Sinus issues, seborrheic blepharitis and MGD

[dijon84]

There's been a few posts about the link between sinus pain and dry eyes recently. Thought I'd start my own thread about my issues instead of hijacking someone else's.

My problem started in February 2011 with an eye infection (I think), treated with chloramphenicol ointment. Just over a week later, I was trying to go to sleep at night and I started getting what felt like a pressure build-up in my forehead. I had this along with eye symptoms (I'm not going to focus on eye symptoms in this thread). I've had this pressure buildup when going to sleep at night ever since, to varying degrees. The pressure building feeling can vary in location. If in the forehead, it is often worst over my left eye (my worst eye for dry eye sensations). The pressure buildup also feels like it is behind my nose and just below my eyes sometimes.

In July 2011, I started getting the pressure buildups during the day. Prescription for Nasonex nasal spray from the GP for a month. Hadn't cleared by then so had a month of Flixonase drops from August (they are quite strong apparently). Then I've been on Flixonase nasal spray ever since. Got an ENT referral in December (not sure why it didn't go through earlier), so it could be June before I see an ENT doctor.

The pressure buildup sensation always appears after a few minutes of lying down with my eyes closed (not sure which of lying down or eyes closed is the main factor). I can also get the sensation if I look down. I'm still doing warm compresses (with an eyebag) twice a day for up to 10 minutes, so these can start to get uncomfortable.

Any comments would be appreciated as I've had these pressure buildups at night for so long now, and will be a while until I see an ENT doctor. Any recommendations for what could help me at night (ie lying down and eyes closed)? I think I'm getting to control of my eye problems now that I have found a good optometrist, so would be good to sort out the sinus problems.

Thanks
Dave

[Colin P]

Hiya Dijon.
Dont discount Tension from 'Tension and anxiety' as this can cause headaches at forehead or the Back of your head ( i know, i get them).
Dont discount either, Eye pain can easily cause headaches- Your eyes are connected directly to the brain and it is known that headaches occur from eye complaints.
Yours does seem a bit specific though ie- every time you lie down, i do agree with you that sinus pressure is a problem i also have cattarh problems- Wa-hay!!.
One more thought while i'm on, I find lying down and closing my eyes helps a lot!! could it be pressure/pain clearing/subsiding and changing to a forehead area headache?.

[littlemermaid]

Dijon84, did you ever take oral antibiotics? just wondering if there's lingering infection. My husband's eye infection just spread down the tear duct (tingly uncomfortable slightly inflamed inner eye corner skin and inside) and although the eye cleared fine there is some doubt whether the Fucithalmic has reached down the naso-lacrimal duct. If we think not, he will take oral antibiotics to clear it. He has lingering sinus congestion, which he often has anyway from eg dust allergy, so we're still wondering whether the topical Fucithalmic has actually seen it off. I don't know whether an infection would grumble on low-grade since last Feb 2011. My poor daughter sleeps sitting up because of congested sinuses. Otherwise, getting rid of allergens fixes the inflammation for both of them. Huge improvement moving out of the Victorian flat, never needed Beconase again. I think your sinuses were good on Lundy?

[Jenn1]

Dijon84, did you ever take oral antibiotics? just wondering if there's lingering infection. My husband's eye infection just spread down the tear duct (tingly uncomfortable slightly inflamed inner eye corner skin and inside) and although the eye cleared fine there is some doubt whether the Fucithalmic has reached down the naso-lacrimal duct. If we think not, he will take oral antibiotics to clear it. He has lingering sinus congestion, which he often has anyway from eg dust allergy, so we're still wondering whether the topical Fucithalmic has actually seen it off. I don't know whether an infection would grumble on low-grade since last Feb 2011. My poor daughter sleeps sitting up because of congested sinuses. Otherwise, getting rid of allergens fixes the inflammation for both of them. Huge improvement moving out of the Victorian flat, never needed Beconase again. I think your sinuses were good on Lundy?

Hi LM,

I think I may have the same problem as your husband as i too have sinusitis and then my eyes started becoming red and sore and dry. I have taken tablets and they provide some relief and will be seeing an ent specialist soon. What happened to your husband and what help did he receive and how is he now? I would appreciate hearing his story and any help or advice? My inner eyes are also sore and was told its likely an infection and my nose is sore too and was told there could be an infection in both?

[Joseph]

I have occular rosacea and when my sinuses become inflamed my eyes become drier. I believe there is a link, in at least some of us, that sinuses and dry eyes go hand in hand

[littlemermaid]

Hi Jenn1 - For info, last week he had a minor left eye infection (no discharge, some overtearing, gritty feeling) spreading down the naso-lacrimal duct slightly, red inflamed skin and pressure, and he was feeling it in the sinus. We do know it's bacterial, cross-infected off an easily fixed external ear infection. Also spread to right eye after 3 days, which is normal (he didn't tell me he had any eye infection for 3 days...). We used Fucithalmic both eyes and it cleared both eyes completely in 5 days, including left eye tear duct by day 3. This week he feels some normal sinus congestion but uncomfortable eyes by the end of the day but he thinks it's a cold virus. Could be. This shows how closely eye infection relates to sinus infection though, as Joseph says.

Hope you guys get progress with your ENTs. We do suffer from our ophth treating eyes only when, obviously, the systems are connected and it was a long time since medical school. Especially also in ocular rosacea.

[Jenn1]

Hi Jenn1 - For info, last week he had a minor left eye infection (no discharge, some overtearing, gritty feeling) spreading down the naso-lacrimal duct slightly, red inflamed skin and pressure, and he was feeling it in the sinus. We do know it's bacterial, cross-infected off an easily fixed external ear infection. Also spread to right eye after 3 days, which is normal (he didn't tell me he had any eye infection for 3 days...). We used Fucithalmic both eyes and it cleared both eyes completely in 5 days, including left eye tear duct by day 3. This week he feels some normal sinus congestion but uncomfortable eyes by the end of the day but he thinks it's a cold virus. Could be. This shows how closely eye infection relates to sinus infection though, as Joseph says.

Hope you guys get progress with your ENTs. We do suffer from our ophth treating eyes only when, obviously, the systems are connected and it was a long time since medical school. Especially also in ocular rosacea.

Thanks for your reply LM. I am curious as to how they tested whether your husbands problems were bacterial or viral, do they take a swab? Also did the fucithalmic sting at first? And thanks for the support.

[Alan27]

There's been a few posts about the link between sinus pain and dry eyes recently. Thought I'd start my own thread about my issues instead of hijacking someone else's.

My problem started in February 2011 with an eye infection (I think), treated with chloramphenicol ointment. Just over a week later, I was trying to go to sleep at night and I started getting what felt like a pressure build-up in my forehead. I had this along with eye symptoms (I'm not going to focus on eye symptoms in this thread). I've had this pressure buildup when going to sleep at night ever since, to varying degrees. The pressure building feeling can vary in location. If in the forehead, it is often worst over my left eye (my worst eye for dry eye sensations). The pressure buildup also feels like it is behind my nose and just below my eyes sometimes.

Maybe you got Chronic Sinusitis?

[littlemermaid]

Why don't eye doctors swab?

Hi Jenn1,
We and the GP guessed it was bacterial and it cleared quickly with Fucithalmic, so it was. This is a very important point. Why don't eye clinics swab more often? If we turned up at an STI clinic with a red eye they would swab first thing, so will the ENT, even the derm swabbed up the nose.

Especially when the ophth know they can't always see the cause of the problem in the slit-lamp microscope. They look for small and difficult diagnostic signs with plenty of room for inexperienced error, like where the tiny dots/lesions are positioned on the eye surface or layers below, or an excess of inflammatory cells floating about and where that's happening. Many people here have unresolved and undiagnosed inflammation and recurrent conjunctivitis-like symptoms. We're all coming away with the currently fashionable 'you have meibomian gland dysfunction, do warm compress' (for perspective, in UK 3y ago when we were seeking diagnosis we had to travel a long way to find an ophth who knew how to assess a meibomian gland).

Here's the Moorfields view 'The results of your eye swabs taken at your last visit were negative with no growth. This is often the case, as flare-ups in blepharitis are usually the result of inflammation rather than infection.'

True, sir, but still. We have had bizarre guesswork diagnosis in the past for viral conjunctivitis, chronic unresolved symptoms with cornea deterioration, and still not got swabbed. I also have flakey theories about normal skin bacteria and fungi in overgrowth causing MG inflammation in hypersensitive people, which we did attempt to sample.

Hope other countries are better at this than the UK, also diagnosing systemic issues through the eye clinic. Look at this astonishing post from Pat Baker. http://www.dryeyezone.com/talk/showt...w-perfect!!!!!

Success at last - my eyes are now perfect!!!!!
I've had 3 years of misery with dry eye/mucus fishing syndrome. I've seen 2 opthalmologists, 2 homeopaths, tried acupunture, reflexology, had tests for Sjogren's, Lupus, allergies. Have tried every topical ointment, eyelid scrubbing, eye drops, cortizone, penicillin, heat pads, ice packs. My specialist said there was nothing more he could do for me. I fished mucus all day, every day for 3 years. My eyes burned, itched and ached 24/7.
3 weeks ago I visited my GP for flu, and almost jokingly suggested he take a swab of the mucus. Tests came back showing I had an infection - "acinetobacter baumanni" - commonly known as the "hospital bug" as it's usually contracted in hospitals. The only treatment this will respond to is Sulphur - I went on a very inexpensive course of Sulphur tablets (South African brand name "Purbac"), and within 4 days my eyes were absolutely perfect - no pain, no mucus, no redness. Whoooooopeeeeeee!!!!!!!!!

PS: Have been on every antibiotic possible as well - saw my GP virtually every month for 3 years, and at no point did he consider doing a swab of the mucus, which in hindsight seems the obvious thing. I have always had dry eyes, but never had the chronic pain, flaking eyelids and masses of mucus. Other sufferers should get the mucus tested as a first resort and work from there, rather than taking ransom (and often useless) medication.

[Jenn1]

Hi Jenn1,
We and the GP guessed it was bacterial and it cleared quickly with chloramphenicol, so it was. This is a very important point. Why don't eye clinics swab more often? If we turned up at an STI clinic with a red eye they would swab first thing, so will the ENT, even the derm swabbed up the nose.

Especially when the ophth know they can't always see the cause of the problem in the slit-lamp microscope. They look for small and difficult diagnostic signs with plenty of room for inexperienced error, like where the tiny dots/lesions are positioned on the eye surface or layers below, or an excess of inflammatory cells floating about and where that's happening. Many people here have unresolved and undiagnosed inflammation and recurrent conjunctivitis-like symptoms. We're all coming away with the currently fashionable 'you have meibomian gland dysfunction, do warm compress' (for perspective, in UK 3y ago when we were seeking diagnosis we had to travel a long way to find an ophth who knew how to assess a meibomian gland).

Here's the Moorfields view 'The results of your eye swabs taken at your last visit were negative with no growth. This is often the case, as flare-ups in blepharitis are usually the result of inflammation rather than infection.'

True, sir, but still. We have had bizarre guesswork diagnosis in the past for viral conjunctivitis, chronic unresolved symptoms with cornea deterioration, and still not got swabbed. I also have flakey theories about normal skin bacteria and fungi in overgrowth causing MG inflammation in hypersensitive people, which we did attempt to sample.

Hope other countries are better at this than the UK, also diagnosing systemic issues through the eye clinic. Look at this astonishing post from Pat Baker. http://www.dryeyezone.com/talk/showt...w-perfect!!!!!

Thanks LM, and I totally agree with your reasoning. A few days ago as a new sufferer I visited an opthamologist who didnt even listen to what I had to say was happening to me, and like you mentioned, she relied heavily on what she could see through her gadgets and I wasnt happy. She came to the conclusion that I had blepharitis, mainly because she couldnt actually find anything wrong with my eyes and saw a few bits of flakes on my lashes, which everyone has to some degree and also I had been using an eye ointment that would have contributed to these flakes. I went to my doctor and he laughed at the diagnosis as he thinks its more of a sinus/infection problem.
I have been given some fucithalmic acid to try and will see how that goes down. And yes swabs should be used as a rule.

[littlemermaid]

Jenn1,
For info because you sound similar, husband has reinfected swollen in the naso-lacrimal duct area, blocked and presumably infected sinuses - he's the allergic rhinitis type (father-in-law recurrent surgery on nasal polyps) - so back to GP Monday for oral antibiotics. Eyes red and watering today. I think you need to ask the GP for ENT if the GP won't swab, ENT will check it out for you (Google sinus infection for explanations and possibles).

[Jenn1]

Jenn1,
For info because you sound similar, husband has reinfected swollen in the naso-lacrimal duct area, blocked and presumably infected sinuses - he's the allergic rhinitis type (father-in-law recurrent surgery on nasal polyps) - so back to GP Monday for oral antibiotics. Eyes red and watering today. I think you need to ask the GP for ENT if the GP won't swab, ENT will check it out for you (Google sinus infection for explanations and possibles).

Thanks. I will be seeing an ENT specialist in a few days and before my nose surgery i've never suffered from sinus or eye problems. Are your husbands naso-lacrimal sacs blocked since his eyes water and also what antibiotics is he usually given? I have tried doxycycline which made me sick and amoxcillin and augmentin, but I was told that unless antibiotics are given for a long enough period or the right types (including through an IV), then infections are likely to return or stay.

[littlemermaid]

Naso-lacrimal sacs: external skin swollen and red, I ask him to put his finger where the probem is, yep it's there, eyes red and watering, no yellow discharge. I asked him to press n-l sacs to see if gunk came out the tear duct but he just wouldn't do it This is what ophth do with children badly infected, there can be no other signs till you do that. Just got prescribed nose steroid, oral amoxycillin, chloramphenicol/neomycin up the nose. As we thought, same old, from your point of view, but hopefully this will fix him for now altho I expect it will happen again. Wish you better luck with ENT.

[chattabob]

Hi Jenn1,
Why don't eye clinics swab more often? If we turned up at an STI clinic with a red eye they would swab first thing, so will the ENT, even the derm swabbed up the nose.

[/URL]

Ye I dont understand this... not just for your eyes but everything.

I remember a time when I went to my GP and they would do all the basics, blood pressure, heart rate, weigh me ect... The last time I was at my Doctors I asked if I could have my blood pressure taken as I felt my blood was boiling up and she said what for?? Ermm so I can see how close I am to having a heart attack or stoke please.

[Jenn1]

Naso-lacrimal sacs: external skin swollen and red, I ask him to put his finger where the probem is, yep it's there, eyes red and watering, no yellow discharge. I asked him to press n-l sacs to see if gunk came out the tear duct but he just wouldn't do it This is what ophth do with children badly infected, there can be no other signs till you do that. Just got prescribed nose steroid, oral amoxycillin, chloramphenicol/neomycin up the nose. As we thought, same old, from your point of view, but hopefully this will fix him for now altho I expect it will happen again. Wish you better luck with ENT.

I really hope this isnt a life long problem. Its really frustrating trying to sleep with painful eyes. Btw, why did the derm swab the nose and is it something to get done?