Filaments on my limbus in my right eye

First, a little history. I suffered a corneal abrasion in my right eye in 2008 when some dry wall fragments fell in my right eye as I was hauling some dry wall into my house. I went to the ER and was given an antibiotic ointment. It healed in about 3-4 days.

I started having problems with my right eye again in March of 2009. It felt painful and these small translucent/whitish bubbles began to appear on the bottom of part of my limbus in my right eye (if you were looking at my eye as if it were a compass, the bubbles would be directly south).I went to the doctor and they said that I had a herpes legion in my eye. They gave me viroptic for it, and I took it for a few weeks, and eventually the problem went away. I'm not sure if it was related to the medicine or not.

Anyway, afterwards I would always get those bubbles on my limbus and redness around it, which would appear randomly and disappear randomly. They were REALLY random. Like, I would get them for 2 hours and then they wouldn't disappear, only to appear a week or a few days later, then I'd have them for a week straight. All the time with eye irritation. I didn't buy the herpes story.

In March of 2011, I went to another doctor who told me I have a rare dry eye disease from my eye injury that causes those bubbles to form, which he called filaments. He gave me restasis, which my insurance wouldn't pay for. I ended up just using liquid tears instead, which seemed to irritate my eye more.

In Nov of 2011, I went to yet another doctor which never seen this problem. She called in the supervising doctor which took a look and said what I have is chronic erosion from my previous eye injury, and that those filaments are forming because the top layer of my eye hadn't healed correctly. They also said that it was that and a combination of possible eye dryness. They gave the antibiotic doxycycline, supposedly for their anti-inflammatory properties. I was also given prednisolone drops, which is an anti-inflammatory steroid. The last thing they gave me was muro to put in my eye at night. All of this was for my right eye.

I didn't really see any difference in the treatment i was given. If anything, it might have been getting worse. About 10 days into the antibiotic treatment, I started getting red bumps all over my chest and back. I figured it was an allergic reaction, so I stopped taking it. The next morning I woke up with a feeling in my left eye. I look in the mirror and those filaments were now in my left eye in the same spot as my right eye!

When I went back to the doctor and they were perplexed, and now they're telling me they don't understand what's wrong with me, so they're going to have me see a cornea specialist next week. They noticed that there was a lot of redness also on the inside of my eyelids, which the supervising doctor suggested could be chlamydia! I know I don't have that because I get tested for STD's every year, and I've only been with 1 person in the passed 2 years. They scraped away those filaments in my right eye and gave me an eye bandage, which is just a contact lens. My eye feels better now with the bandage on. There are no filaments forming because the lens prevents that.

I would really like to know what's wrong with me. Could it really be herpes or some exotic disease?

[John C Hagan III, MD, FACS, FAAO]

Go to Dr. Hagan's blog and read the section about recurrent corneal erosions.  And the word is "lesions".  Everything you said is consistent with the combination of dry eyes, recurrent corneal erosions and filimentary keratits.

Having a correct diagnosis doesn't make it easy to control (not cure).

See the corneal specialist. Chlamidia is not likely nor is HSV.

JCH MD

[spellbinder2050]

Here is a follow up on my situation.

An initial note: I was unaware, but the doctor had already wrote down that what I was experiencing was filamentary Keratitis.

Monday, Dec 12th, 2011

My doctor told me that I was negative for Chlamydia. She took off my bandage lens, and there were no new filaments. I ended up seeing a corneal specialist the same day. She put plugs into my bottom tear ducts in both eyes where my tears drain into (lacrimal punctum) and told me to keep using liquid tears, but to increase the dose to 4 times a day in both eyes. Then I was given a new bandage lens.

She also suggested giving me oral antibiotics. I told her about my allergic reaction to deoxycycline, so she suggested I take erythromycin. I told her that after the cessation of doxy, that my eyes actually got worse, so she didn't give me any antibiotics at all. I was scheduled to return that following Friday.

Friday, Dec 16th, 2011

My eyes had been feeling a lot more comfortable with the punctual plugs. I told my doctor that and she said my eyes were looking better, but that I still had inflammation of the conjunctiva in my inner eyelids, which manifests as redness (There is more redness in my right eye).

My bandage lens was removed, and I was given an appointment for Dec 30th.

Sunday, Dec 18th, 2011 (today)

My eyes feel fine, and there are no new filaments. My only problem is that sometimes I feel my right eye twitching, especially when there's heat in my face from the ventilation system in my apartment.
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My doctor's course of action at this point is to figure out the underlying cause to the eye dryness and the formation of those filaments.

I'm thinking that those filaments are forming because my dry eye is causing the recurrent corneal erosion, which then results in those filaments, but that doesn't explain why I got those filaments on the bottom part of my limbus in my left eye after the cessation of doxy (The filaments in my left eye only lasted a few days though). Also, it doesn't explain the inflamed conjunctiva in my inner eye lids.

I will keep posting.

[John C Hagan III, MD, FACS, FAAO]

Filaments on the botton of the cornea often means exposure keratitis due to the lids separating when you sleep.

Discuss starting on restasis; long term it usually the best option.

JCH MD