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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi, I am only 23 years old and Ive worn soft contacts (Acuvue

Customer Question

Hi,

I am only 23 years old and I've worn soft contacts (Acuvue 2) without any issues for the past 8 years. Roughly 8 months ago (last May), I took a trip to Europe. The very first day I arrived, I was rubbing my right eye and a patch of my eye turned red. I didn't think anything of it but the redness persisted. Gradually over the next week or so, both my eyes started getting redder and redder -- the redness was slight for the first couple of days, but by Day 5 my eyes were turning a terrifying shade of red by the end of the day. Each time I removed my contacts and left them out for a day or two, my eyes would turn white again. I thought it may be an infection, since I have the same degree contacts in both eyes, so I don't keep track of which one goes in which eye - I use them interchangeably.

After I got home, I immediately went to the eye doctor, who prescribed Tobradex to me and told me to go a week without contacts. After the week was over, I put my contacts back in. My eyes starting looking a little bloodshot again, but nowhere near the red they had been in Europe, so I thought they were recovering. After I ran out of Tobradex, however, my eyes started getting redder and redder again.

Over the past six months, I've been to five different opthamologists. I've been told that the problem is dry eyes (I was on rewetting drops for weeks with no avail), allergies (I tried Claritin, zyrtec, etc), GPC (giant papillary conjunctivitis....I was told to wear only glasses for over a month and prescribed Crolom in my eyes twice daily), and blepharitis (lid scrubs, bacitrin twice daily, and doxycycline 20mg twice daily).

The rewetting drops did nothing, the Crolom did nothing, and the doxycycline seemed to help a little but did not solve the problem (I've been on doxycycline for a little over 2 months now). My eyes are to the point where they are always slightly bloodshot regardless of whether I am wearing contacts or not. They turn especially red when I strain them, i.e. when I brush my tongue and gag, drinking, etc. The redness seems to retreat slightly when I shower and when I sleep especially long. Once in awhile, my eyelids will feel strange.....it feels almost like there is something on them, and it feels weird to try and open my eyes really wide. My current doctor has said that it is ok to have daily contacts for a couple hours daily, but I use them SPARINGLY at most, maybe one day a week for only 5 hours. For around 2 months before that, i strictly stuck to glasses but nothing improved either.

I am panicking because I fear that I will never have white eyes or be in contacts again, and my eyes have reached a point where they are ALWAYS pink and bloodshot, even without contacts. My current opth. is suggesting I use Tobradex again, but I know that long-term use is never good and it only helped for awhile the first time.

I don't use Visine very often because I know it doesn't help the actual condition, but I couldn't resist and used it the other night.....and I broke down and cried when I saw how white my eyes turned because I was not used to seeing them like that anymore and I was so desperate for an answer.

Does anyone share a similar problem or have any suggestions? I'm scared, worried, panicked, and I'm beginning to lose hope. =(
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

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

Dr. Rick :

Thank you for your detailed history. You are right on one issue: Visine is bad for your eyes. It may make them white for an hour or so but it just makes things worse.

Dr. Rick :

It sounds like you have seen a large number of highly qualified ophthalmologists and, unfortunately, have received almost every diagnosis under the sun for the redness your are experiencing.

Dr. Rick :

From what you have posted, I think you are suffering from a number of conditions all at once....and the problem is that you are only addressing one of them at a time. Let me tell you a little bit more about what I mean and what you can do at home to help :)

Dr. Rick :

It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, 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.


 


I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.


 

Dr. Rick :

That fact that you improve so much on Tobradex makes me even more certain that the above therapy will make you better :)

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?


 


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS

Expert:  Dr. Rick 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.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.


We have been experiencing technical difficulties with the chat system. Please allow me to retype my chat here for your review:



Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : Thank you for your detailed history. You are right on one issue: Visine is bad for your eyes. It may make them white for an hour or so but it just makes things worse.
Dr. Rick : It sounds like you have seen a large number of highly qualified ophthalmologists and, unfortunately, have received almost every diagnosis under the sun for the redness your are experiencing.
Dr. Rick : From what you have posted, I think you are suffering from a number of conditions all at once....and the problem is that you are only addressing one of them at a time. Let me tell you a little bit more about what I mean and what you can do at home to help :)
Dr. Rick : It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, 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.

I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.

Dr. Rick : That fact that you improve so much on Tobradex makes me even more certain that the above therapy will make you better :)
Dr. Rick : Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS
Expert:  Dr. Rick replied 1 year ago.
I am sorry to see that you have given me a poor rating for the assistance I have provided. Ratings do not apply to system malfunctions...only to the quality of the expert.
I would ask that you give me a chance to provide you with further data so that you have the information you need to address your issue.
I would appreciate a good or excellent rating and will work hard to obtain it if given the chance.
Thank you.
Customer: replied 1 year ago.
Hi. Im sorry to tell rate you like that. Dont take it personaly. I appreciate the help provided but the first line of treatment should address the CAUSE of the dry eye, rather than simply treating the symptoms with eye lubricants, the most commonly prescribed treatment. I suppose healing the dry eyes or glands not working properly isnt the best way to do. It may never work till the cause of it is addressed. Could be an infection for example stafilococus. Not sure what it may cause. If you have any suggestion or advice what suppliments might be helpfull i will consider it. Im already takin all possible vitamins and minerals and am going to add coloidal silver and GSE to get rid of any possible bacteria or infection.

Thank you

Regards
Expert:  Dr. Rick replied 1 year ago.
"akin all possible vitamins and minerals and am going to add coloidal silver and GSE to get rid of any possible bacteria or infection." is not going to work in my professional opinion.

The best way to get your tear film back in line and decrease any bacterial load is with the warm compresses and lid scrubs I've discussed above.

The therapy I discussed does address the underlying physiologic cause of the dry eye issue even if it doesn't specifically name/find the offending agent.

I am sure that if you follow my advice you will be see a marked improvement in 3 weeks.

And I hope you will remove the stain to my online rating by changing your response to a positive rating.
Customer: replied 1 year ago.
Thank you for your advice.I'll try the baby shampoo eye lid scrub for three weeks with the hot compress as well and will get back to your rating after that. One question is remaining from my side and that is if you advice me to do so for three weeks and then i can i simply stop doing it whether its working or not. Is it correct?
Why you may think GSE or coloidal silver is not going to work. I have many friends who are using it and had great results.

Thank you.

Regards
Expert:  Dr. Rick replied 1 year ago.
Erick,

No...actually, after three weeks you can do it less often, say once a week. But, I can tell you from personal experience, after you start feeling better you will (as did I) stop doing the lid scrubs and your symptoms might, or might not, return. If this happens, just start back up.

I am glad that you have found my advice helpful. But, unless you do me the favor of pressing the positive feedback button, the stain of the poor feedback will remain on my online rating which, as you know, is very damaging.

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 1 year ago.
Hi

I have a question about the babyshampoo lid scrubas you recomended. Want to ask what exactly to buy? Is it just a baby shampoo for hair?? If yes how can i use it? just put on my hands with water and wash my eyes? Or shall i use somethig else? Please let me know step by step as i have never done it.

Thank you
Expert:  Dr. Rick replied 1 year ago.
Erik,

Yes. Just your run of the mill Johnsons & Johnsons baby shampoo....the yellow stuff. :)

In the shower, place the shampoo on your index fingers (like toothpaste), 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.

Don't worry about getting the shampoo in your eyes -- it is "no more tears" formula doesn't hurt ;-)

You can also do this at the sink with warm water, but in the shower is more convenient.

Le me know if I can do anything else to help.

Dr Rick MD FACS
Customer: replied 1 year ago.
Thank you. Just came from the shop and found the one you said. Yellow stuff.
Once again many thanks ill start today.

Regards
Expert:  Dr. Rick replied 1 year ago.
Erik,

My pleasure. Remember. This is not an instant fix; it takes a few weeks and even might get worse before it gets better :)
Customer: replied 1 year ago.
I started to use the baby shampoo but i also still use dry eye non preservative eye drops (soothe) Is that ok to use the natural tears after eyewash with the babyshampoo?

Thank you

Expert:  Dr. Rick replied 1 year ago.
yes. It sure is.
Customer: replied 1 year ago.
Thank you very much.
This service is very good and i like the speed of it.
Truly good.

Once again thank you!
Expert:  Dr. Rick replied 1 year ago.
Erik,

We got off to a bad start but I'm glad you hung in there and gave me a second chance to assist you.

It is a pleasure to help you. Take care and have a good weekend :)

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