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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 13038
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a 60 year old male. I had unprotected one time 3-4

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I am a 60 year old male. I had unprotected sex one time 3-4 weeks ago and no sex since nor any prior. Last week, I developed itching on the glans penis and that evolved into painful urination for he past 4 days. I also developed what I thought was, as did the APN, pink eye 6 days ago...for 5 days I was treated with antibiotic eye drops, but with no relief...it is now spread to both eyes and the itching, burning, grainy feel in the eye and some eyeball discomfort is getting extremely uncomfortable - tough to make it thru a day. I just took an 8-pannel STD test, but results are not available for 3 days. What can I do for the eye problem right now until a diagnosis is made and a treatment plan developed? Thank you.
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D. Love replied 11 months ago.
It will help if you could provide some further information:
Which eye drops were prescribed?
Did the APN also evaluate the burning with urination beyond ordering the STD panel?
Are you scheduled to be seen by an Ophthalmologist?

Customer: replied 11 months ago.

not sure if this went thru...tobramycin ophthalmic solution .3%. I did not mention the STD possibility - embarrassed to do so. I tried the solution as directed for 5 days with no results, actually worse (crusting in AMs, itching and burning all day, discomfort to the eye ball). Went thru a different vendor for a STD-8 panel test (Quest), but results will not be ready for 3 more days and I am not sure my eyes can take it. Thanks

Expert:  Dr. D. Love replied 11 months ago.
Are you scheduled to be seen by an Ophthalmologist?

Customer: replied 11 months ago.

No...have not done that - would they be able to prescribe medicine to help relieve the symptoms, (root cause too?) even though the oral drops did not help?

Expert:  Dr. D. Love replied 11 months ago.
Thank you for the additional information.

There are several issues to consider in this situation.

I ask about which antibiotic eye drips to be certain that it was one of the recommended antibiotics, and the tobramycin is recommended. The most likely cause of a conjunctivitis (the medical term for pink eye) that does not respond to a good antibiotic is a viral infection. There are actually several types of viruses that can cause conjunctivitis. Most of the viral infections are caused by the viruses that cause colds, and will have a similar duration, usually a few days or so. However, a few of the cases of conjunctivitis can be caused by a virus that causes a nastier infection and will usually persist for several weeks. (I actually had this myself a few years ago.) The only way to properly diagnose whether this type of viral conjunctivitis is present is to be seen by an Ophthalmologist, which is why I asked whether you are scheduled to be seen.

I would note that it is possible to develop a conjunctivitis related to gonorrhea or chlamydia as part of infection elsewhere. Although the STD panel may take several more days to return, the Ophthalmologist would be able to determine from exam whether this is a concern. It is also important to note that the statistical likelihood of infection from a single encounter of unprotected intercourse is low, so it is far more likely that this infection is not due to one of the STDs, but I mention it as a possibility.

Therefore, the next step that should be done is to arrange for an evaluation by an Ophthalmologist. If you (or someone else in your family) are already established with an Ophthalmologist's office, then you can call the office directly and they will probably be able to work you in. If you are not established, then it may be necessary to get your APN to call and arrange a rapid evaluation.

As for the original question of what can be done to help ease symptoms until you can be seen, there are several interventions to consider. It may help to apply very warm compresses to the eye. I simply used a wash cloth soaked in very warm water, as this can be folded and form fitted to cover the eye. You also can use cotton balls or paper towels to wipe any crust off the eye. It may be soothing to place artificial tears into the eye, which may ease some of the grainy feeling in the eye. It also would be appropriate to avoid placing any other things into or around the eye, such as contact lenses, etc. Anything that is involved in treatment (wash clothes, cotton balls, etc,) should be assumed to be contaminated and kept from contact with anyone else (family, friends, etc.).

It is also appropriate for you to be seen fort he burning with urination. While an STD is the most worrisome for you with the recent sexual encounter, there are other infections that can cause such symptoms, the most common being a prostatitis, and a physical examination would be the best indicator of whether one of these infections is present.

If you have any further questions, please let me know.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 13038
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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