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My eyes water and burn so bad-they're very red and splash my

glasses. My Opt. gave me...
My eyes water and burn so bad-they're very red and splash my glasses. My Opt. gave me Lotemax every 2 hrs. for past 3 days. I also combined artificial tears. No relief at all. My heralogist says I eat too much yeast and that my liver is inflamed causing this eye condition. Have you ever heard of that?
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Answered in 2 minutes by:
11/22/2010
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,443
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick :

Hi. I can help you today.

Dr. Rick :

Never heard of the liver thing......your herbatolgist is off base.

Dr. Rick :

It sounds like you have a couple of things going on. First is allergies, second dry eyes and third blepharitis.

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes is very common, especially after the onset of menopause, and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, then temporary punctal occlusion of the lower puncta, then temporary occlusion of all 4 puncta then surgical ( non-reversable) closure of the puncta.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on you eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have effect you can use over the counter allergy pills such as Travist, dimetapp or zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in a week or so you should have a complete eye examination by your local ophthalmologist.


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Customer reply replied 6 years ago
I never said anything about gunk in my eyes. I don't have that problem. Just burning, red and watering all the time.
Oops. Sorry. I gave you too much of my handout. My mistake.

Forget the yeast/liver link.

I think you are having problems with your normal tear film. Try the lid scrubs outlined above for a few weeks....I am betting you will see an improvement.

Steroids can have serious side effects and I would not be so quick to jump into their use. If the lid scubs and natural tears have not helped in 2 weeks or so I would make an appointment to see an ophthalmologist. I would also stop using the lotemax for now, especially if you are trusting in an optometrist to manage any damage they might cause.
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Customer reply replied 6 years ago
Won't allergy pills just dry out my eyes even more??
Skip that whole part about the allergy pills....I messed up and send you too much information. Just do this part and the tear drops:

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on you eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

I am very sorry about the mix up. :)

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Customer reply replied 6 years ago
Relist: Dr. Rik gave me incorrect information 2 times to the same question-I don't think he even thought about what I told him .
Dr. Rik gave me incorrect information 2 times to the same question-I don't think he even thought about what I told him
Customer reply replied 6 years ago
Will someone else take a look at my problem?
Customer reply replied 6 years ago
Relist: Still waiting for another expert to help me. Please answer.
Thank you.
Still waiting for another expert to help me. Please answer.
Thank you
I will opt out so another ophthalmologist can help you. Sorry I wasn't able to assist you. Have a good day.
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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified

Hello and thanks for your question.

I have read your question including the background associated with your problem, what your herbologist said, and what Dr. Rick has said. In many respects I agree with what Dr. Rick has said, but please allow me to explain what I mean and maybe a different explanation may make more sense for you.

First of all, let me start by saying that to diagnose anyone's eye condition based solely on history is not a complete diagnosis because the examination of the eyes is many times crucial for diagnosis. However, many times the symptoms you're experiencing along with the other history you provide leads to one or two strongly suspected diagnoses as is these case with you.

I think Dr. Rick is right; these symptoms are highly unlikely to be related to your liver and the over-consumption of yeast.

Your symptoms are classic for dry eyes with inflammation. It may seem backwards that your eyes can be dry when there is so much tearing, but the tearing is a reflex in response to dryness that doesn't resolve the problem the way one would think. When there is inflammation in the eyes and/or eyelids, this is usually from what's called blepharitis, although this inflammation can occasionally spill over to the cornea and if it does (would only know this by an exam of your eyes), then treating this blepharitis as I will detail below is usually not enough; essential treatment, but not enough.

The eyelids are key players in making a layer of tears that coats the surface of your eyes called a tear film. The inflammation that is blepharitis keeps the eyelids from making that tear film as healthy as it needs to be and so the eyes dry out. Also because there is inflammation in the tears because of the blepharitis, there are bacteria pooling in your tear film. Often times an antibiotic +/- steroid drop or ointment is used to help kill the bacteria. This therapy is usually only used in a pulse fashion, to start out the treatment and then only used when there are flare-ups, not on a regular basis for most people. However, treating this with a steroid drop for a few days is not enough to treat this entire problem, it is usually just an adjunctive measure combined with the baseline treatment as I state below.

The baseline treatment for blepharitis and what I think you should start doing, is 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 (Sterilid or Ocusoft) or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations 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; often times combining this with the topical steroid helps to bring relief sooner. Also the eyes are still significantly dry during this 3-4 weeks so use artificial tears one drop in each eye, 4x/day. 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. Also you may need an antibiotic/steroid combination medicine to help augment the therapy. If after 3 weeks of diligent treatment you are better, but not completely normal, you may need to see your eye doctor to assess for other causes of dry eyes, as blepharitis is only one cause of dry eye. Many times dry eye patients have more than one cause of dry eyes (Restasis is an excellent treatment for those people with dry eyes because they don't make enough of their own tears). Each cause of dry eyes needs to be appropriately treated for your symptoms to resolve.

Does this help answer your question? I know this was a wordy answer, but it is my hope that hearing these things in a different way may make more sense and be more beneficial to you.

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows for the deposit that the JustAnswer website has collected from you to be credited to me for my help resolving your concern.

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Also, any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated.

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 be examined by your doctor.

Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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