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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11313
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have swollen eyelids following years of contact lense wear

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I have swollen eyelids following years of contact lense wear and allergic conjunctivitus. What can I do ? Eyes get very dry in the night.
Dr. Rick :

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

Dr. Rick :

Are you still wearing contact lenses?

Dr. Rick :

Hi. Welcome to chat. Can you see what I am typing?

Customer:

No I stopped wearing contact lenses and had lasic surgery in 1999. Very successful. Still no glasses!


Customer:

Yes i can see what you are typing


Dr. Rick :

That is great! LASIK surgery is a very well known cause of dry eyes so I wouldn't be surprised if that is part of what is going on with your dry eye issues.

Customer:

Are you there?

Really? I didn't know Lasik caused dry eyes

Dr. Rick :

It is also possible that your eyelid swelling is making your eyes more dry by affecting the way that your tears are spread across your eyes, much like how old windshield wipers cause smearing on your car.

Dr. Rick :

Yes....it sure can :(

Customer:

Yes i think at night the swelling causes my tear ducts to get blocked. Most creams make the swelling worse, not better. One opthalmologist suggested steroid cream but I don't like the idea of that.


Dr. Rick :

In any event, it is not unusual for the cause of chronically swollen eye lids to be caused by a number of issues, all working together to cause problems. You have already mentioned having dry eyes and allergies but I would bet that you also have blepharitis.

Customer:

What is that?


Dr. Rick :

I agree with not rushing to use steroid creams as they can have all sorts of side effects.

Dr. Rick :

Here is some information on what this is and how you can treat it at home -- without surgery :-)

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 :

I'd give this a try for three weeks or so and see how much things improve. If you are still having problems you might want to consult an exterior disease/corneal specialist and/or consider eyelid surgery if indicated.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Just as aside isn't it amazing that in today's day and age we can be chatting with you in France and me in Wisconsin and we might as well be in adjacent rooms? :) What will our grandkids world be like?

Dr. Rick :

Also, if your eyes are really dry at night you could try using some ointment, such as Refresh PM or lacrilube. The only problem with this is that these ointments tend to significantly blur your vision....

Dr. Rick :

Please remember the top 3 ratings are positives [Excellent service is my goal] and this is how we are compensated. Rate my answer when you are satisfied. If you feel the need to rate low, please stop and reply to me via the REPLY TO EXPERT button with the issue you have. I will be happy to continue further and do everything I can to provide you with the service you seek.

Otherwise, a high positive rating is very much appreciated, bonuses are great, and find me anytime for follow up.

Let me know if you have further questions.

Dr. Rick :

I see that you are typing and that could mean a couple of things: 1. you are actually typing or, 2, the chat system has frozen up. I'll give it a few more minutes and if I've not seen anything from you I'll switch over to the Q&A system. That system works a lot like 'text messaging' but, unlike the chat system, it almost never freezes up. We can continue to work on your question there. :o)

Customer:

ok


Customer:
Customer:

It seems that certain food like wheat make the swelling worse, so I am trying control my diet too.


Dr. Rick :

That seems like an excellent idea and any sort of allergy, even to food, can make swelling of the eyelids worse.

Customer:

OK thanks Dr Rick, I appreciate your help.


Dr. Rick :

My pleasure. Have a good day :)

Dr. Rick and other Eye Specialists are ready to help you
I hope your eyes feel better soon.