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I have dry eye syndrome, but I think I have allergies now. I…

.I have dry eye...

.I have dry eye syndrome, but I think I have allergies now. I took a steroid/antibiotic twice, but as soon as I go off, the symptoms come back, and now instead of my eyes being very dry, they are watery. And I use Restatis.

Doctor's Assistant: When was the last time you had your eyes checked? In general, how has your vision been lately?

I have been being treated by my eye doctor and he says that my "eye health" is fine, but the eyes keep getting redness, itchiness and pockets on my cheekbones. I have even taken Claritin and Sudafed with the Restatis, and a prescription allergy eye drop. Nothing seems to be helping.

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Customer reply replied 12 months ago
Will I be able to receive an answer soon? I will be leaving the office in one hour. Please let me know if you need any additional information about my condition from me.
Answered in 4 hours by:
7/21/2017
Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Eye
Satisfied Customers: 59,634
Experience: Medical Doctor Trained at a Top Academic Institution
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Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

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is your mouth dry too?

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Customer reply replied 11 months ago
No

what meds do you take?

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Customer reply replied 11 months ago
I only use Restatis eye drops and I just started with the Olopatadine eye drops 3 days ago, once a day. I started Zyrtec a month ago, and just added Sudafed to it. My "eyes" are fine, not blood shot or anything. It's around my left eye mostly that it's red, a little scaly, a bit itchy, and runny eyes. Then I get what look like mylar festoons on my cheekbones, left side bigger. I have no idea what causes them. They come and go.
Customer reply replied 11 months ago
I am waiting for a response to my last answer.
Customer reply replied 11 months ago
could someone please respond. Thank you.
Customer reply replied 11 months ago
Why haven't I gotten an answer to my question? It is now July 24th and I paid the money for a professional response. Please refund my $23 immediately, or have someone answer my question. Thank you.
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,160
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 premium services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

I do not recommend steroids for this issue....

Let me explain:

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. If this does not give relief then your eyelid opening can be made smaller with surgery (lateral Tarsorrhaphy).

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?

Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)

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.

Dr. Rick MD FACS

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Customer reply replied 11 months ago
Thank you for your thorough reply. I believe I have all 3 of those conditions you describe. I do not want any sort of surgery at this point, but ironically I just started doing the lid wash with baby shampoo two days ago, so I will see if that starts to help. I don't really like the artificial tears because it seems like they don't do anything, but maybe I just need to be consistent with them. I have been taking zyrtec or Claritin daily. That does seem to help a little bit so I will continue to do that. The moisture in my eyes is thin and clear, it is not thick. When I first got the dry eye syndrome 3 years ago, I would have the clear thickness in my eyes, but it seems to be just regular tears now. I do use restatis daily and will continue to use that.

Sounds like you are on the right track......

Remember, this treatment takes time....be patient :)

Have a great day.

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

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,160
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
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