Conjunctivitis and dry eye

I seem to have conjunctivitis that won’t go away. The optician initially said it was because I was wearing my contact lenses for too long. However, I then stopped wearing them for about 2 weeks, with no luck, then I went to the ophthalmologist who then prescribed Optilast (Optivar in the US, the azelitine) for allergic conjunctivitis (I do have seasonal allergies and take Telfast/Allegra or Loratadine (the generic ingredient in Claritin) and Sinufed (pseudophedrine)). She also prescribed Refresh eye drops. I returned 6 weeks later and my eyes were still red. She then also prescribed an antibiotic cream and Genteal eye drops instead of the Refresh (or that I can use either/ one one week, the other another week). I also stopped wearing my contacts at this 2nd meeting (about a month ago). Until two weeks ago, however, when I realized that this was a bad idea, I had also put in a drop of Visine “Get the Red Out” in the mornings as I had always awoken with extremely dry eyes and was still tired when I woke up. I have since stopped, yet my eyes look to be no whiter then they were 2 months ago. For the past 3 weeks I also haven’t worn my contacts and am only wearing glasses (which I hate!). She also said my eyelids flip quickly. My veins are extremely visible and the sides of my eyes seem to be red.

Also, I am on the computer a lot and read a lot and my eyes are often dry and I’m often “tired” after this or after short naps. My eyes are also dry upon awaking. Of course, after putting water or eye drops in my eyes, all is better. But is there something I need to be doing as 2 months of conjunctivitis seems to be quite ridiculous and I want new contacts! I’m going back to the M.D. in another week but I suspect it will be more of the same. Is there anything specific I should tell her or ask her to do?.

[Michael J Kutryb, MD]

You should be tested for chronic dry eye.  Shirmers testing, rose bengal or lisamine green testing can sometime help to diagnose dry eye keratopathy.  If you have dry eye problems - then you can go down the road of punctum plugs, restasis drops, flax and fish oil oral supplements, frequent preservative free artificial tears in the day and lubricating ointments at night, lifestyle modifications and more.  If your problem is not due to more than just dry eyes then treatment gets even more complex.  It may take many visits to get things right - and you should be persistant with seeing a good ophthalmologist until you get at least a little control over your chronic problem.  Wearing contacts also adds another layer of difficulty to the situation.  Remember you likely have a longstanding problem - it will never be cured - just improved with proper treatment and lifestyle changes.

MJK MD

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A related discussion, chronic dry eye was started.