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I have itchy, watery eyes. puffy and this morning had a puss

discharge in corners of both...
I have itchy, watery eyes. puffy and this morning had a puss discharge in corners of both eyes. No real pain or excessive redness. What can I do. Have tried over the counter eye drops and Alegra.
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Answered in 5 minutes by:
5/8/2013
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,636
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
Dr. Rick :

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

Dr. Rick :

Do you wear contact lenses?

Dr. Rick :

Do your eyes feel like something is in them?

JACUSTOMER-nq1eguib- :

no and no

Dr. Rick :

Ok. That

Dr. Rick :

That's good...

Dr. Rick :

I think we can get you feeling better with some home therapy.....

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.


Dr. Rick :

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.


Dr. Rick :

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.


Dr. Rick :

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.

I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.

When your eyes are "dry" and irritated they make more tears....this is the "something is in my eye" mode of tear production, not the "my eye feels fine and I'm making tears to keep things moist" mode. The use of natural tears will help your eye turn off the flood of "something in my eye" tears that comes from your eyes being dry.

Does this make sense?

Dr. Rick :

Also, stay away from drops that say "gets the red out" as these will just irritate things and make your eyes redder in the long run

JACUSTOMER-nq1eguib- :

I have no problems with my tear ducts, the discharge is not thick and like gunk it is more like puss.

Dr. Rick :

I just put the tear duct thing in there to be more complete. You are correct that your problem really isn't with the tear ducts.

Dr. Rick :

From what you have posted, I do not think you require antibiotic eye drops. The puss like stuff you are describing is most likely fibrin and gunk from the inflammation and irritation rather then puss, like you would get with an infected wound in your arm.

Dr. Rick :

If you were to go to an ophthalmologist, I believe you would be told the same thing. If you went to a GP, you would get either antibiotic eye drops, antibiotic pills, or both.......

Dr. Rick :

But, in my town, the GPs and I have an understanding: If they don't treat eyes, I won't treat heart attacks :-)

Dr. Rick :

Does this make sense to you?

JACUSTOMER-nq1eguib- :

No my eyes are not dry they are watering almost continually. do I need to see a doctor for antibiotic eye drops or is there and over the counter drop?

Dr. Rick :

Did you notice what I said about watering eyes?

Dr. Rick :

I do not believe you do not need antibiotics at all.....the above therapy will work, even though it seems low tech.....

Dr. Rick :

There is no over the counter antibiotic drop. If that is what you are convinced you need, you will have to see a doctor. I would suggest seeing a GP as an ophthalmologist will probably just tell you what I have told you.

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

JACUSTOMER-nq1eguib- :

So a natural tears eye drop and the above cleaning will clear my eyes up?

Dr. Rick :

Along with either continued allergy or Rx pills.....You are suffering from ocular allergies, abnormal tear film, probably blepharitis and anterior segment dysfunction, based on what you have told me.....not a bacterial eye infection.

Dr. Rick :

I meant to say OTC allergy or Rx allergy pills.....

Dr. Rick :

Are you still there?

Dr. Rick :

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. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

I guess you have stepped away from your computer. Have a good day and I hope you feel better soon.

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,636
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick
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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,636
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Experience: Ophthalmology since 1994 with Retina sub-specialty interest

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