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Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience:  Board Certified Ophthalmologist
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I am having irritated eyes from last year. My opthalmologist

Customer Question

I am having irritated eyes from last year. My opthalmologist says it is blepherites. She has prescribed tobradex 4 times in the last one year. The irritation and redness go away only to come back in 1-2 months. It switches from eye to eye. It starts with my eyes looking tired and progressess to eyes or eye getting very red and sensitive to sunlight and feeling like there is dirt in my eye. My family doctor told me that it is not a good idea to take the above gel repeatedly. I am trying to find a homeopathic remedy. Please tell me what to do.
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. Stevens replied 8 years ago.

Hello there

what else are you doing besides using the medicine when prescribed?? using heat packs, wipes?

Customer: replied 8 years ago.
I am using 'lid care' solution to clean my eyelids every morning. I don't have very much discharge. Only very dry discharge. I also feel my eyes being gritty and dry so I am using artificial tears a few times a day.
Expert:  Dr. Stevens replied 8 years ago.

hello there

the tobradex has a steroid and it can cause cataracts and glaucoma. I typically use this when there is a component of posterior blepharitis or meibomitis. It is the most common cause of sore, gritty eyes. Lets talk about the eye a bit. You may or may not know, the tears that help lubricate the eye are made of 3 different components. One is the actual watery component made in the lacrimal gland under your brow. It is where the water is made and if you get something in your eye or your eye is irritated, this gland goes in to overdrive and causes tears to be produced excessively. Second, is the mucous component and rarely do patients have a deficiency of this (often there seems to be an abundance). Third is the oily component of the tears and this comes from the glands at the base of the lashes, called meibomian glands. Those glands are often the culprit in someone with your symptoms. If those glands drain poorly, often as a consequence of aging, sometimes associated with rosacea (cause of adult acne), the tears are unstable and the eyes become irritated and can tear.

Unfortunately, unless the glands become more functional, the situation never gets better. So the best treatment for this situation is the faithful and consistent application of heat packs which help the oils get moving. We are not talking a warm washcloth, that gets cold quickly, rather a heat pack that applies constant heat for at least 3-5 minutes at a time. If this does not provide good relief, your doc may consider an antibiotic like doxicycline, tetracycline or minocycline for 6-8 weeks or longer. These help the glands drain better. Also, use lubricant drops a few times a day, Refresh Celluvisc is a wonderful one to try. This regimen will help you make more stable tears and reduce the surface irritation and help make your eyes feel better, and in time the symptons will improve. If you actually have lots of mattering and discharge, you can get a prescription of erythromycin ointment which is much more mild and has no seteroid to worry about. Take care and let me know if there is any more questions or concerns.

Sincerely ***** *****

Customer: replied 8 years ago.
Should I continue the lid care every day? I have very dry skin. I don't have rosaesia but had acne 2 years ago and is gone now. I am 49 yrs old. Where can i get these hot packs?
Expert:  Dr. Stevens replied 8 years ago.
I would cleanse the lids daily, using either teh commercial product you have or getting baby shampoo and mixing with water and using it on a washcloth to cleanse the lashes and lids. Heat packs can be bought at walgreens walmart, rite aid and can be reused. Regards ***** *****
Customer: replied 8 years ago.

If I don't go to the specialist is there any danger just trying these heat packs first even if my eye is very red?

Expert:  Dr. Stevens replied 8 years ago.

It is typically considered acceptable to try the regimen I suggested and see how you do, the only other thing the eye doc would consider is to add the antibiotic ointment. Regards *****

Customer: replied 8 years ago.

but how would the antibiotic ointment will drain the glands better?

Expert:  Dr. Stevens replied 8 years ago.
It does not, sometimes the lashes will have microscopic evidence of infection and this needs treatment with the antibiotic. If you dont have a whole lot of discharge, mattering, eyes being glued shut in the morning, youwould not necessarily need the ointment at this time. Regards
Dr. Stevens and other Eye Specialists are ready to help you
Customer: replied 8 years ago.
My eyelids don't look swollen or red which seems to be a symptom of clogged glands. it is only the white of the eye that is red. Again, it changed from eye to eye in the last couple of recurrances
Expert:  Dr. Stevens replied 8 years ago.

if you have any more questions let me know, regards