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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3193
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Eyes/Nose/Ears

Customer Question

1.5 years ago, my eyes started to get very red/sore/tired when looking at my ipod screen, video games on LCD screens. Now they get that way with any type of TV/monitor - even with the brightness and contrast turned all the way down. Also, during the same time period, I have lost my sense of smell and taste. Also have vertigo originating in my right year - though this problem started about 5 years ago. I have had my eyes checked by optomotrist and opthomalagist, take lots of allergy medication, drink lots of water, use eye drops, everything...Any ideas????


 


I am originally from Houston Texas - very humid - but now live in Doha, Qatar - the middle of the Arabian desert for about 3 years.  I drink LOTS of water every day and have a hepa-rated air purifier in my bedroom.

Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Doctor DanB : Hello and thanks for your question. Are you available to chat?
Doctor DanB : Do you have a dry mouth and/or nose?
Customer:

yes, I often have dry mouth and nose...also, should have mentioned that i have a cold sore that recurs in the tip of my right nostril

Doctor DanB : It sounds
Doctor DanB : It sounds like you have what is commonly termed dry eye syndrome, but what is more aptly called dysfunctional tear film, but it goes along with the other dry symptoms you are having. Let me elaborate...
Doctor DanB : People with a dysfunctional tear film can have multiple different symptoms from dull aching or pressure, sharp or stabbing pain, morning tearing, burning, and often eyelash mattering to tearing, stinging, itching, burning, a gritty/foreign-body senstation or just intermittent vision fluctuations. Their symptoms sometimes get better as the day progresses or they can often times worsen throughout the day, but they can get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving. A dysfunctional tear film can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to a dysfunctional tear film.  Allergies in the eyes can also contribute (and or make worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. 
Doctor DanB : I believe you are likely one of those people with this innate deficiency in making heir own tears (which is manifested in other dry mucus membranes in the body such as the nose and mouth). This is called Sjogren's's syndrome.
Doctor DanB : I would recommend using artificial tears 4x/day in both eyes (one drop per application). But the key in treating this dysfunctional tear film syndrome is to use the artificial tears regularly and consistently, everyday. If they are used only sporadically and then, only when your eyes are bothering you, they only work for a few seconds.
Customer:

Interesting...this seems to fit my symptoms. By "artificial tears", do you mean otc eye drops or something stronger?

Customer:

Also, would the dryness cause my lack of smell/taste? Anything I can do about that? Sorry to ask for treatment as well as diagnosis, but I am about 3000 miles away from competent healthcare...

Doctor DanB : You got it. OTC eye drops. As long as you use a drop that does not have a redness reliever component in them, just about any brand will work well. If you're doing this 4/day forb3-4 weeks and you still aren't better, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for at least 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body). The dryness could very well affect your sense of taste and smell because the mouth and nose require a certain level of moisture to function in smelling and tasting thins. Unfortunately, your current place of residence exacerbates all of these problems. I would start by just using a saline nasal spray two-three times per day to provide some moisture in your nose. Make sense?
Doctor DanB : Do you have any other concerns or questions about this topic?   
Customer:

Yes, makes sense. I think you have answered a question in about 5 minutes that no one else has been able to for 2 years...You don't happen to practice in Texas do you?

Doctor DanB : No, unfortunately. I'm in Oregon. Do you have any other concerns or questions about this topic?   
Customer:

No, thanks again.

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3193
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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