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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience:  30 years experience treating patients with eye problems
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I am 56 and have bad allergies and get shots every two weeks.

Resolved Question:

I am 56 and have bad allergies and get shots every two weeks. My eyes are very sensitive and lately they are just irritated all the time. My left eye goes thru stages where tears just pour from them uncontrollably. My doctor seemed to feel that I had dry eye. So I have tried the artificial tears, etc along with my allergy drops. Last night I tried genteal eye lubricant. My eyes are so much worse today (bright red and irritated) and I have to go out to my daughters basketball game in one hour. Anything I can do to help them not look like martian eyes? All I want to do is keep them closed but I have to go!
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. C. replied 1 year ago.
Hi, my name isXXXXX hope I can provide some helpful information.

It sounds as though you may have a corneal erosion. It may be a good idea to see an ophthalmologist. Sometimes there is an underlying auto-immune condition that is the cause. If eye lubricants aren't helping, it may be necessary to wear a eye "bandaid" which is basically a lens that is left in place to allow the cornea to heal. This prevents the blinking of the lid from shearing off the newly growing layer of cells from the front of the cornea.

A combination of mineral oil and lanolin can be used at bedtime to reduce daytime symptoms.

Please REPLY if I can clarify anything. I hope you get some relief soon. This can be terribly disabling.
Customer: replied 1 year ago.

what is corneal erosion as I have no pain in my eyes - just irritation and redness!


 

Expert:  Dr. C. replied 1 year ago.
Corneal erosion usually causes severe tearing. That's why I thought of it. Usually symptoms are worse in the morning. It's not painful but feels like something got in the eye. Regardless, it sounds like seeing an ophthalmologist might be a good idea if you're not getting relief with the treatments recommended by your regular doctor.
Customer: replied 1 year ago.

I have been seeing an opthalmologist. I have never been able to use any kind of oil or creme to take my mascara off - it always irritated my eyes so I think that is why this ointment also irritated my eyes to the extent it did.


 


Any other ideas?

Expert:  Dr. C. replied 1 year ago.
I'm glad you're seeing an ophthalmologist. Some people find the preservatives in the pre-made ointments very irritating. I wonder if plain mineral oil or lanolin would irritate as much? There are also some homeopathic eye drops that may be less irritating.
Customer: replied 1 year ago.

I hve tried plain mineral oil and cannot use it! I am trying the similasan eye drops which do not seem to be doing anything

Expert:  Dr. C. replied 1 year ago.
It sounds terribly frustrating. I've messaged another expert who may be able to come up with some other ideas.
Customer: replied 1 year ago.

thank you very much!!

Expert:  Dr. Tom replied 1 year ago.
Hi, Dr. Collins asked me to see if I can help..... I'm online now and would be happy to help you with your question.I understand what you are asking. Just reply and we'll get started. Dr. Tom
Expert:  Dr. Tom replied 1 year ago.
Is is possible for you to send a digital photograph of your eyes?
Customer: replied 1 year ago.

how do i do that - i took a pic with my iphone - can i send it to you?


 

Expert:  Dr. Tom replied 1 year ago.

Yes...use the paperclip to attach the photos.

 

But I have prepared an answer for you because I did not think you were available tonight.

 

Here it is: ( I already sent this, but will do so again).:

 

Since you apparently are off-line now, and we can’t establish an active dialogue, I’ll make a few observations that may be of help.

I have been viewed your conversation with Doctor Collins, and your comments regarding your previous ophthalmic evaluation.

It is a fairly common situation that a patient who has allergic conjunctivitis may also have dry eye disease, eyelid oil gland dysfunction or blepharitis. You may have all three of these things occurring at one time, or intermittent activity of each from time to time. The dry eye syndrome in itself can give you pretty severe redness and watering. There is also the possibility that preservatives in the artificial teardrops and over-the-counter antihistamines may contribute to the overall problems you’re having with your ocular surface.

On the first encounter with a patient as you describe yourself, we typically ask that patient to discontinue all topical, ocular medications with the exception of a non-preserved tear film lubricant. You should be able to find non-preserved artificial tears in any pharmacy. We re-examine after a week or two to establish what is normal and what is not normal on the ocular surface. If we find that it is an oil gland related blepharitis, we recommend frequent application of hot compresses, cleansing of the eyelid margins and eyelashes and often use a short course of topical antibiotic ointments. If there are clear elements of dry eye syndrome, there are numerous modalities of treatment. Examples are frequent artificial tear drop (non-preserved) application, possibly the use of Restasis, and lachrymal duct occlusion. If the symptoms are more consistent with allergic causes ( by microscopic slit lamp examination we can determine the cell type reaction on the inner eyelid, and by this we can be pretty certain if there is an active allergic problem going on). If it is, we would usually treat with a short course of anti-inflammatory medication, often in the form of steroid eye drops.

The management of a problem such as yours can usually get the eyelids and conjunctiva back into good shape in a few weeks.

So until you can have another evaluation, and have established a treatment plan, I would recommend limiting your self treatment to non-preserved artificial tears used very frequently. Also, I would encourage you to be persistent in working with an ophthalmologist to get this problem under control.

I hope this has been helpful and useful information. And I’d like to wish you the best of luck in getting your eyes straightened out.

Customer: replied 1 year ago.

Expert:  Dr. Tom replied 1 year ago.
Thanks for the photographs. From the degree of swelling of your upper lids it may well be that there is an oil gland inflamation present. Is it possible for you find a corneal and external disease ophthalmologist to completely re-evaluate you?
Customer: replied 1 year ago.


I will look for another opthalmologist - don't know if I will be able to find one who specializes in this but apparently the doctor I have been going to fr the past 6 years has not been helping me so i will look for another.


 


thank you for your help - at least it points me in the right direction!

Expert:  Dr. Tom replied 1 year ago.
You are welcome...best wishes.
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience: 30 years experience treating patients with eye problems
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