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My eyes no longer focus at the same time. it makes reading…

Customer Question
My eyes no longer...

My eyes no longer focus at the same time. it makes reading difficult. sometimes if I am in a car, it's better to keep my eyes closed

Doctor's Assistant: Thanks. Can you give me any more details about your issue?

Normal size print is the hardest, if I am reading a book, the bottom of the page is the hardest. I am also using a magnifying glass for some ptint

Submitted: 2 years ago.Category: Eye
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Answered in 56 minutes by:
1/31/2016
Eye Doctor: Dr. Rick, Board Certified MD replied 2 years ago
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,252
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with additional services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

How old are you?

Do you were glasses or contacts?

How long has this been going on for?

Do you have any other ocular symptoms or problems?

Do you have any other medical problems or take any medications?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

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Customer reply replied 2 years ago
I am 60 yr old, and have noticed the problem probably since 12/15. my medications have been the same for years. I have no other eye problems. I have diabetes type II controlled by medication and diet. my A1C was 6.1. I regularly see my PCP. I have kidney stones and neuropathy, and have appointments with my PCP, urologist, and neurologist within the next 2 months I am clinically depressed and on Effexor. I wear glasses with progressive lenses .
Eye Doctor: Dr. Rick, Board Certified MD replied 2 years ago

Thank you for that additional information.

I believe I know what is going on. Please allow me to explain:

It sounds like you may be suffering from dry eyes and tear film problems.

Dry eyes can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to dry eyes. Allergies in the eyes can also contribute (make dry eyes 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). 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. People with blepharitis have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.

Because blepharitis is so under-diagnosed and the treatment for it is relatively benign, you might consider starting this treatment, while concurrently continuing artificial tears. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.

It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.

Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.

If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).

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. If you've tried these recommendations and still don't feel better then you should consider seeing an ophthalmologist for a dry eye evaluation.

Does this make sense to you?

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'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.

Dr. Rick MD FACS

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