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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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hi, i am a 36 years old female. i have a severe dry eye, red

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hi, i am a 36 years old female. i have a severe dry eye, red almost all the time. my ophthalmologist suggested i test for arthritis rheumatoid. my mum has it. i have several joints pain. one of my arms sometimes gets numbed during night. on another regard, i have red rashes that appear and very persistent to vanish though i use a medical ointment that contains cortezone. these rashes appear to be coming from under skin and have no protrusions on the skin. i have a small lump behind my left ear. my question could i have any autoimmune disease that combines all these symptoms? is it for granted that i have rheumatoid?

Doctor DanB : Hello and thanks for your question. Are you available to chat?

hi, yes available

Doctor DanB : Yes, it is certainly possible that autoimmune disease is causing your dry eyes as well as your other symptoms. I do think getting some autoimmune laboratory workup tests would be useful for you. However, if you have not had a thorough dry I workup by a cornea specialist, I would recommend this. The reason for this is there are many causes and reasons for a dry eye or a dysfunctional tear film syndrome. Let me elaborate...
Doctor DanB : The front of your eyes has a layer of tears coating it called the tear film (this layer of tears is different from the tears you produce when you cry or have an irritation in your eye). The tear film normally provides a healthy environment for the front of the eye (the cornea and conjunctiva) and also contributes significantly to clear vision. When the tear film is unstable or unhealthy (there are many reasons why this can be so, which I will get to) it becomes dysfunctional and can produce uncomfortable symptoms and blurry vision. This is called a dysfunctional tear film.People with a dysfunctional tear film can have multiple different symptoms ranging from redness, dull aching or pressure, sharp or stabbing pain, morning tearing, burning, and often eyelash mattering to tearing, stinging, itching, burning, a gritty/foreign-body senstation or just intermittent vision fluctuations. Their symptoms sometimes get better as the day progresses or they can often times worsen throughout the day, but they can get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving. A dysfunctional tear film can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to a dysfunctional tear film. Allergies in the eyes can also contribute (and or make worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Any kind of eye surgery can actually cause and/or worsen this Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out.
Doctor DanB : Because there are numerous reasons for dry eye, if not all the reasons that exist in one patient are treated, it can seem as though the ones that are being treated are providing no benefit. Does this make sense?

it makes perfect sense, actually my eyelids every now and then get inflamed and swell,,, also if i cry they look as if they r sacs or pouches filled with liquids


nevertheless, i am too worried about rheumatoid

Doctor DanB : That's why I think the lab work up is a good idea. Do you have any other questions about this?

thank you very much

Doctor DanB : My pleasure. Good luck. Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied. My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!
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