Please help...eyes just got really bad and im scared to take Chloramphenicol drops!

[HYPERHEAD]

Hi all

I have been suffering from MGD and blepharitis for 6 months but when I woke up 2 days ago and i had the most intense burning and tearing in my eye and since then ive had a gritty feeling in the outer corner of one of my eyes really noticable red veins in the whites of both my eyes and slightly swollen upper eyelids which a rubbing below my eyebrows and causing dry skin to appear.

So i decide to look under the upper eyelid where the grittyness was and i noticed a slight swelling and it was white or slight yellow in colour compared to the red on the other unaffected eye..so i stupidly panicked and thought it was cancerous and booked a emergency doctors appointment.So i saw the dr yesterday and she said it was a inflammation of the upper tear gland is this correct?? which was causing the swelling in the corner of my eye and also causing the enlarged eyelids?

She was very robotic about the whole situation then prescribed me Chloramphenicol eye drops and and celluvisc eye drops which i had to insist on

I havent taken the Chloramphenicol as i read about possible Aplastic anemia but this seem to be related oral form and not topical..should i take these or avoid them or tey heat compresses more often to treat swelling

Also do i take both of the drops one after the other.. for example Chloramphenicol drops first then preservtive Celluvisc drops straight after?

Why did this happen ? Was it because i wasnt doing heat compresses every day and not twice a day or was it a reaction to the baby shampoo or viscotears i was taking and also i was only using the viscotears now and then when i needed them? Also i recently used suncream near my eyes would have that caused this?

Sorry for all the questions but Please help as i need to treat this swelling asap and thanks so much for being such a great community..love you all

Mario

[poppy]

My opinion: it probably doesn't matter whether you take the chloramphenicol or not, though I doubt it would cause any harm to take them. It's an antibiotic, correct? Thing is, your inflammed gland may not be a bacterial infection anyway, in which case the antibiotics will not help. Plus, ordinary bacterial eye infections usually clear up on their own anyway without antibiotics. You probably got the inflamed gland because you are prone to them due to your bleph. Most likely it will go away on it's own in a few days, although you may get it again in future. I would just do lid hygiene twice a day until it clears, and artificial tears and warm compresses if it makes your eyes feel better.

If you do take the drops, I would use them first then 15 minutes or more later, use the celluvisc.

[HYPERHEAD]

Thanks for your opinion poppy

So that whitish colour in the corner of me eye (looks like a small sac ) is caused by the inflammation which was what was causing the gritty feeling due to the swelling rubbing on my eyeball correct

Funny enough since i have been using the other preservative viscotears twice a day now my eyes dont feel as gritty in the corners..now and then isnt obviously enough.Do you think i should switch over to the newer celluvisc drops i got yesterday as they are preservative free?

Also i wonder if the baby shampoo is also contributing to that gritty feeling??

Can anyone further clarifiy on the Chloramphenicol possible side effects

thanks again..

Mario

[dijon84]

Baby shampoo and Viscotears - sounds like the advice I got when I first went to Specsavers. I've now found a much (much, much, much) better optician. She said don't use baby shampoo as if it gets in your eyes, it destabilizes your tear film. She recommended Blephagel to use in the evening - leave it on the eyelids overnight then wash it off in the shower in the morning. I think the Blephagel is helping me. A few months previously, I abandoned baby shampoo and I started using Blephasol (applying it with cotton buds). I thought it was good - a benefit of Blephasol is you don't have to wash it off after applying it.
It still staggers me that one of the largest UK opticians is still recommending baby shampoo for blepharitis.

[littlemermaid]

Hi Mario,

Topical chloramphenicol 0.5% ophthalmic eyedrops - we have been in chronic use for 2y on/off to control ocular rosacea with reinfecting MGD for a child, no probs. The max we've ever used is 3/day in a tapered course to clear infected bleph (although we've had no probs in chronic use min 2/wk). It clears any infection, yes, but the ophth also see a reduction in inflammation (this is why we are using it for maintenance, without an antibacterial min dose it all comes back). We also manage conjunctival inflammation without infected bleph which clears well with chloramphenicol + steroid, better than steroid alone. Your daily warm compress and lid hygiene (we just use warm water/cotton wool or flannel, whatever suits) is, of course, essential for bleph long term.

Side effects - we have had very rare drug reactions to some meds because LM seems to be sensitive but this just makes us careful. The trick is get informed from the FDA etc sites and be aware, get tested for side effects when on long term meds. Stop, obviously. Get A&E advice. I have to say the GPs were particulary awful on this. 'Drug reaction' is a gem for accessing the emergency eye clinic 24/7. Weigh up risk/benefit. Somebody somewhere has had a reaction to absolutely anything, esp with allergy.

Preservative free - What I would be worrying about is sourcing the preservative-free capsules of chloramphenicol (Bausch & Lomb Minims). Lloyds chemist will order them in on NHS prescription. The rest round by us, inc Boots, have been non-starters because it's 'not in the catalogue' (all they have to do is to make the effort to look at the online catalogues). We did get red-eye on a second course of the chloramphenicol ointment (preservatives, before we got wiser), presumably flared up because of the base or preservatives on an already sore eye, but that's it. No probs on preservative-free version. They are refrigerated 2-8 degrees normally, although there is some flexibility, and we carry them about in an insulated bag designed for insulin.

Eyedrops - Agree with Poppy, a 15 min gap at least is a good idea. We always leave 1/2hr gap between any drops but that's not always convenient. We always press closed the tear drains (puncta) to avoid systemic absorption or affecting the sinuses, even with the tear substitute drops, so that would solve some worries. Also close the eyes for a few minutes after instillation to let the magic happen rather than the eyelids doing their job ie sweeping drops away like windscreen wipers.

Artificial tear substitutes - the ophth usually says choose one that suits you because they're all much the same. We are using Celluvisc, preservative free, in chronic use 6/day because it coats well. Also like Hycosan range with preservative-free delivery bottle (hyaluronic acid is supposed to aid cornea surface recovery). So yes, preservative free especially if the eye surface is suffering anyway and you think your eyelids are sensitive. With the goal of long-term healing, we minimise all drops as tears are kicking in again and the eye surface is improved.

You are right to look for someone to help you manage this condition with confidence, maybe a few second opinions We get used to hanging out at the eye clinics with various problems, try to turn up looking at your worst to get in. Also agree with Dijon84, you could find a local optician quite good at this, maybe advertising dry eye management, have a chat about tear film, glands, dry patches that show up with the green dye etc.

[HYPERHEAD]

Hi

OMG!! I took the Chloramphenicol drops at 7.30pm and had the worst side effects and still have some side effects now. I started to feel weak and very confused and couldnt focus at all and my head was very tight and i feel very anxious. I cant sleep right now as im still feeling very weird..im upset cause they made my eyes feel much better.

Im still feeling confused and weak right now..what should i do now?? Should i contact my dr as i need to get my eye infection under control, also should i discontinue using them??

[littlemermaid]

Hmm. Obviously don't use them without doc advice if you think it's a reaction. How many times have you taken them before without problems? But continue Celluvisc to keep your dry eye comfortable until you can see an ophthalmologist. Hyperhead, are you sure this isn't pure anxiety? Our reaction to chloramphenicol was just red eye. There are plenty other choices of antibacterials for your infection, eg we've also used Fucithalmic, which is nice.

[HYPERHEAD]

Hi little mermaid

I've never used these before but my body is very sensitive to most drugs ..I wasn't anxious when I took them but as soon as used the drops my eyes felt really strange and I felt really lightheaded and weak

I really appreciate your kindness .. What do think I should try next

[littlemermaid]

Hello Hyperhead,

http://www.cks.nhs.uk/blepharitis#314838004 The UK NHS Clinical Knowledge summaries just got very useful and here is the advice on managing blepharitis, with links to red eye and dry eye so you can see what should be happening on treatment options.

Basically, in doctor-world, if something doesn't work or someone has a reaction to a prescription like this, they expect you to re-present to the prescribing doc so they can try something else. I didn't know this before. To get medical attention, this means turning up persistently with an unresolved problem until you get the help you deserve, need, paid for in taxes.

http://www.nhs.uk/Pages/HomePage.aspx. NHS Choices website to find out what your regional eye service pathway is. Round by us, you need a GP or high street optometrist referral to the county triage service, who treat or refer to the hospital eye clinic. I'd be aiming for the hospital eye clinic if you have a history of drug sensitivities, with a past history typed out. Many GPs are hesitant to assess eyes and would advise seeing a high street optician for the initial assessment and referral.

High street optometrist - would be pleased to see you for advice today (Saturday, £) and they might be good for a decent hospital eye clinic referral. The key is to turn up with something horrible so that they are out of their depth and their regulations oblige them to refer. Make sure you get the qualified dude though. Looking after the blepharitis is becoming part of their job although they shouldn't attempt the other symptoms involving prescription. Some are awful, some are faking it, some are very good if they're recently trained or updating their skills.

Hospital eye clinics - at the weekend can be random depending who you get. Sometimes it's a very kind and keen and thorough registrar, so if it's convenient, could be worth turning up again with this as a drug reaction looking for advice if you need help this weekend rather than wait for referral. Phone ahead to find out where to go out of hours. If they assess it as not serious, keep asking 'where should I go for help then?' The triage nurse is the one to talk to. You can get the number off the hospital website. They should also advise you on available local services.

High street pharmacists - can be fabulous on eg drug reactions if you get the right one, recently trained. Those guys are seriously brainy. And if they don't know they don't hesitate to get online and look it up. We got a spot-on excellent eye consultation once from one of these consultation room pharmacist schemes that have started up in the big chains.

With young children, they manage bleph without antibiotics and antibacterials as far as possible, using warm compress only, no lid hygiene chemicals, so this could be OK for you to get things moving for now. See Moorfields or Good Hope websites.

GP - I really sympathise with this difficulty finding medical attention and good advice but it does mean seeking out a decent doc for ongoing help. There is a massive load of anxiety here and you do need some real-life support. I think I'd also be down the GP on Monday, but make sure you get an appointment with the nice one(!)

Drug reaction history - if you keep posting, you might find someone else similar to talk to about treatment options. I think it's the action of systemic drug groups that we consider, but contact reactions can be to anything.

Private practice cornea specialist - if the NHS round by you isn't so organised or funded, or you get prioritised low, this is an option since your eyes are precious http://www.dryeyezone.com/talk/showt...octor-who-will Just phone up the secretary and book same week. Using the private sector has it's own problems, being unregulated and unmonitored. It's good to use someone who is working through the insurance agencies then there's some guarantee of quality. Being uninsured, I love the NHS ongoing, better service anyway when it's good, but when it's not good, paying to see the same specialist for consultation is a relief. I notice Southampton have, on their NHS website, something like 'We appreciate that people with conditions considered less serious are in need of advice and this is why we list our private clinic services to provide access to this'. Hmm.

These are just some ideas on your options. NHS Direct may be useful although they usually conclude, see a doc. Please let us know how you get on finding advice. Again, helping people with the fear and anxieties is a big part of good ophthalmology. I have in the past seen GPs and paid ophthalmologists just to deal with this aspect.

Self-medication and self-management isn't good until we've done the rounds of the docs to find out where we are on diagnosis and treatment options. Remember many people here have already done this. Even then, you need regular checks.

[tearless2]

Wow, little mermaid, you are the expert managing dry eyes in Britain. I am so impressed - your daughter's lucky to have you as an advocate!

[HYPERHEAD]

UPDATE:

The Bad:

Eyes got gradually worse over the last few days as the dr said i didnt need antibiotic drops, but i have recently discovered some triggers of making the eyes more sore and aggrevated.

I Recently found out hot showers and washing eyes with a flannel using baby shampoo would really make me eyes worse and gritty maybe it was the shampoo or rubbing the eyes or even the shower heat that caused this ?

Also i have noticed these red vessels appearing on my upper eyelids ..looks like broken vessels like rosacea...eeeek!! ? Is this due to the infection or blepharitis or the hot shower and will these go?


The Good:

Decided to try green teabags and cucumber on the eyes last night due to severe irritation and grittiness and OMG what a miracle!! I was shocked it got rid of most of the irritation and redness and my eyes look much whiter and better today..yipeeeee!!

Do you think i should still get anti biotic drops now?

Thanks ...