Eye irritations I have been having for quite some time

[Ryan_1577]

The problems I have been having all began a couple of months ago. When the problems first began, I had this constant feeling like there was a foreign object in my right eye, so about after five days of this I went to the optometrist. When I went there, I was told it was just eye allergies, and he gave me a steroid, and another eye drop called patanol. I took this for about two weeks or so, and then my allergies and problems went away. Then a month or less later, my allergies and symptoms came back, this time even worse; now in addition my eyes where itching a lot, sometimes felt sore, felt like pressure is behind them, and a general feeling of discomfort (sometimes i get this feeling like their just out of place). So just nine days ago last Monday, I went to the optometrist again (same office, different doctor). This time I was told again it was probably just allergies, and just given one eyedrop, called elestat. He told me then it takes about three days to start working, and now nine days later my eyes are literally bugging me all of the time, even when I take them as instructed, and my eyes are bugging me so much due to this to the point where It takes me about 3-4 hours just to fall asleep. A new symptom that has emerged in the last few days is increseased redness in my eyes, mostly at night.  

So, I am uncertain of what I should do beings that I was just there last week. Is it likely that its allergies and that I just was not given good eye drops for my personal case, or is it possible something more serious is going on that both optometrists missed in the exam?

[Forum-OD-MP]

it is much, much more likely that this is still allergies and that elestat is not doing it for you.  hardly any *serious* eye condition causes the symptoms you describe.  i am personally not a big fan of that drop (elestat), i dont think it works very well.    

i myself am very much like you.  i have *heavy* ocular allergy to the point of madness sometimes.  extreme itching, redness and watering during 4-5 months of the year.  patanol does pretty much nothing for me.

go back (or call them) and tell them the elestat is not working for you.  if you were my patient i'd put you on ALREX.  thats what i had to do for myself...

alrex is a very mild steroid (the mildest?).  its FDA approved for long term use, and is the only steroid approved for use in allergies.  start using that 4x/day for awhile and i bet you feel much better.

[Ryan_1577]

.....now that you mention it, Alrex is the steroid that the first optometrist put me on, I didnt list the name before because I forgot the name of it. So as I said, the first optometrist instructed me to take both alrex and patanol; at first he told me to take the steroid four times a day and the patanol two times a day, then after that I took both the steroid and the patanol two times a day; this did a pretty good job during the first time I had the symptoms. And I also forgot to mention in my first post, that in-between the first and second time I went to the eye doctor, I had just called the place and told them my symptoms came back, and then they prescribed me just Patanol (didn't actually go in this time, just picked up the prescription from the pharmacy), that time not along with the steroid. So I took patanol alone for a while, it didn't work much, then I went again and got the elestat, which has done nothing for me (the first optometrist I went to acted like the Alrex is only temporary, while he mentioned some people are permanently on patanol, which Is why I think he only prescribed patanol in-between the two visits). So should I try and get alrex and patanol again, or just alrex for this?

[Ag-i-doc]

this is all open for debate as to whether or not you need alrex or patanol or both.  lots of eye doctors are kind of "scared" of rx'ing long term steroids, b/c of the risk of cataracts & steroid-induced glaucoma.  with the newer generation steroids like alrex and lotemax that is not nearly as common.  they are specifically designed *not* to cause steroid-induced intraocular pressure spikes.  but technically it is still more of a risk than putting a patient on patanol, so most docs still prefer the patanol or its competitors (optivar, zaditor, elestat, allocril, etc).  and indeed *most* of the time patanol does the job for *most* allergy patients.  its a good drug.  the most commonly rx'd ocular drug ever, i think.

but for someone who is on an antihistamine and is still getting no relief (like you), or for someone who has recurrent/chronic allergy symptoms (again, like you) its my opinion and it has been my experience that alrex is one of the only things that gives true relief.  yes, there is some fairly miniscule chance that long term alrex use could cause glaucoma or early onset cataracts, but sometimes the relief is worth the risk.  thats obviously a descision you and your doc have to make.  and maybe they'l want to check your pressure periodically to make sure you're not developing glaucoma.  unlikely in my opinion, but technically possible.

if you were my patient i wouldnt bother with the patanol.  you've had previous failure going that route.  i frequently do exactly as your other doc did (alrex 4x/day then patanol 2x/day with alrex 2x/day, then eventually only the patanol).  but when the symptoms COME BACK as fiercely as you are describing, then i go with 4x/day alrex until the patient feels better.  then i just have the patient use it less & less.  4x/day for awhile...say 6 weeks.  then 3x/day for awhile, then 2x/day for awhile...if you have more symptoms, go back up to 4x/day.  if you have less symptoms, go down to 2x/day or once/day or skip a few days.

thats my take, anyway.  good luck

[Ryan_1577]

So do I really need to go in for another exam, beings that I was just in and they will probably just say its allergies again, or should I just try and call and tell them elestat is not working, and say I specifically want to be prescribed Alrex and patanol? I mean, I don't want to go in for another exam again unless I really need to, and I also don't want to go in and then just get prescribed another eyedrop like elestat that won't work for me. So since you are suggesting I have these two specific eyedrops (alrex and patanol), would you say it would be best for me to call and ask for those two eyedrops, rather than go for another exam?

[Ag-i-doc]

i guess i'll never tell anyone here in this forum *not* to go get seen.  but IMO its probably uneccessary.  try calling and asking for the alrex rx.

[Ag-i-doc]

and again, i wouldnt bother with the patanol...

[Ryan_1577]

I just have another question regarding this..... earlier this night my eyes where feeling like I had gotten something in them, so I got some paper towels, wet them, then wet my eyes with it and then my eyes starting feeling worse later, even a bit worse than they usuually do; now they feeling really loose and like they are out of place or something, and they also feel heavy. Off and on, I have been putting water in my eyes, especially if they get really sore (sometimes it will help if they are really sore, and sometimes it doesnt), although lately they seem to just make things feel even more weird. Is this just because the allergies are reacting to the presence of water in my eyes? Just wondering why the allergies have been starting to feel worse whenever I put some water in my eyes.

[Ag-i-doc]

this is my opinion:

but i think putting water in your eye is like licking your lips.  it doesnt really help much, and kind of makes it worse in the long run.

[Ryan_1577]

Well here is an update on the situation.... I decided to just go ahead and get another exam today, so I went in and told the optometrist about all of my irritations and symptoms (all of which I have described on these forums), and specifically asked if anything else was wrong besides allergies and he said no. Reading through my chart and seeing I had been prescribed Alrex and Patanol in the past, he prescribed those two eyedrops to me again. So tonight, interested to see if Alrex would work alone (which he, like you, said it probably would), I took only the Alrex and not the patanol. Then suddenly a couple of hours later (probably 2 or less), my right eye (which is actually the eye that has been predominantly affected by the allergies: most of the time only my right eye bugs me a lot, but sometimes both will, and on occassion only the left will, but I did put eye drops in both eyes and my left eye does not have any pressure build-up, only my right one does) starts feeling very tense and I can feel a lot of pressure in my right eye. I read through the paper that comes with the Alrex, and read that increased intraocular pressure is one of the adverse reactions that can possibly happen when taking Alrex. Now this is most certainly not the first time I have experienced pressure build-up and discomfort because of it (and I also have had instances where pressure will build-up in both eyes, but again, it ususally only builds up in the right eye when it happens), but because of the fact that that eye is experiencing a lot of pressure build up instead of some relief finally.... it seems Alrex, at least at this point, is not helping the eye (it may have helped the left eye, or that eye may not be irritated or experiencing any of the symptoms since it doesn't most of the time when compared to my right eye). So I have some questions: could this pressure buiild-up be unrelated to Alrex and be caused by something else (could it be that I am just experiencing pressure like before, and that Alrex is not causing it, but also not doing anything to help it)? Or does it mean that it is caused by the Alrex, and I am having a bad reaction to it (although again, since I put it in both eyes and only one is experiencing pressure, this doesn't make sense, to me at least). What, in your opinion, is most likely causing the pressure build-up (remember it's building up in the eye with the most allergic problems), and if it's not the Alrex causing it, then why doesnt the Alrex prevent the pressure from building-up like that to begin with? And also, what should I do if this continues to be a problem? If it helps at all for you decide what is most likely the cause of this, since age and gender can play a fairly large role for certain things related to the eyes, I am a 19 year old male.

[Ryan_1577]

And also, if I am experiencing pressure build-up after taking the Alrex, could taking the patanol make it worse? Now that the pressure is increased, I am unsure if I should take patanol or not, for I do not want to make the pressure buld-up even worse.

Is it possible the pressure is being caused by something unrelated to the allergies, which can not be seen in a regular eye examination?

[Ryan_1577]

Today, the pressure was not only in my right eye, but also on the right side of my head, and for a little while on my forehead as well; I took some tylenol, and it helped to relieve the pressure on my head a little bit, but not the pressure around my eye. I am beginning to wonder if this pressure problem is part of something else, and if the pressure I am feeling behind my right eye is only one of the things it is affecting. I do not always have pressure around my eye(s), but when I do, it is very irritating, and it sometimes varies from just a little bit of pressure to what can be probably be considered a lot. As for this being a side-effect of any type of headache, I don't think it is because I do not have any headaches or pain really when this happens, just the pressure itself. If this continues to be a serious problem, what should I do? is there any over-the-counter medicine I can use for now to help relieve the pressure when it gets bad?

Also, when I took the Alrex for the first time, I touched the tip of the bottle on the side of my finger.... then I later read in the paper that comes with the eye drops that touching the tip of the bottle against any part of the skin or the eye can contaminate the bottle and possibly cause eye diseases or even lead to loss of sight; it kind of striked me odd that some warning for this is not on the bottle itself, but only in the paper that comes with the eye drops. So I was just wondering, is this a very serious issue, where if you accidently touch the tip of the bottle against the skin or eyes you should discard the eyedrops immediately and get new ones, or is this the type of situation where you should try to avoid it, but don't need to discard the eye drops if you accidently touch it against your skin once? Just curious about this, as the eye drops do cost a fair amount of money and I just got them. So far I have taken them a few times, but I would certainly like to know more about this.

[aeslabby]

I have similar problems, and much of it is related to my sinuses, as I chronically get infections.  The swelling in the sinuses can problems in the eyes, and is also very closely related to allergies.  I would highly suggest seeing an ear, nose and throat doctor...rather than just an optometrist.