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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11363
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have an eye fog problem in my right eye. I am 58, male, no health issues, no meds. I wear rigid gas permeable
contact lenses, and have for about 35 years; I have keratokonis in my left eye which requires a special "feather
touch" lens which brings my vision to, I am approximating, 20/80. My right eye is 20/15 with a normal RGP lens. My
eyes tend to be dry, which I understood was a side effect of the serious acne I suffered as a teen.
My right eye is usually foggy when I wake up in the morning. If I put a drop of peanut, jojoba, or corn oil in the
eye it becomes cloudier, but in about an hour it clears up completely, especially if I've been in the shower and have
splashed water in the eye. I figure the water disperses the oil which one drop is too much for the eye. A drop of
contact lens comfort solution works just as well to disperse the oil.
If I am out and about, such as biking, walking, driving, actually using the eye, there is no fog problem, and the
activity will slowly clear up an existing fog. If I have no fog, lying on my back will often bring on a fog. If I
have put a drop (which is too much) of oil in the eye lying on my back will clear up the fog caused by too much oil.
If I am under pressure, such as cooking an elaborate meal in the kitchen, or doing intensive work on the computer,
that will sometimes bring on a fog; the fog diminishes when I relax.
On a normal day I can clear up my morning fog with oil and water, go about my activities, but around mid-afternoon
the fog returns. If I put a drop of oil in the eye followed by a drop of comfort solution, that will clear it up
over the course of about two hours. I figure it takes that long because the clearing of oil and solution are
hindered by the rigid contact lens.
Will you please suggest what I can do.
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, for all sorts of reasons, 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 :

Does this make sense to you?

Dr. Rick :

Please remember the top 3 ratings are positives and Excellent service is my goal. Your positive feedback is how we are compensated. If you aren't 100% satisfied, just click "reply." I will be happy to discuss your issue in more depth and do everything I can to provide you with the information you require.

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Let me know if you have further questions.

Customer: replied 5 years ago.

Hi Dr. Rick

Thanks for the detailed answer; I've copied it to a notepad file and will refer to it.

One more question: I'm finding that when I generate tears by much yawning the tears wipe away the cloudiness at least as effectively as the oil. What, in your opinion, is the over-the-counter artificial tears product that most closely approximates natural tears?

Thanks! I will check back on this page

Although they can be a bit pricey, Bion Tears are very good.
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