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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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My daughter has had red, itchy eyes for 8 weeks The Dr. gave

Resolved Question:

My daughter has had red, itchy eyes for 8 weeks
The Dr. gave her Erythromycin Ophthalmic Ointment
(thinking it was pink eye) there was some discharge in the corner of her eye.
It did NOT help, so they tired AK-Poly Bac which seemed to help for about 1 week.
The red, itchy eyes got worse and her vision went to 70/60 so they thried Fluorometholone 0.1% (3 times a day for 1 month)
The symptoms are worse...
Now they gave her Pataday (olopatadine Hydrochloride 2% solution)...
Nothing is helping ....
They said it is episcleritis....
Could this be a WRONG diagnosis?
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. James replied 8 years ago.
Is she currently being seen by an eye doctor?
Is this in one eye or both eyes?
Does she have any discharge?
Customer: replied 8 years ago.
It was her left eye until 2 weeks ago... now both eyes

Yes, she is seeing a Dr. (who seems very flippant and just says "well try this and schedule an appointment for 3 weeks out"

Her vision has dropped to 70/60   Dr says that she can't give her a perscription until this clears up... it has been over 6 weeks now.
Expert:  Dr. James replied 8 years ago.
6 weeks weeks is a long time for pink eye or other conjunctivitis. It does appear that the symptoms are due to ocular surface inflammation. A common cause of this is blepharitis. Bacteria such as Staph are colonized on the eyelashes. People can develop an immune response to the toxins produced by the Staph.

Treatment consists of lid scrub with baby shampoo and topical steroids. If possible, a second opinion may be helpful, especially since the current doctor is not confident with his diagnosis or not willing to explain his thought process.

Remember to press the green accept button. It was a pleasure helping you with your question. Best wishes to you and your daughter.

Disclaimer: Information provided is for educational purposes only and does not establish a patient-physician relationship nor substitute for a personal consultation with a physician.
Customer: replied 8 years ago.
About the same time that her eyes became a problem, she also had a rash above her upper lip, beneath her nose... this was itchy with small bumps....

I brought this to the attention of her regular doctor and asked if this could be from scratching the itch and then touching her eye..

The Dr didn't think so... but suggested that we put hydrocortisone 1% cream on the irritated area...   and said I should see the Eye Dr. for the eyes... (which we did). I brought this same question up for the eye Dr... who did NOT think the two were related.

The rash on her face has NOT cleared up as of today....

Do you think that these two things can be related?
Expert:  Dr. James replied 8 years ago.
It is not likely related. A pink eye can sometimes be caused by HSV (herpes simplex virus - though not the one commonly associated with an STD). It can cause a pink eye but with skin blister on the eyelids and around the face.

You can ask the ophthalmologist if he think HSV is a possibility.
Customer: replied 8 years ago.
The Eye Dr. is calling this Episcleritis...

But, there is NO eye pain associated only itching...

The symptoms do not match...
Expert:  Dr. James replied 8 years ago.
Itching is more a symptom of ocular allergies. The Pataday and FML should help with that. If there are signs of blepharitis (which your eyedoctor can see using his magnified view), then lid scrubs to reduce the bacterial colonization is recommended.
Customer: replied 8 years ago.
How long is it safe to use FML (Flurometholone)? She has already used a full bottle... And is on her second one now. Is it safe to use both FML and Pataday together?

I'm tempted to stop the FML (it has NOT made any positive changes)
Expert:  Dr. James replied 8 years ago.
FML is a steroid. Longterm use can cause cataracts and increase eye pressure. FML is a weaker steroid compared to the other available eye steroid drops.

It is safe to use FML for an extended period of time as long as an ophthalmologist is monitoring for the side effects. It is safe to use Pataday and FML together. If you choose to stop the FML, I recommend you notify your daughter's doctor first.

Please remember to accept if my answer has been helpful.
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