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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11414
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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5 years ago my eyelids swelled and my eyes burned and I

Resolved Question:

5 years ago my eyelids swelled and my eyes burned and I could hardly look into the computer for long - I was miserable and diagnosed for dry eyes. I was put on restasis and drops and plugs, etc. Things got better but now 5 years later my eyes still are constantly irritated - usually mildly, but sometimes worse. Rain makes it worse and rain actually irritates my skin too. I'm thinking now it is some kind of allergy. My eyes are good; it's the skin around my lid that gets so irritated. I'm allergic to wool and many shampoos, lotions, soaps. After 3 hours at my friends house with 2 cats and 1 dog my eyes were very bad - not watery or sneezing, just extremely irritated. Do you have any advise for me?
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Well 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 are very common 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, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

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. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

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 your 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 affect 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 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.


Dr. Rick :

You have already been through a lot with your eyes....give the above treatment at least 3 or 4 weeks to kick in....things may get a little worse before they get better as the glands unplug. Don't be discouraged. :)

Dr. Rick :

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Expert:  Dr. Rick replied 6 years ago.
let me know if you would like to discuss this issue further. Have a good day.
Customer: replied 6 years ago.
thanks - I have done the lid scrubs and warm compresses - but not regularly - so I'll make me a chart and really stick with it for 3 weeks. As far as the dry eyes, I have taken restasis and had plugs - all four. I didn't notice that much difference with the plugs . . . and I stopped the restasis 6 months ago and my eyes feel better. I stopped the lacrilube at night and my eyes felt much better. I think a lot of the things for dry eyes were actually making it worse ?? My dr says I have more tears now - getting better. Then I told him I stopped restasis and lacrilube - he was very surprised. Could it be that allergies is the main problem and the things for dry eyes were just irritating ?
Expert:  Dr. Rick replied 6 years ago.
that is very possible.
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