Dr. Dan B. : Hello and thanks for your question. What kind of soap and/or shampoo are you using on your face or hair?
baby shampoo or head and shoulders and dove soap, sometimes irish spring soap. sometimes i dont use anything and they still sting and water.
Dr. Dan B. : Other than after a shower, do you have any of the following: eye redness, dull aching or pressure, sharp or stabbing pain, morning tearing, burning, eyelash mattering, tearing, stinging, itching, burning, a gritty/foreign-body senstation or just intermittent vision fluctuations?
morning tearing, burning, occasionally eyelash mattering in the morning, sometimes a gritty feeling
Dr. Dan B. : Thanks for that. The most common reason for the eyes to be causing these symptoms is due to a dry eye, also called a dysfunctional tear film syndrome. The front of your eyes has a layer of tears coating it called the tear film (this layer of tears is different from the tears you produce when you cry or have an irritation in your eye). The tear film normally provides a healthy environment for the front of the eye (the cornea and conjunctiva) and also contributes significantly to clear vision. When the tear film is unstable or unhealthy (there are many reasons why this can be so, which I will get to) it becomes dysfunctional and can produce uncomfortable symptoms and blurry vision. This is called a dysfunctional tear film.People with a dysfunctional tear film can have multiple different symptoms ranging from redness, dull aching or pressure, sharp or stabbing pain, morning tearing, burning, and often eyelash mattering to tearing, stinging, itching, burning, a gritty/foreign-body senstation or just intermittent vision fluctuations. Their symptoms sometimes get better as the day progresses or they can often times worsen throughout the day, but they can get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving. A dysfunctional tear film can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to a dysfunctional tear film. Allergies in the eyes can also contribute (and or make worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Any kind of eye surgery can actually cause and/or worsen this Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. Your symptoms sound consistent with blepharitis; I would recommend starting this treatment, while concurrently using artificial tears. 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 I would recommend using artificial tears 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. 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. If you are a person that doesn't make their own tears very well, then you may also benefit from taking that 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 at least 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).Because there are numerous reasons for dry eye, if not all the reasons that exist in one patient are treated, it can seem as though the ones that are being treated are providing no benefit. If you've tried these recommendations and still don't feel better then you should consider seeing a corneal specialist for a dry eye evaluation.
Dr. Dan B. : Does this make sense?
Dr. Dan B. : Do you have any other questions about this?
i dont understand how my eyes could be dry if they are so watery?
Dr. Dan B. : I know this sounds paradoxical. However this tearing that happens because your eyes are dry, or more aptly because the tear film is dysfunctional, is a reaction or a reflex that your brain stimulates because of the dysfunctional tear film. However, this tearing is not sufficient to make healthy or stabilize the tear film. Does this make sense?
Dr. Dan B. : You bet. Do you have any other questions about this?
Dr. Dan B. : Okay. Good luck to you 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 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!