Doctor DanB : Hello and thanks for your question. Are you available to chat?
Doctor DanB : First let me say that one of the most common things that causes chronic red eye is when someone uses eye drops with a redness reliever component in them. These get-the-red-out drops are useful to decrease redness in an eye on a short-term basis; however, when they are used chronically, over many weeks to months, the eyes can get habituated to them, and more and more of the drop is required to keep the eye from being red. Therefore, the eye tends to stay red regardless of how much of that drop is used. For this reason, I think it is appropriate only to use those kinds of drops for a few days at a time only. If you are using one of these drops, this is the first and most important step to finally ridding yourself of the redness. If the redness-reliever drop has been used for a long time, it will take awhile for the effects of the drops to "wash out", so to speak. By awhile I mean that it may take 4-6 weeks for the eyes to stop being so red after having stopped these drops.Aside from the use of these redness-reliever drops, the most common reason for chronic red eye is an inflammation of the eyelids called blepharitis. It is so incredibly 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. Because this is so incredibly common and also because I can't examine you, I would recommend starting the treatment for blepharitis. 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. There are many reasons for dry eye besides blepharitis that one person can have at the same time. If you are a person that doesn't make their own tears very well, 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 up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body). 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? Does this information help address your concerns? Do you have any other questions about this?
Doctor DanB : I'm sorry but I am about to step into the OR for surgery. If you have further questions, please let me know what they are and I will be happy to address them when I return. If you are satisfied with your answers then... 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: Is there any surgery that can correct this problem. is there any truth that eyebrite surgery is available on the west coast. Why isn't the surgery offer here on the east coast.
Customer: Is there any truth that I-Brite surgery is available that could make red eyes white again. is there any where on the east coast that offers this surgery.
Doctor DanB : I do not know of a provider that offers the surgery on the East Coast. While this surgery promises white eyes, it does so at a significant risk to the patient, and does not guarantee that it will stay white forever only after the surgery for a little while. That's why I do not think that surgery is a very good or safe option. I think by far the best way to treat this is to get off the redness reliever drops and treat the original problem that caused the eyes to be red and not try to do a surgery or procedure to cover up the problem. Does that make sense?