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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11365
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Three weeks ago, I had my first panic attack (at age 40 no

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Good evening,
Three weeks ago, I had my first panic attack (at age 40 no less) and was told I had anxiety disorder. I was prescribed 20mg of celexa and .5 mg of xanax up to 3 times a day as needed. Almost immediately after I begin taking the medication, I've noticed I've become very sensitive to light. After 3 days, I stopped taking the celexa and this week I was prescribed Zoloft because the doctor said I might react to it better. I began taking Zoloft on Tuesday.
The light sensitivity has come and gone. I've gotten every blood test there is, a CT scan, as well as an EKG, and all test come back normal. I've also seen 2 differenct opthomologists, who told me that, outside of a case of "dry eye", which has been treated with eye drops, that my eyes are healthy.
This light sensitivity, which I did not have before my panic attack is almost unbearable but nobody seems to be able to give me a reason. My opthomologist thinks its the antidepressant, but my doc said I'm responding well to the AD (after 2 days)?
What could be the cause of this?
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
Dry eye can cause sensitivity to light. I am glad to hear that two different ophthalmologists have examined you and found your eyes to be healthy, with the exception of dryness. This rules out the majority of significant issue that might have been the cause of your symptoms.
At this point, since your doctor feels that the AD is already showing signs of being helpful, I think you should continue to take it as directed.
Now. Concerning your eyes....I think that there is a home therapy that you can do that will make them feel better. Here is some information on what to do (some of the conditions discussed do not apply to you...just read the treatment part.):
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 and the use of a medication called restasis to improve your 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 is 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.
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.
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. 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
Customer: replied 4 years ago.

Thank you for your answer!

So you think it might be an allergic reaction, more so than the side effects of the medicine?

I think so.
Try the home therapy and continue taking the meds. Hopefully, in three weeks both your eyes and your panic attacks will be much better :)
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
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