Eye drops burn really bad and make eyes sore

[dgreen97]

Anybody have the problem (not all the time but most of the time) where you put in eye drops and it makes your eyes burn really bad and turn really red. By red I mean lots of veins show up in the whites of your eyes. The burning lasts like 3-5 minutes and eyes feel sore afterwards. I'm guessing this is from inflammation but I'm not sure why this happening since eye drops are supposed to soothe the eyes. Any ideas?

[jenny2008]

not from regular non-preserved drops.. what type of drops are you using?

[ringo]

In my experience it is from the inflammation, sometimes even non preserved tears burn an inflamed eye.

[kitty]

I find when my eyes are really dry and on fire to begin with even my favorite drop stings when I put them in. You might try starting with a bit of sterile saline (get a small bottle from the contact lens section) and put some of that in before putting in your drops. It can provide a sort of cushion. I find the drops least likely to sting me are theratears (in vials) and my new best friend, FreshKote.

[dgreen97]

i've tried theratears, systane, bausch and lomb soothe xp, and many others and they all seem to burn and make my eyes ache and random times. sometimes i'll put them in and nothing happens but other times (more often now) they burn really bad.. then my eyes start to ache. if i open my eyes its burns every more. after about 3-5 minutes the burning goes away but then my eyes are sore/aching for hours afterward. what could be causing the inflammation? my eye turns really red with lots of veins and burns badly. its weird because my eyes felt a little dry and before i put the drops in they weren't aching. after i put the drops in (i only put 1 in each eye) i've had aching ever since. i put soothe xp drops in. any ideas on why my eyes become inflammed? is it because they're dry?

[ringo]

It seems like you have developed a significant inflammation. That usually happens when you have dry eye. There may be other causes for your pain and sensitivity to eyedrops but from my experiene and many othe dry eye sufferers, it is the inflammation.
As a first step talk to your doctor about trying a mild steroid drop for a couple of weeks and see whether you wll still feel pain when you instill drops.

[DryEyeSurvivor26]

Have you tried Optive? I have very sensitive eyes as well and that drop has never irritated my eyes.

[dgreen97]

never tried optive i should look into that. i'll have to talk to my doctor about trying steroid drops. are they really expensive? are there any other methods to reduce eye inflammation like taking ibuprofen? i read somewhere that flaxseed oil is supposed to help with the inflammation but i guess its not working for me because i take it every day and still have the issue. the inflammation is probably the root of this problem. my eyes feel dry so i put in the drops. they burn and then they feel sore and ache for a long time.

[DryEyeSurvivor26]

You can try taking ibuprofin (I have been taking it recently for eye pain) but that is not a good long-term solution. Neither are steroids however. Steroids aren't too expensive if you have good insurance. Flaxseed oil is supposed to help but in cases of moderate / severe dry eye it probably won't be enough. I take it too. Try Optive Sensitive (non-preserved; it comes in little vials) if you have especially sensitive eyes

[dgreen97]

thanks for the responses. i'm taking about 400mg ibuprofren now.. just started yesterday. i want to see what effects it will have on the improvement of my dry eye problems/pain. I hear that ibuprofen has some risks of increasing dry eye, but it will also help in reducing inflammation so hopefully i don't get that side effect. i would try steroid eye drops but i really don't like the idea of taking the risk with glaucoma. have you tried steroid drops ringo? by the way i looked up the optive sensitive drops but i didn't see them on the artificial tears list on this site. do you know what ingredients are in them?

[DryEyeSurvivor26]

Optive Sensitive ingredients are listed here:
http://www.drugstore.com/qxp204680_3..._eye_drops.htm

Steroid drops won't cause any complications if only used for a short period of time (ie a couple of weeks). They are generally only used to get bad bouts of inflammation under control.

[indrep]

dgreen
Are the drops you are using preservative free?
The mineral oil in Soothe can be irritating to some people.
The sytane with guar only "coats" the nonhealthy cells of your cornea.

As you can see there are a number of things that could be irritating to your cornea depending on the drop.

What causes inflammation on the ocular surface is a hypertonic tear film (too much salt). This is most times refered to as increased osmolarity of the tear film. Many artificial tears are themselves hypertonic and this could cause exacerbation of the issue.

One way to stop inflammation is with a topical antiinflammatory. This is not a permanent solution as it does nothing to stop the cause f the inflammation.

Another way is topical steroids. Once again not a long term solution.

The best way is to attack the cause, which is water/salt ratio on the ocular surface, by increasing the water held on the ocular surface. This slowly reduces the osmolarity of the tear film and stops signaling the brain to increase inflammation.

[ringo]

Hi indrep,

Could you please explain more about the water/salt ratio and the osmolarity of the tear film? As far as my understanding goes, that ratio is disturbed due to the aqueous deficiency in the eye, i.e. dryness.
Do you mean to say that retaining more water on the eye surface is done by continuous instillation of good artificial tears, punctal occlusion, and protective eyewear, expession of oil glands?

I completely agree with you on that one. Also the artificial tears may dilute the inflammatory substances in the tears.

What is a bit unclear to me is how does improving the water/salt ratio in tears resolve an already existing dry eye inflammation on the ocular surface?

For example, it has been shown that retaining more tears on the surface of the eye through punctal occlusion causes more damage to the eye surface unless inflammation is treated before that, as the plugs trap the infammatory components in the compromised tear film on the eye surface for longer.

Also, would balancing of this water/salt ratio be feasible by the methods I mentioned above only, or there are additional things you have in mind?

Would the inflammation be improved by these methods, regardless of the severity of the dry eye condition?

Thank you in advance.

[indrep]

The osmolarity changes due to lack of water. The lack of water can happen from two causes, one, not producing enough aqueous in the steady state or the tears evaporate too quickly. So in order to reverse the osmolosrity we must keep as much steady state tear volume on the ocular surface as possible.

Constant wetting with artificial tears can be harmful, preservatives, hypertonic solution, washing out nutrients, etc.

Punctal occlusion, Lipid expression, goggles are all good.

Yes improving the salt/water ratio is the only way to improve the condition. Keep in mind that whatever caused started the disease now causes cell death (apoptosis) because a hypertonic solution in contact with a cell will pull all the water out of the cell causing death. So the only way for your epithelial cells to heal on the ocular surface is to provide an environment for them that is healthy.

The statement about punctal occlusion is easily refuted by nonpharmaceutical studies. In fact the DEWS report showed that 80% of patient responded to a two week steroid and punctal occlusion. Restasis needed five tries with the FDA and on the fifth try had to include patients with punctal plugs to gain approval. (fdarestsisdata.org)

Logically a study that says "inflamed" tears are bad doesn't make sense. How would the cornea recieve nutrition? provide clear vision? attempt to heal itself?

Keep in mind why inflammation is happening on the ocular surface. Inflammation leads to something known as "vascular permeability". Many people notice with a flare up that the blood vessels in the eye are more prominent. This is to allow more "serum", a hypotonic solution, to make its way to the ocular surface in an attempt to lower the osmolarity of the ocular surface. To reduce tears at a time when the cornea is crying out for more would be counterproductive.

The answer to your question "will these other methods help over time?", is yes. My wife was almost homebound due to her eyes, result of sever RA for 20 plus years. She has been on Oasis TEARS plus for 24 months now and is quadra plugged. At four months she stopped having mucous strings and had dropped from 6-7 drops a day to 4. At 24 months she is down to 1-2 drops a day.

The key to any of this therapy is maintaining the therapy long enough for it to work and then continuing a maintenance regimen. Once the lacrimal glands and meibomian glands are damaged you will never have the "best natural" tear film so we hope to maintain the best tear film we can have.

I hope this helps, this is a greatly reduced summary of the very complex disease.