HELP= month long redness and sclera lining inflaming + damaging surface

[Huss]

I am a dry eye suffer for about 5 years now and something is happening that I have not yet experienced.

About 4 weeks ago I went out and had a rough night (around lots of flashing lights in the nightclub, alcohol, etc). I know this is very abusive especially with my condition. I normally don't have nights this extensive. Anyways from that weekend onwards I developed redness in several veins from the inside of my left eye to my sclera. The redness would fluctuate dependent on my activities and time spent around bright lights, dryness etc.

It has been getting really uncomfortable to the point that I'm thinking this was as uncomfortable when I first developed dry eyes in my first and second year.

Currently-
-Left eye is red only in the area I mentioned
-It seems like the sclera is inflaming only on the left side and slowly spreading to the bottom
-Visually it looks as if my astigmatism or unevenness of my eye is getting worse in that area only. If I look to the right the 'skin' on the eye seems to push upwards against each other to form a 'ripple effect' which does not happen in my other eye.
-my lids are both very blood red up and bottom in both eyes
-I have stopped restasis and hot towel compress, using only cold compress until I can figure out what it is


Unfortunately, to see an ophthalmologist here it seems to be quite a bit of a wait. My family doctor could not find anything wrong. I am calling every day to see if there is a last minute cancellation I may be able to fill in.


Any and all help is appreciated. Is this something any of you have hear of or experienced?

[DrGary]

Huss,

Considering the long wait to see an ophthalmologist and your general complaint it would seem prudent to find a local optometrist. Optometrist's have a doctorate degree and are highly trained in eyes care. While they cannot perform surgery, they are (for the most part with individualization of specialty) equally trained in eye disease. I advise to ask around to get "a good one". I suggest a private office with a few doctors. Also, you mention you are on Restasis, which is a prescription medication for dry eye. I would assume your ophthalmologist prescribed that? One more quick thing about providers - while many MD's and primary care providers are very intelligent and well meaning, they may not have the diagnostic tools available to an eye care professional time permitting.

I will not attempt a diagnosis, but it sounds generally like an inflammatory event that should be evaluated. Things to consider would be medications, contact lens usage of any kind, change in diet or stress, physical or mechanical irritation to your eye structures (foreign bodies) and certain systemic conditions (thyroid, arthritis diabetes etc).

Best of luck
Dr. Matter

PS. You cannot gauge the amount of astigmatism in your eye by viewing it with the naked eye

[Huss]

Hey,

Thanks Dr.Matter.

I have not had much luck with optometrists in the past and tend to gravitate towards ophthalmologists, but your right. I have an appointment tomorrow with a new optometrist who hopefully can shed some light on what exactly is happening.

I'm trying to think of anything that has changed and am not having much luck.

As for the "astigmatism" I associated the 'ripples' on my ocular surface as being that. What could it be?

[Huss]

If anybody is interested as a result of this happening to you, I went to an optometrist who prescribed Alrex. It has a low dosage of steroids which I was hesitant in taking. However after day 1 and 4 drops a day I am already seeing a positive result with the redness clearing up and my inflammation beginning to decrease.

She was not sure what caused it, but said my eyes look healthy with the exception of the inflammation and dry eye damage to the ocular surface in the one eye.

[littlemermaid]

'ripples' on my ocular surface

If this helps, when LM gets an orange peel look to the sclera, possibly red eye with a raised bumpy patch, maybe what you are seeing as wrinkly, she has an inflamed dry eye surface and little tear film, in danger of further neovascularisation. We see an ophth quickly to assess it: increase steroid temporarily to control inflammation, improve MG function with antibacs and compress (she has chronic MGD, may be different for you), increase tear film substitute drops. Am hoping you are not just relying on steroid for control, but protecting the eye surface and using tear substitute drops, whatever you need to heal this. When the eye is 'quiet' again we reduce drops to the minimum. I'm wondering what damage she saw. Conjunctivochalasis looks like ripples in the microscope but I don't think you would be able to see it yourself.

[Huss]

Thank you! Its much better now, although I do see light ripples that I am unsure whether or not they existed before. Tear film substitute drops and eye drops, is their a difference and what brand would you recommend?

[Hopeful2]

I believe that tear film substitutes are also known as artificial tears, whereas 'eye drops' refers to any drop put in the eye, steroids, antibiotics, or artificial tears.

If you are looking for a lubricating drop, it is generally recommended to go with a preservative free drop (i.e. single vials). I have recently started using Refresh Endura and I am pleased with it. It contains a small amount of castor oil which is believed to have anti-inflammatory qualities. On the down side, it is pricey ($19.50 at Shopper's for 20 vials). It is essentially the same as Restasis, but without the cyclosporine. It appears that it is no longer available in the US. . . I wonder how much longer it will be available in Canada now that Restasis became available as of this Spring. . .?
Could your ripples perhaps be a pinguecula ( see google images)?