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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10553
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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In the last year I have had Bells palsy twice, I am still having

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In the last year I have had Bells palsy twice, I am still having eye problems though, and my eyes are still affected with blurred vision, itching, and around my eyes puffy and itchy and sore. I also have a runny nose occasionally and sneezing in the mornings, and have trouble looking down (vision blurred). At first I thought it was severe hay fever, but it is now getting worse.

I have been treating my eyes with wipes and eye drops for infection. But although they relieve the symptoms it is still causing discomfort.

I do hope you can advise

Thanks Roger

Dr. Rick :

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

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.

Does this make sense to you?

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Let me know if you have further questions.
Hi Roger,

I see that you have given me good feedback for your followup question but you have not given me positive feedback for this one.

Please mash the excellent feedback button. Thanks :-)
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