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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7859
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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have copd taking spiriva, symmbicort, proair, in last 2 weeks

Resolved Question:

have copd taking spiriva, symmbicort, proair, in last 2 weeks in morning matting of left eye and yesterday noticed blurred vision in left eye, ? medication probable cause?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. My name isXXXXX and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

Do you wear contacts?

Dr. Rick :

Do you have any other symptoms? Eye pain etc?

Dr. Rick :

Is the mattering only in the morning and clears up during the day?

Customer:

no contacts, glasses

Customer:

no other symtom

Customer:

only in a m

Dr. Rick :

Ok.

Dr. Rick :

How long have you been on these medications?

Customer:

2 or 3 + years

Dr. Rick :

Ok. In that case, I believe it is unlikely the medications are at fault.

Dr. Rick :

It sounds like you have an anterior segment issue going on. The good news? This is something you can fix with home therapy. Let me tell you a bit about this:

Customer:

just an eye infection or have slight cateracks from last visit to eye doctor

Customer:

both eyes

Dr. Rick :

Ok. Cataracts wouldn't cause this problem either....and It makes sense that both eyes are affected....


 

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.


 

Dr. Rick :

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.

Dr. Rick :

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.


 

Dr. Rick :

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.

Dr. Rick :

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 :

Does this make sense to you?

Dr. Rick :

Are you still there?

Customer:

i guess

Customer:

you are the doctor

Dr. Rick :

As you can see, I do not think you need to stop your meds...but from your response, it doesn't seem that you buy this line of thought....

Customer:

the real problem is blurred vision?

Dr. Rick :

From what you have posted, I really feel that this is what is going on......

Customer:

in left eye

Dr. Rick :

Ok. Tell me more about the blurred vision. Does it get better a few hours after you wake up or has it stayed blurred since you first noticed it?

Customer:

ok i will give it a shot

Dr. Rick :

Also, is it mostly your central vision that is blurred or is the vision in your entire left eye blurry?

Dr. Rick :

I am happy to discuss the vision issue further....

Customer:

entire left eye it may get better later in the day

Dr. Rick :

Ok. Well, good news. Serious retina issues, such as macular degeneration, or other things like cataracts, don't get better as the day goes along....but blurry vision from the problems I've discussed above does......

Dr. Rick :

Does this make sense to you?

Customer:

sure does,

Dr. Rick :

Ok.

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

Dr. Rick :

I hope you feel better soon. Have a good weekend :)

Customer:

thank you, XXXXX XXXXX started on your suggestion and take my medications for copd.

Customer:

i appreciate this being avavilable

Dr. Rick :

sounds like an excellent plan

Dr. Rick :

My pleasure. Glad I could help :)

Customer:

have a great day

Dr. Rick :

You too. Bye

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7859
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
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