Conjunctivitis that won't disappear

[aisrael]

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. 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 a cream and Genteal eye drops instead of the Refresh (or that I can use either/ one one week, the other another week). 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.

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. 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! (The optician and ophthalmologist refuse to give me a new prescription until this is fully cured). I’m going back to the M.D. in another week but I suspect it will be more of the same.

[John C Hagan III, MD, FACS]

Conjunctivitis is an infection and nothing in your description sounds like an ongoing infection. The hallmark of allergy is intense itching which seems to be abscent.

Your history is compatible with Dry Eye Syndrome. This is especially true if your are female, over 40, on estrogens or birth control pills. Your allergy medication can contribute to drying out the eye.

Use the search feature on this page and the Health Topics to review the extensive postings and discussions of how dry eye can be treated.

When you see the next ophthalmologist do not let the staff put any drops in your eye till the ophthalmologist looks at your eyes. Tell the Eye MD you think you have dry eye syndrome and ask for a Schirmer Test and an evaluation of your tear breat up time.

If this confirms dry eyes discuss a 4-6 month trial of Restasis. You may need to give up your contacts.

While you are waiting for the appointment start using any one of these at bedtime:  Genteal Gel, Refresh Liquigel or Refresh PM (an ointment and the strongest moisturizer). During the day try Systane 4-6 times or any preservative free artificial tears.

JCH III MD

[aisrael]

But I have red-eye, where my veins are visible and red, similiar to pink eye (my eye is not pink except that the corners seem a bit red and the veins are visible). I did pick up some Genteal Gel, so we'll see how that works -- should my eyes be less red? Is there a way to "get the red out"?

[John C Hagan III, MD, FACS]

You need to know why it's "red-eye". If its dry eyes genteal may help.
Don't use Visine or get the red out products.

JCH III MD

[helpfulhint]

Patanol (olopatadine) is similar to optivar, but is far more effective in eliminating allergic conjunctivitis, as it stabilizes mast cell production.  You may need to take an antibiotic to kill the bacteria of the pinkeye, and then, as soon as you finish the last day's dose of the antibiotic, then you may begin use of the patanol eye drops to prevent a recurrence of another bacterial infection and to treat the allergic conjunctivitis.  Yes, allergic conjunctivitis is nasty, it will last indefinitely until properly treated, months even.  Optivar is not nearly as effective in treatment as patanol, so spend the extra money on patanol and save money on all these doctor's appointments.  I had the same problem and this was what worked for me...antibiotic, followed by immediate, twice daily dose of patanol, every day, even when you have no symptoms.  It must be used consistently, everyday, during allergy season or it won't work.  Never use visine...makes symptoms worse.  Also, wash hands and face after being exposed to outdoor/ indoor allergens.  The fact that flushing your eyes with water helps suggests that this is an allergy problem.  The solution to pollution is dilution.

[John C Hagan]

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