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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11420
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Last Month (Sept 14th) I had a problem with my left eye. A

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Last Month (Sept 14th) I had a problem with my left eye. A trip to the doctor diagnosed small tears on the eye from perhaps a dry eye or irritation from a sleep mask I was using. Antibiotic drops were given and the problem was resolved.
I have a new pain in the same eye today. Very different from first. The first was swollen and teary. This is painful with a red lower eyelid that looks like I applied a red eyeliner along the bottom lash. Also have a headache, which feels similar to a sinus headache. Can you help?
Dr. Rick :

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

Dr. Rick :

I'm glad to hear that you were able to get to the bottom of what was causing your pain the last time we spoke and that things responded well to treatment.

What you are describing now sounds like an anterior segment/tear film problem. This would go along, in part, with your recent possible diagnosis of dryness of your eyes.

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.

If things don't show some improvement in a few weeks I'd suggest you have your ophthalmologist take another look at you. Remember...the above home therapy is not an instant fix -- so give it time to work :-)

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Customer: replied 5 years ago.

Thank you for your response. I uderstand the scrub but if it is due to a dry eye condition should I be using nightly eye drops? If so, what is your recommendation? Does the red line under the eye indicate pink eye in any way? I don't want to spread anything around. The whites of my eye are completely white. One additional complicating factor is that I am having major surgery next week and will be unable to drive for 6 weeks. Should this be addressed before that or should I wait a day or two and see? Surgery is next Wednesday.

Any of the artificial tear will work. I like Bion tears but they are kinda pricey....
No. I don't think you have pink eye so don't worry about giving this to all your friends and family. No need to lock yourself in the basement :-)
This should not impact your surgery in anyway. I would continue with those plans as scheduled.
And. Best of luck on the surgery. I hope it goes well and you heal up fast.
Have a good evening.
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