eye movement pain and swelling

[612wade]

Two months ago on my way back from a camping trip I started getting pain in my left eye when I'd look to the left or right. The following Monday I saw an eye doctor that treated me for pink eye, with Neomycian, that it turned out I was alergic to. In about two weeks the pain/swelling/headaches went away on their own. I felt and looked fully recovered as my eyes would not be swollen in the mornings and my vision was excelent once again. I had not been exposed to pink eye and the problem seemed to be viral. Two months later the symptoms have returned. Severe pain when I look left or right, left side of head aches, and the area all around my eye is swollen. No unusual discharge or tearing though. By the end of the day and 3-5 200mg ibuprofin later the swelling goes away a little. I went to another eye doctor who said I have an enflamed tendon on the left of my eye, she called it cellulosic, or something like that. I was prescribed 1700mg of amoxicillin per day. It seems to be helping but the pain meds might be doing it too ( Tylenol and Ibuprofin). My nose is clear but I wonder about a sinus infection. Also I wonder about my cat alergies. Could either affect just one eye? What about a tear duct infection, would that make my eye tendon hurt this much? And finally how can you tell if and antibiotic is working? Thank you Thank you Thank you for any advise. PS I have no insurance and very limited income.

[Sandra M Brown, MD]

Facial swelling is not consistent with optic neuritis.  The next time you have an acute attack, go see an Eye-MD ophthalmologist and ask them whether it might be orbital myositis.

[Sandra M Brown, MD]

It sounds like you have orbital myositis.  An antibiotic (amoxicillin) is useless to treat this condition.  However the eyelid swelling may have made the doctor consider cellulitis, which is a skin infection, which is why amoxicillin was prescribed.

Orbital myositis is an autoimmune disease whereby the muscles that move the eye become inflamed, making eye movement very painful.  The inflammation can move to the front of the eye, making it red and causing the lids to swell.

Orbital myositis is extremely responsive to prednisone.  Medications like ibuprofen can help also (tylenol not really), but prednisone is much more effective.  You need to find another eye doctor to consider this diagnosis and prescribe prednisone.

Note also that a condition called optic neuritis can cause pain with eye movement but does not cause the eye to get red nor the lids to swell.  I don't think you have optic neuritis.

[612wade]

Ok Sandra. You rock! My appointment is at 10:30 tommorrow. Thanks a lot for all the help.

[612wade]

Sounds like you know your stuff Sandra. My eyelids do not seem to be swollen, just the area around my eye. It is going away but still very painful after 5 days. Does that make you consider optic neurosis? Also any tips on keeping this from reoccurring?