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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11360
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I was on accutane for 43 days & then I started to have eye

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I was on accutane for 43 days & then I started to have eye issues so discontinued the pills. I was taking 80 mg per day. My one eye has a pressure behind it that is contant even when I shut my eyes. It is like a nerve or something? I always have to close the eye completely when I am outside as the wind is unbearable. I have been using an eye gel for very dry eyes for 1 week & have been off accutane for 1 week without any relief. Have you ever heard of this & will it go away? I have been checked out by an optomotrist & opthalmologist but they just state this is dry eyes? It seems like something way more to me. Can you help??
Dr. Rick :

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

Dr. Rick :

I am glad that the optometrist and ophthalmologist did not find anything serious wrong with your eyes. I do agree with you, however -- it does seem like you are suffering from more then just the routine dry eyes.

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 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 :

If you do the above home treatments, as well as continuing to use the tear replacement drops you should feel better in a few days.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick :

I see that you are offline. We can use the Q&A system to 'text message' each other. An email will be sent to each of us every time something is posted to this thread.

Let me know if there are there any other concerns or issues you would like to discuss on this topic.
Customer: replied 6 years ago.
Have you ever heard of the permanent damage to the eyes from accutane?
I do not believe that you have to worry about irreversible damage.
Customer: replied 6 years ago.
Okay, just concerned as I have been off accutane for 1 week & no relief. Do you think this could be unrelated to the accutane?
I have never heard of symptoms like yours that have been traced to accutane use. I agree with your ophthalmologist that you are suffering from an anterior segment/tear film issue.
The best way for you to make sure about any connection to accutane is to is talk to the MD who prescribed the accutane to see what she thinks concerning these side effects
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