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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Last night my right eye ball is tender, especially to the upper

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Last night my right eye ball is tender, especially to the upper right. It hurts as if it is bruised. About 2-10 when not touched, but when I shut my eye, or touch my closed eyelid, the bruised discomfort increases momentarily to 7/10. The conjunctiva is red and inflammed looking, but only in the one eye, and only on the right side. There is minimal discharge.

Dr. Dan B. : Hello and thanks for your question. Is that eye light-sensitive? Is there any tearing or change the vision? Have you had a cold recently?
Customer:

Not light sensitive

Customer:

Minimal tearing.

Customer:

Slight feeling of irritation

Customer:

I haven't had a cold recently and have never had sinusitis

Customer:

(I'm a registered nurse, but my specialty is chronic wound management)

Dr. Dan B. : Any itching, burning, mattering of the eyelashes, or foreign- body sensation?
Customer:

No

Customer:

Not enough exudate to matt the eye lashes

Customer:

No significant foreign body sensation

Customer:

Just a little, like the conjunctiva is irritated.

Customer:

It doesn't feel like when you have a foreign body in your eye. Nothing like having a speck of soot in there or anything.

Customer:

I'm still at work, managing OK.

Customer:

Strangely, my co-worker has woken with a similar thing, though not as bad. I haven't seen him for a week and have never touched him. He comes from the same town as me though, which is 50km from where we work. Neither of us have ever had anything like this.

Dr. Dan B. : Did this pain wake you out of sleep this am?
Customer:

No

Customer:

I just noticed it as i went to sleep last night, and noticed it on waking

Customer:

and then, my eye has become more irriated during the day

Customer:

I can still work, but its difficult to concentrate

Customer:

I just don't know if conjunctivitis (bacterial / viral) can cause this bruising type pain....

Dr. Dan B. : Okay give me a couple minutes to type up my response to you
Customer:

I can attach a picture

Dr. Dan B. : Sure. That'd be great.
Customer:

R) eye
Full Size Image

Dr. Dan B. : Great. Thanks for that photo. Let me type up to you I think is going on.
Dr. Dan B. : I think you have scleritis which is on the more involved part of the spectrum of episcleritis. Episcleritis, in most people who have one episode, is not caused by anything that we can detect with physical exam and laboratory workups. For that reason, a person who has one, initial episode of episcleritis, usually does not need to have a thorough laboratory/radiologic workup done to assess for causes. On the contrary, though, for someone who has had multiple, recurrent episodes of episcleritis, there is more likely to be a systemic disease that is causing the episcleritis as a byproduct. Most commonly, when there is a systemic disease causing the recurrent episcleritis, it is an auto-immune disorder such as lupus, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, inflammatory bowel disease, polyarteritis nodosa, sarcoidosis or Wegener's granulomatosis. However, uncommonly, this can be caused by infections such as herpes zoster virus or syphilis. If these recurrences are mild and infrequent, then it may not be worth your while to investigate these with an exhaustive laboratory / radiologic workup. However, if they are frequent and inhibit your life, then this type of workup may be fruitful in your quest to determine the underlying etiology. If you are diagnosed with one of these diseases, the treatment of this disease can be helpful in reducing the frequency of your episcleritis episodes.
Dr. Dan B. : Does this make sense?
Customer:

Just a moment, taking it in

Customer:

Yes, thankyou. I don't have any of those diseases, to my knowledge.

Customer:

Can it be caused by bacteria?

Customer:

Eyes from front just now
Full Size Image

Customer:

I mean, what treatment should I be considering?

Customer:

And is this 'bruising' pain on palpation usual for scleritis?

Dr. Dan B. : Yes because this can be bacterial usually is idiopathic. It usually responds to flurbiprofen but could require some steroid drops or pills. Yes, this bruising type of pain is very characteristic of scleritis.
Dr. Dan B. : Do you have any other questions about this?
Customer:

No, thankyou, that's great!

Dr. Dan B. : My pleasure. Good luck. 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!
Customer:

Thanks again. Goodbye.

Dr. Dan B. : You're welcome.
Dr. Dan B. : I hope this has been helpful. If so...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.
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