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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11310
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Every 1-2 months my eyes got red and inflamed. It usually

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Every 1-2 months my eyes got red and inflamed. It usually started out with the eyes getting slightly watery then become slightly sticky with some clear discharge; no pain, no itching, just bright red and the feeling of stickiness, last for 2-4 days then OK again . I've been to my ophthamologist several times but no root cause was identified. I was given Tobradex drops to use for 10 days and come back for re-check. With the drops the redness usually gone so re-check w/ the dr did not show any abnormality, so far unknown cause. This has been going on for a 5 years now, my vision is OK, at 40+, i wear glasses for computer at work (4-5 hrs on computer a day). Don't know why i have this recurring problem, what steps should i take to deal with this. Looking forward to your answer.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.
Dr. Rick :

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

Dr. Rick :

It sounds like you are suffering from an anterior segment/tear film issue. Many times, as we get older, and especially after eye surgery, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.

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 :

This makes perfect sense since it gets better with the drops, but then tends to recur. I think if you do this simple home treatment and thereby address the underlying condition(s) perhaps you will break the cycle and not have these recurrances.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick :

I see that you are offline. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Expert:  Dr. Rick replied 5 years ago.
Let me know if there is anything else you would like to discuss pertaining to this issue.
Customer: replied 5 years ago.

Is prescription drops such as Tobradex not to be used for long term? what are the risks of my continue using it for my condition?

Expert:  Dr. Rick replied 5 years ago.
You can't use the drops forever....the antibiotics will stop working as the bacteria become resistant to it due to continued exposure...also the "dex" part is a steroid, which is has many dangerous issues when used long term. Not to mention that the drops are expensive....
Customer: replied 5 years ago.

I went to my opthamologists 5 times last year, each time with steroidal drop to help ease the symptom but no unsual cause.

I also see my optometrist yearly but so far no unsual anything show up either. I have not have any eyes surgery.

I use tear drops daily, but I notice that teardrops sometimes add to the stickiness instead of helping (I've tried at least 5-6 different OTC tear drops brands), any suggestion?

Expert:  Dr. Rick replied 5 years ago.
I like bion tears, they are not sticky.
I'm sure the steroid drop makes things feel better....but it not treating the problem... it may seem silly (and low tech) but the baby shampoo works.
Don't waste your time with an optometrist on this issue. If things don't get better with my suggestion perhaps you should consult a cornea/external disease specialist since your general ophthalmologist has not been able to come up with a long term solution for your symptoms.
Does this make sense?
I have to step away from my computer for an hour or two but will check back when I return to see if you have any further questions or comments.
Have a great day and I hope you feel better soon.
Customer: replied 5 years ago.

One more question, would you know some cornea/external disease specialist in the bay area near Cupertino San Jose that you recommend for me to see in case i need to see them next? thanks so much for your help, your info are so far very helpful.

Expert:  Dr. Rick replied 5 years ago.
Dr Marks is a cornea specialist in San Jose. Here is his contact information.
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. I would also be happy to continue to answer any more questions you have until we have resolved your concern.
Customer: replied 5 years ago.
Also why is washing the eyelid would help the redness in the white part of the eyes?
Expert:  Dr. Rick replied 5 years ago.
It will help with all irritation around and in your eyes...
I would have discussed pinguecula but you said that your ophthalmologist had not found anything abnormal on exam and, surely, he would have told you if this was the cause of your redness....
Customer: replied 5 years ago.

Thanks Dr, will try washing with baby shampoo. How long should i expect to start seeing an improvement? and can this be done long term? any particular brand of shampoo that you recommend?

Expert:  Dr. Rick replied 5 years ago.
My pleasure. It will take at least 3 to 4 weeks of doing this everyday before you will see things getting better.
I like Johnson and Johnsons...the yellow stuff we all used as kids.
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