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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I thought it might be allergies and I have tried a warm compress,

Resolved Question:

I thought it might be allergies and I have tried a warm compress, but it's been three days now, could you tell me what it is?
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 :

What sort of symptoms have you been experiencing?

Dr. Rick :

Do you wear contacts lenses?

Customer:

Hi, yes I do wear contacts

Dr. Rick :

Ok. What symptoms have you been experiencing and how long has it been going on for?

Dr. Rick :

Do you feel like something is in your eye?

Dr. Rick :

Do you have any eye pain or decreased vision?

Customer:

It's been going on for three days almost, first both my eyes hurt when I moved them, just a dull ache,

Customer:

Now it's just my left eye when I look all the way to the left

Customer:

Mostly left/up and left/down

Customer:

I first thought it might be a cold but I have no other physical symptoms except for sneezing from allergies

Customer:

No, I don't feel like something is in my eye

Customer:

And I have no vision problems...

Dr. Rick :

Ok. One more question :)

Dr. Rick :

Is your eye or eyes sensitive to the light?

Customer:

No, not so much. I can check now

Dr. Rick :

ok. I'll wait.

Customer:

No, I don't think so, I don't usually like looking at the light without sunglasses on, so I don't think anything is different..

Dr. Rick :

Ok. Try one more thing for me....well two more :)

Customer:

Right now it even hurts if I look right and down

Customer:

Sure

Dr. Rick :

using your index finger rub around on the side of your nose by the top of your eyeball. Is there pain or tenderness when you do this, especially by your left eye.

Customer:

No, no tenderness

Dr. Rick :

Ok. Well, I think I've got it narrowed down to a couple of things....

Dr. Rick :

From what we have discussed the most likely cause of your problem is trochleitis, which is inflammation (usually from no cause that can be found) of the superior oblique tendon and trochlea system....one of the 6 muscles that move your eyeball.

Dr. Rick :

It is treated by an ophthalmologist in the office by injecting a long acting steroid in the area. I've done this many times and it is very, very effective.

Dr. Rick :

This condition is a clinical diagnosis and does not need a huge medical workup...

Dr. Rick :

You can expect to feel back to normal within 2 or 3 days after treatment.

Dr. Rick :

Since I can't examine you I can not, from what we have discussed here, rule out scleritis..but an eye exam would be able to easily figure out if this process is at work.

Dr. Rick :

This is not a job for an optometrist so make sure you are seen by an ophthalmologist (eye MD)

Dr. Rick :

Does this make sense to you?

Customer:

I don't know what the last one was

Customer:

scleritis

Dr. Rick :

That is inflammation of the wall of your eyeball. It can also cause pain with eye movement, but given how specific you were able to be in describing what movement causes you the most pain, I feel confident about you having trochleitis.

Dr. Rick :

But I'm much better diagnosing eye problems in person -- chat is not a very sharp medical tool lol!

Customer:

So it's not a sinus problem? seeing as the pain in my right eye went away now?

Dr. Rick :

Yes....if it come and goes it could be a sinus problem. When it comes to pain around the eyes the sinus are many times at fault. I didn't understand that the pain is not always there...I'll try to pay better attention ;-)

Dr. Rick :

One thing that people always worry about is a brain tumor. If you are considering this as a possibility I can tell you without a doubt, that is not what you have going on.....

Customer:

There is no pain when I'm just looking normally, it's just when I try to see if I have any pain and I force my eye to the far left and right that I feel it...

Customer:

My eye is not swollen

Dr. Rick :

That could be from what we have discussed or it could be mild conjunctival irritation. Since your eye is not swollen, red, watering, itching etc I do not feel it is from allergies.

Customer:

Okay, thank you!

Dr. Rick :

My pleasure. I hope you feel better soon.

Dr. Rick :

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. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Customer:

Thanks!

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you
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.
Rana,

The pleasure is all mine :)


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

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