxitrol is not the treatment of choice if it was.

Dr. Rick :

can you upload a picture of your eye and eyelids?

Dr. Rick :

I'd only use steroids for severe or prolonged episcleritis that was not responding to other therapy...

Customer:

not at this time Dr. I was given the generic version via walmart. my swelling seems worse in the morning and goes away during the course of the day with a cold compress every so often. even the bubble on the sclera goes down. but it always comes back every morning

Dr. Rick :

Ok. Without seeing you or a picture, I am at a disadvantage but this sounds more like an anterior segment/tear film/allergy/blepharitis issue.

Dr. Rick :

If that is the case, the generic maxitrol won't work...which is what is going on.

Dr. Rick :

Would you like to try a different therapy with an easy home treatment that will address dry eyes, allergies and blepharitis all at once?

Dr. Rick :

I think it will work.....let me know and I can tell you about it.....it's just a lot of typing :)

Customer:

im looking for my camera charger

Dr. Rick :

k

Dr. Rick :

let me type this information for you while we wait so you will have it if needed.....

Customer:

my biggest concern is this blister on my eyeball

Customer:

and now the swelling of both lids


 

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 :

This does not sound like episcleritis. It sounds like what I have outlined above.

Customer:

I was thinking allergic conjunctivitis to be honest what do you think of that


 

Dr. Rick :

The blister on your eyeball is most likely a conjunctival cyst from you immune reaction. The above home treatment should work

Dr. Rick :

Does this make sense to you?

Customer:

what do I have to lose

Customer:

why would my Dr say it is episcleritis

Dr. Rick :

Not sure. Everyone makes mistakes. Of course, I can not examine you but, from how you have responded to therapy and what you have posted, that is not what I think you have

Dr. Rick :

Of course, the best thing to do would be to have another exam but, as you said, that is expensive. I think this is a less expensive alternative that should make you feel better.

Dr. Rick :

Do you think this would be helpful?

Customer:

i can try it. i wash my face regularly tho

Dr. Rick :

Washing you face is a totally different thing.....

Dr. Rick :

Give this a try, OK?

Dr. Rick :

I know that we have discussing this for quite some time now and have covered a lot of things but, with time and this therapy -- as low tech as it sounds -- I really think you will get better. You can stop the maxitrol if you want.

Customer:

i cant find my camera charger

Dr. Rick :

Having 5 children I know exactly what you are going through....

Dr. Rick :

I can't find anything around my house.........

Customer:

but I will try it. can you elaborate on the whole puncta


 

Dr. Rick :

That is just a way to plug off your tear ducts......I do not think that will apply to you.

Dr. Rick :

Please remember the top 3 ratings are positives [Excellent service is my goal] and this is how we are compensated. Please don't click "bad" or "poor" service as this leaves me negative feedback. If you aren't 100% satisfied, just click "reply." I will be happy to discuss your issue in more depth and do everything I can to provide you with the information you require.


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.


 

Expert:  Dr. Rick replied 2 years ago.
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Customer: replied 2 years ago.
so by washing my eyes with baby wash and warm compress this will all go away
Expert:  Dr. Rick replied 2 years ago.
That is the plan. It will not happen overnight and you can do the baby shampoo lid scrubs and warm compresses more then once a day if you want.

People don't like this therapy because it isn't a $100/bottle drop but, after 20 years of practice, I can tell you it works....even if it is not high tech.

Don't forget to mash the excellent feedback button 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 :-) :-)
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7807
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you
Customer: replied 2 years ago.



hey Dr rick. I am still experiencing the same issues and even worse at times


 


Optional Information:
Person's Gender: Male
Person's Age: 28

Already Tried:
I have been experiencing an extremely swollen red eye on my right side. I have a cyst on the conjunctivia or sclera. I saw an opthalmologist who diagnosed it as episcleritis and perscribed maxitrol steroid drops for ten days and then to cease use. Dr Rick on just answer said it was blepharitis and told me warm compress and to wash the lids with baby shampoo and to use artificial tears. it felt as if it was getting better but it has now come back with avengence. The eye feels sore when moving




Expert:  Dr. Rick replied 2 years ago.
sorry to hear about that.......Sounds like you have episcleritis in addition to possible blepharitis, since thing got better for a bit.

Episcleritis tends to come back, just like is happening to you.

I suggest you take ibuprofen 600 mg 3 times a day along with still doing the lid scrubs and, if you want, use the drops your doctor gave you.

If you have not already had a workup for any underlying conditions, such as gout, syphilis, or collagen vascular diseases you might consider having your doctor do this...however, in the vast majority cases of episcleritis no underlying systemic conditions are found.

Does this make sense to you?


Please remember the top 3 ratings are positives [Excellent service is my goal] and this is how we are compensated. Please don't click "bad" or "poor" service as this leaves me negative feedback. If you aren't 100% satisfied, just click "reply." I will be happy to discuss your issue in more depth and do everything I can to provide you with the information you require.
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.

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