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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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I am 67 years old and female. Recently I have been waking up

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I am 67 years old and female. Recently I have been waking up with a scratchy feeling in my eyes. My left eye is worse than the right. It's like a crusted substance kind of like pinkeye, but under the lid instead of around the eye. This morning I noticed that there seems to be a puffy place on my left eye. It is at the edge of the iris on both sides of the iris. Can you tell me what this may indicate? And what should I do about it?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Doctor DanB : Hello and thanks for your question. Are your eyes itchy? Are they red, burning, painful, light-sensitive, tearing or is the vision intermittently blurry? How long has this been going on? Have you had a cold or stomach flu recently? I've noticed you've been offline for a while. I'll check back in with you later to see if you've had a chance to answer these questions.
Customer: The answer to your questions is predominantly yes. They have been red, itchy, tearing, matting, and sometimes the matter makes me have a blurry spot. My vision has been clear though. I have not had a cold or flu. I have always had allergies, but this condition is new. I believe this has been going on about a month, but the puffed spot on my eye has appeared within the last few (@3) days. When I wake in the morning, my left eye does not come open at first. It feels very dry and stuck shut. It opens in a few seconds later.
Doctor DanB : Okay, given the duration of your symptoms, I suspect this is from blepharitis. Let me alaborate...
Doctor DanB : Blepharitis is an inflammation of the eyelids that causes dysfunction of the oil glands in the eyelids which results in inflammation in the eyelids, tear film (layer of tears coating the front of the eye) and the front of the eye itself. It is very common and can come in many different varieties, severities, and presentations.  It can cause any of the following symptoms: burning, itching, discharge, tearing, dry or gritty feeling, foreign-body sensation, light-sensitivity, redness, pain and/or blurry vision.  For some who have blepharitis, they don't have any of these symptoms but can still have the inflammation.  
Doctor DanB : In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done. It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.  Any artificial tear without this redness-reliever chemical in them should be fine; some brand name examples that my patients like using are Refresh, Systane, Blink, Optive.  Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working. You may also need an antibiotic/steroid combination drop if the inflammation has not significantly calmed down after 2-3 weeks.
Doctor DanB : Does this make sense?
Doctor DanB : Do you have any other questions about this? 
Doctor DanB : Your feedback is important to me and will help me improve my encounter with future customers.  Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated.  If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.  My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry! 
Customer: I have replied but did not receive an answer. I have received a message that there is something wrong with the format. So I am waiting for the answer.
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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Expert:  Dr. Dan B. replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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Expert:  Dr. Dan B. replied 1 year ago.
Okay, given the duration of your symptoms, I suspect this is from blepharitis. Let me alaborate...
3/2/13 8:34 PM
Blepharitis is an inflammation of the eyelids that causes dysfunction of the oil glands in the eyelids which results in inflammation in the eyelids, tear film (layer of tears coating the front of the eye) and the front of the eye itself. It is very common and can come in many different varieties, severities, and presentations.  It can cause any of the following symptoms: burning, itching, discharge, tearing, dry or gritty feeling, foreign-body sensation, light-sensitivity, redness, pain and/or blurry vision.  For some who have blepharitis, they don't have any of these symptoms but can still have the inflammation. Â
3/2/13 8:35 PM
In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done. It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them. Â Any artificial tear without this redness-reliever chemical in them should be fine; some brand name examples that my patients like using are Refresh, Systane, Blink, Optive. Â Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working. You may also need an antibiotic/steroid combination drop if the inflammation has not significantly calmed down after 2-3 weeks.

Does this make sense? Does this information help address your concerns? Do you have any other questions about this?

It appears as though you are not in the chat room currently. I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need. If you would like to ask further questions or clarification regarding anything I've said, please let me know and I will be happy to address your concerns when I return to see if you've responded. If your concerns have been resolved...

Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!

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