intractable eye irritation

[kg17]

My eyes experience a mild redness (especially in the inside corners of eyes), burning, uncomfortable irritation with increased light sensitivity for the past three months that occurred initially during a trial of Xalatan (I was not wearing contact lenses at the time).  I've been to three opthalmologists (one is a repected corneal/external disease specialist at university).  I'm told I have no signs of infection, ocular surface is good, Schirmer test shows mild dry eye with use of punctal plugs, small sign of allergy.  I tried a short course of steriod drops which relieved my symptoms, but they returned as soon as I stopped.  Restasis for three months has offered no improvement.  Pataday and Acular provide no benefit either.  I am at a loss as to what to do next.  I would greatly appreciate any direction or ideas.  

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

Then get a second opinion with another ophthalmologist that specializes in cornea/external eye disease.

FInd one at www.aao.org

JCH III MD

[kg17]

I appreciate your help.  I had not worn contacts for the past 9 months, including the past three months when the irritation started.  I just began wearing them this week with the opthalmologist's okay.  I will resume the Restasis.  I am curious as to whether the punctal plugs could be creating the constant irritation, inflammation.  I had one plug taken out and my eye immediately worsened with dry eye so I had it reinserted.  I am taking all measures to aggressively treat dry eyes and don't feel that that is the issue.  I just don't know how to find out a proper diagnosis and treatment.  I want to make sure my eyes are healthy and it's difficult to deal with constant pain and discomfort.  

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

If you are wearing contacts now then 99%+ of the time the problem is the contacts. If you are wearing them stop them.

Stay on the Restasis. Improvement has been documented up to 6 months after starting them.

JCH III MD