Inflamed and dry eye. What could it be?
May 6, 2022 2:39 PM Subscribe
My relative has an inflamed and dry eye, with slightly blurry vision. It started last month and has been going down with some prescription eye drops but we don’t know what it is. Have you experienced anything similar?
MeFi has been great on the past at diagnosing things that have stumped our doctors so I’m turning here again.
He has seen multiple doctors and specialists, and taken a battery of tests, with no diagnosis at the end.
He is in his mid 60s and has cholesterol, hypertension, and acid reflux, but is otherwise ok. He wears glasses with the right lenses for his vision and lives in a mild tropical climate.
He also spends a lot of time reading on the phone for work, unfortunately.
The tests have all come up negative, including those for autoimmune diseases and such.
MeFi has been great on the past at diagnosing things that have stumped our doctors so I’m turning here again.
He has seen multiple doctors and specialists, and taken a battery of tests, with no diagnosis at the end.
He is in his mid 60s and has cholesterol, hypertension, and acid reflux, but is otherwise ok. He wears glasses with the right lenses for his vision and lives in a mild tropical climate.
He also spends a lot of time reading on the phone for work, unfortunately.
The tests have all come up negative, including those for autoimmune diseases and such.
My first thought was Sjogren’s Syndrome, which is what I have (I’m just recovering from the bout of inflamed corneas I seem to get every spring). But it’s autoimmune, so if they’ve managed to 100% rule out anything autoimmune, I guess it’s not. Allergies can absolutely have similar effects.
posted by The Underpants Monster at 7:09 PM on May 6, 2022
posted by The Underpants Monster at 7:09 PM on May 6, 2022
These exact symptoms are what sent me to the ophthalmologist a few years ago and after a few false starts on steroid drops that never helped, it turned out to be Dry Eye--which is the most innocuous name for something that can make you pretty miserable!
The dryness can cause significantly blurry vision, inflamed eyeballs, and often but not always a gritty feeling or feeling of having a foreign body in the eye. Counterintuitively, it can also sometimes cause the eyes to stream tears because of the irritation, though they're not properly lubricating tears.
I use a prescription eye drop called Restasis daily and it's made a huge difference. Lubricating eye drops--NOT like Visine or saline solution, but the drops labeled preservative-free lubricant drops--also provide a lot of relief, and that's what I use when I'm out of Restasis and my next refill isn't here yet. And yes, warm compresses help a lot--I rarely remember to do them, but when I do, it feels so much better.
These symptoms can also match other conditions, too. Blepharitis, as already mentioned (and it's my understanding blepharitis and dry eye can be related or comorbid?). Ocular rosacea is also a thing. If they started taking a blood pressure or stimulant medication, it could be a side effect of that (usually presents as dry mouth, but it can be dry everything else, too). Or yeah, it could just be seasonal allergies. Or even just dehydration, though in that case they might have other symptoms like headaches and dark urine.
Most of these things aren't going to show up in blood tests for stuff like autoimmune issues. Sometimes you have to diagnose by trying treatments. It could be worth trying the warm compresses and lubricating drops to see if it helps.
posted by rhiannonstone at 7:35 PM on May 6, 2022 [3 favorites]
The dryness can cause significantly blurry vision, inflamed eyeballs, and often but not always a gritty feeling or feeling of having a foreign body in the eye. Counterintuitively, it can also sometimes cause the eyes to stream tears because of the irritation, though they're not properly lubricating tears.
I use a prescription eye drop called Restasis daily and it's made a huge difference. Lubricating eye drops--NOT like Visine or saline solution, but the drops labeled preservative-free lubricant drops--also provide a lot of relief, and that's what I use when I'm out of Restasis and my next refill isn't here yet. And yes, warm compresses help a lot--I rarely remember to do them, but when I do, it feels so much better.
These symptoms can also match other conditions, too. Blepharitis, as already mentioned (and it's my understanding blepharitis and dry eye can be related or comorbid?). Ocular rosacea is also a thing. If they started taking a blood pressure or stimulant medication, it could be a side effect of that (usually presents as dry mouth, but it can be dry everything else, too). Or yeah, it could just be seasonal allergies. Or even just dehydration, though in that case they might have other symptoms like headaches and dark urine.
Most of these things aren't going to show up in blood tests for stuff like autoimmune issues. Sometimes you have to diagnose by trying treatments. It could be worth trying the warm compresses and lubricating drops to see if it helps.
posted by rhiannonstone at 7:35 PM on May 6, 2022 [3 favorites]
In addition to the daytime drops, I also use a nighttime ointment ( I use a store brand, but the name brand I used to use was Refresh PM). My Sjogren’s is complicated by the fact that one of my eyelids doesn’t stay completely closed at night.
If the problem persists, the ophthalmologist may suggest occluding the lacrimal puncta, the openings that drain excess tears away from the surface of the eye. This can be done with removable plugs or by cauterizing them shut. (I’ve had both; plugs have fallen out and cauteries have re-opened. Currently have in a set of plugs that have lasted over a year.)
posted by The Underpants Monster at 6:02 PM on May 7, 2022
If the problem persists, the ophthalmologist may suggest occluding the lacrimal puncta, the openings that drain excess tears away from the surface of the eye. This can be done with removable plugs or by cauterizing them shut. (I’ve had both; plugs have fallen out and cauteries have re-opened. Currently have in a set of plugs that have lasted over a year.)
posted by The Underpants Monster at 6:02 PM on May 7, 2022
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