Puffy eyelid (no pain), Red eye

I slept in my contacts a month ago and woke up with blood shot eyes. This has happened three or four times in my lifetime. I am 26. I took out my contacts and put in alot of visine (which I know is wrong) and my eyes were mostly white three days later and I put my contacts in again. This happened again slight redness,  for three weeks when I finally decided not to wear contacts for the following three weeks. I have to admit I wore them for 16 hrs a day, and did not clean them as much as I should have. I have beenbattling this for six weeks now and my main symptoms are puffy eyelids with a red eyelid margin, red eye that comes and goes slightly itching (today a lot in one eye) and slight burning- especially when I use a computer which is about 6 hours a day.

I first saw an optometrist who said I had dry eye and ocular rosacea and to keep my contacts out for a little while, even though I do not have it in my face ( I know that 20% of people experience in their eye first who have rosacea) A second optometrist just told me that my eyes were 95% better and gave me zylet for a day which seemed to work. It got slightly red again two days later(whether this was from computer strain, which my glasses cause, or allergies or rosacea I dont know) this is where the puffiness really started to happen. I saw another (yes a third) optometrist who said I have dry eye and rosacea and wants to put me on 20 mg doxycyline and omega three pills. Their theory was that since there was no itching (which there is some now) that is was rosacea and not allergies…

I take the pills and have been for two or three weeks. I am hesitant to start the doxy because I know you cant be in the sun etc. I would however do anything to get this to go away! **There is no pain, or crust on My eyelids**

I finally saw an optomologist who said all it was was allergy. He did not have the best bedside manners. Whether or not he is familiar with Rosacea I dont know and he did not seem very concerned. He said I had mild symptoms and to try either patanol, zaditor or optivar. He did multiple tests on me including, the shirmer test on me the first time and said that my tears were fine(the one with the paper) I started Zaditor which seemed to work a little and switched to optivar which I dont think helps much. I will go back to zaditor or patanol. (Or if this is something unrelated to allergies it doesnt matter-is there a preference?

While things seemed a little better. I got worse one day and one of my eyes turned bloodshot for three days, without my contacts in! I went back to the optomologist and he basically was very rude and toldme to keep doing the drops. I understand his frustration but I am at a loss myself…
I got a second opthomologist who was also rather curt and said I  did not have rosacea, the contacts ticked my eyes off and I’m showing some signs of bleph,problems with my Meibomian Gland,  and allergies and to keep going with the treatment. He said my eyes looked fine he only looked in my eyes with a slit lamp  after staining them. I dont know if it was just that it was an easy for him to say or if he doesnt know much about rosacea either.

I personally believe this was excaerbated by the facet that I moved to a new home and started sleeping on a bed that was outside for two weeks (dusty and moldy) I had allergies when younger and used to get allergy shots for dust mold mites and pollen.

Rosacea does not run in my family, even though i heard it is not hereditary. I respect doctors and their opinions but I am frustrated by ones who dont really seem to care that much. I dont want to feel like im in there way, but with my front desk/sales position it is rather important to me. I have a -6 prescription and I im trying to consider lasik as glasses are a pain, give me headaches and seem to strain my eyes more making them more red. I started wearing contacts for 6 hrs a day or so and they don’t turn red wheni have them in or take them out. I can feel dryness if I don’t use drops consistently, which I do. They are not Too uncomfortable and I switched to daily disposables.

My main concern is my prescription strength and that I really cant adjust to my glasses physically I feel. I am desperate to either find contacts that work or refractive surgery. Is there any answr?

I am desperate. On maui we only have these two clinics. I would like to find an answer. Treatment for allergies calls for cold compress while rosacea and bleph call for warm. Are lid scrubs effective? I started them and may start seeing results but I am worried about the thin membrane of my eyelid or aggravating it. while this may seem minor to many it is major tome.

I used to party alot and this stopped immediately. I now sleep 8 hour a day and I am willing to do anything to correct this.

Please let me know after you read my nove,! what you think this may be. I have really been running in circles. Should it be rosacea I need to treat it immediately so It doesnt get worse with doxy. Would this hurt anyway to do?

Danny
***@****

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

You may need to go one of the other islands that has a cornea specialist Eye MD ophthalmologist.

Your problem is likely exacerbated by wearing the contacts. Lasik will likely be a good option. A new drop Azasite is often helpful for blepharitis and rosecea around the eye.  

Most patients with 'rosaccea do not need oral tetracyclines maybe 20% do.

Again I would go to a larger island and see a cornea specialist. Talk to him/her while there about lasik

JCHMD

[wasurenbo431]

Thank you very much!! I really appreciate your response! it was prompt, professional and much of what I needed right now. It is respectable that you give such advice. I know it is difficult to do so without seeing the patients eyes...

I will ask a doctor about Azasite. I wil lbe making plans to go see sugeons over there as I will pick out two or three to discuss surgery with. I want to be very careful.

Do you mind if I ask one more question? Even with a little dry eye and "rosacea" you would recomend Lasik? Of course I wont hold you to your answer! I guess I am just wondering if you have heard of successes or not. I dont mind dealing with symptoms but symptoms AND -6 vision is relatively difficult for me. I would want to do it now rather then letting symptoms get worse or develop an immunity to contacts.is that even possible?  Do you think i can wear contacts? I started three days ago for 5 or 6 hours a day only.I would only wear them 6 hrs or so and they seem to be fine. Ocular rosacea is a difficult disease to diagnose ive heard and im just wondering why half of them did and half of them didnt. (The more experienced doctors said I didnt have it)

Lastly, lid scrubs. Should I be SCRUBBING the inside of my lid? is this dangerous? the box says to wipe laterally against the lashes. i started this three days ago.

I am sorry i guess that was more than one question!

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

Studies have been done that show that over a lifetime that the cost and risk of contact lens wear (say for 50 years) is much more expensive and riskier than LASIK. Remember with you contacts and your dry eye/blepharitis that the risk of a serious infected corneal ulcer is much higher than the normal wearer.

I can't tell you what to do but in similiar cases in our practice we get the dry eyes and blepharitis and rosacea cleared up and under control then we do the lasik.

If you are using occusoft eyelid cleaning foam or theratears steriLid cleaning foam you shut the eyes and shampoo the lashed and top outside part of the lid.  You do not need to scrub inside the lid that's not where the problem is.

JCH MD

[wasurenbo431]

Dr Hagan.

I hope you are well! Are you gearing up for the holiday season?

I had an  update and I was wondering if you could comment on one thing. I know it is diificult without seeing my eyes. Just a question on your experience with a certain drug.

I went back to the optometrist who thought I had rosacea. I had to as she refers people to the corea specialist for Surgery, which i was interested in doing as soon as my symptoms go away. She has been the one of many that have listened relatively well during this time.

FYI - The two opthomoligists, thought i had allergies.. I used zaditor and optivar. My only symptoms are really pinker eyes (not crazy red) and puffy eyelid margins. ( i didnt want you to have to read the "novel again!)
some days are worse some are better. glasses and the computer make them a little more red which goes away. It is definetly worse in the morning, and gradually gets better. I tried sleeping in two homes to see the difference, none really. I initially had issues after sleeping in my contacts 6 weeks ago. I wear them for 6 hours or so without trouble if i use pres-free drops..


So the optometrist said my lids look much better. she said I probably dont have rosacea (The second opto said this as well) **She prescribed restasis and Lotemax**.  She said the Lotemax will jumpstart the restasis and hopefully i could maybe have my symptoms cleared up before two or thr  emonths for the possibility of surgery. She said that I should come back in 6 weeks unless there is a problem. I want to get this cleared up, surgery or not. if its not degressing then i dont need it

***My question - I am a little worried.  It also says to get your eyes rechecked in ten days after using lotemax however she said come back in 6 weeks? Is this a practice that you have seen before in your clinic? the lotemax combo? can i wear contacts if I wait 30 minutes before putting them in (I only wear for a few hours or so) I know you said it exacerbate sthem but they dont seem to be red or irritated.. sometimes i feel them and then i take them out...**

My update - If I dont see too many noticable changes in zaditor, optivar or patanol. I am tempted to continue and be patient as  The opthomologist prescribed me with this (he did the most tests) and the second opthomologist, who didnt really listen much didnt prescribe anything else.

I have my good days and bad.. Im trying to figure out how to recover or if its even possible. some of these forums are rather depressing and my heart goes out to the people who struggle. I still hope that I dont have this problem for years on end, as selfish as that may sound.

What do you think about the combo? or should i just stick with the allergy drops... Of course its hard for you to tell without seeing my eyes. the optometrist said my lids looked better! and my tears were pretty good too. The second optho said my lids werent that bad! The scrubs may have worked over the last week! its in the mornings they seem bad..

I know its difficult without seeing my eyes.. I wanted to just see what you thought!  and what your experience has proven..

I value your  input highly, and most importantly, your time!

Thank you Dr. Hagan...

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

1. A steroid (lotemax) is often used to jump start restasis. Normally only one bottle is used and when its gone its not refilled.
2. You will likely need to wait about 4 months before restasis kicks in
3. can't tell you anything about the contact ask your fitter.
4. If optovar,zaditor and patanol haven't worked within 10-14 days they aren't going to work.
5. See the best refractive surgeon (lasik) you can get to. Do your own research. many optometrists get kick-backs called "comanagement fees" from the surgeon. These usually aren't disclosed to the patient. Conflict of interest and not full disclosure.

JCHMD