Eyelid crust and pain

[Joseph]

All day it seems that my eyes have sand and salt in the corners that itch, burn and make my eyelids sticky when blinking. I also get SEVERE pain in the inside corner of my left eye on and off everyday that can last for hours. My doctor said that he does not see any irritation and I quote " I honestly don't not know what is causing it. " Where do I go from here? I am so frustrated and feel like their is not an answer to this which means how in the heck do I start to fix it..

[NotADryEye]

Joseph,

Crusting can be a sign of infection. Sometimes doctors will prescribe broad spectrum antibiotics. Sometimes it is best to culture and test for effective antibiotics.

Itching is usually a sign of allergy.

The pain can be so many different things. You may have a blocked meibomian gland, chalazion. You may have had some trauma. You may have erosion. You may have lashes growing in the wrong direction. There are numerous conditions that can cause the pain you describe. You can try looking in a magnifying mirror but you may not see anything.

If my doctor told me he didn't know what was causing the pain I would see another doctor.

Where do you live. Maybe someone on DEZ can recommend a good ophthalmologist.

[Rebecca Petris]

I'd rather have my doctor admit he doesn't have a clue than ply me with treatments just in case they help... preferring under versus over medication/treatment.

Pain stuff can be funny and elusive... sometimes it's possible to pinpoint an exact cause, sometimes it's not. On the medical side, we can attack identified problems and that may, or may not resolve the pain issue and we have to live with that uncertainty. On the symptom side, we just go empirically on what helps most to relieve it. I know, most people have such a downer on the idea of "palliative" approaches as opposed to cures BUT at a practical level, when our goal is to get through the day more easily and reduce pain & suffering, and knowing so much of the ocular surface disease stuff can be stubbornly chronic, there's plenty to be said for focusing on addressing symptoms so long as the way we do it is not harmful in any way.

With ocular surface diseases, the picture is often complicated because there can be so many pieces with no obvious link to the pain. A lot of people here have several things going on... MGD, rosacea, poor lacrimal production, poor lid closure, maybe conjunctivochalasis... each successive doctor they see is convinced that X is "the" determining factor, and attacks it with their usual hammer, which fixes X but not the pain. Or as in your case... maybe seeing nothing.

[NotADryEye]

With ocular surface diseases, the picture is often complicated because there can be so many pieces with no obvious link to the pain. A lot of people here have several things going on... MGD, rosacea, poor lacrimal production, poor lid closure, maybe conjunctivochalasis... each successive doctor they see is convinced that X is "the" determining factor, and attacks it with their usual hammer, which fixes X but not the pain. Or as in your case... maybe seeing nothing.

I agree. This is a multi-factorial condition with numerous co-morbidities. For me, for example, there has not been a single "determining factor" as much as continuous addressing of issues to either eliminate them and/or stay ahead of them as they arise or become symptomatic. For this approach to treatment accurate diagnosis is key. You can't just throw darts at the board. That is why I am so grateful to have a doctor who knows exactly what is going on at every moment and has the skills, experience and tool kit to address everything.