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Ask Dr. A.S. Desai Your Own Question

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2107
Experience:  MS Ophthalmology with 11 years of surgical expereince
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My 80 year old Dad has been having dry and itchy eyes for about

Customer Question

My 80 year old Dad has been having dry and itchy eyes for about a year now. He says his ophthalmologist gave him some sort of ointment for nighttime, but during the day, his eyes get so dry that he has to put napkins soaked in warm water on his eyelids to give him some relief. What could this possibly be since his eye doctor doesn't know?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 1 year ago.
Hello,

Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .

Along with lubricating eye ointment such as lacrilube , for overnight effect, he can put lubricating eye drops durong the day, 1 drop 4 times a day. There could more than one reason for the dry and itchy eyes such as blepharitis with meibomitis or allergic conjunctivitis wih dry eyes. For blepharitis with meibomitis, simple home measures along with the suggested lubricating eye medicines should help-

Many appropriate systems of eyelid hygiene exist, and all include variations of 3 essential steps. First, application of heat to warm the eyelid gland secretions and to promote evacuation and cleansing of the secretory passages is essential. Individuals  are directed to use soaked warm compresses and to apply them to the lids repeatedly. Warm water in a washcloth, soaked gauze pads, or microwaved, soaked cloths can be used. However extreme heat should be avoided.  

Second, the eyelid margin is scrubbed mechanically to remove adherent material, such as  crusting, and to clean the gland orifices. This can be completed with a warm washcloth or with gauze pads. Water often is used, although some clinicians prefer that a few drops of baby shampoo be mixed in one bottle cap full of warm water to form a cleaning solution. Attention must be directed to gentle mechanical jostling or scrubbing of the eyelid margin itself, not the skin of the lids or of the bulbar conjunctival surface. Vigorous scrubbing should be avoided as it may be harmful.  

Third, an antibiotic ointment is applied to the eyelid margin after it has been soaked and scrubbed. Antibiotic-corticosteroid ointment combinations can be used for short courses, although their use is less appropriate for long-term management and should be used strictly on the advise of the ophthalmologist.

Dry eyes can occur from involvement of any of the 3 layers of the tear film. The tear film has 3 layers- aqueous, lipid and mucin. The most frquent layer to be affected is the aqueous layer. It is seen due to increased evapouration of tears as can be seen with excessive hours in front of the laptop/computer/television or long hours of continous reading or writing. It can also be precipitated by excessive exposure to air conditioning or even very hot and humid climate. The treatment is in the form of tear supplements such as over the counter preservative free Refresh tears eye drops , 1 drop 4 times a day for about a month.

Not everyone would have all the above mentioned precipitating factors but these measures have been very effective in mot individuals . Since your father is already using warm compresses and eye ointment, he just needs to add the lubricating eye drops and do the lid scrubs gently. For persistent dry eyes restasis eye drops are given and those are also ineffective or cause intolerence, then silicone plugs are placed in the lacrimal puncta. These aspects can be discussed with his ophthalmologist.

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.Thank you and best wishes.It was a pleasure to have answered this question.Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist
Customer: replied 1 year ago.

I remember having blepharitis myself, about 14 years ago, and my doctor told me it was because I was allergic to some kind of chemical in the workplace (I had just changed job functions at my job, working in the cargo area of an airline). But the condition eventually went away with the application of the ointment and warm eye scrubs like you had mentioned. My Dad has had this condition for a long time. Will it eventually go away? Why hasn't his doctor told him it was blepharitis?

Expert:  Dr. A.S. Desai replied 1 year ago.
Hello Liz,

Chronic blepharitis or posterior blepharitis may not show visible signs on eye exam as it occurs due to dysfunction of the meibomian glands. In such a situation it might get missed on routine eye exam. Since he has symptoms suggestive of this condition, the above suggested measures can be given a try. Alternate treatment for ineffective cases has been mentioned above and can be discussed with his doctor. Yes, it can disappear with proper lid care and medicines suggested,

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.

Thank you and best wishes.

It was a pleasure to have answered this question.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

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