Eyelid swelling: preservative reaction?

[y-gwair]

Ever since my long-standing eye dryness started to worsen last Autumn, I've been suffering from increasing degree of eyelid swelling. The upper and lower lids have been very puffy in the mornings, with a definite round swelling around the inner third portion (worse in right eye). I had my lower puncta occluded in early December, which seemed to increase the inflammation generally, and probably worsened the eyelid swelling.

2 weeks ago, my specialist started me on Maxidex steroid drops to control the inflammation and immediately my eyelids started to balloon overnight, and remained noticeably swollen through the day. Up until this point I'd been using viscotears 4 time a day, and simple eye ointment at night; I hadn't found them helpful but was following ophthalmologists advice to keep taking them. By this weekend, applying the ointment was unbearably painful, so I stopped applying both kinds of lubricant. The swelling disappeared overnight (eye still a little puffy and painful, but they didn't look like I'd been punched and then had chickpeas inserted under the lids as they'd appeared previously).

I'm continuing with the steroids, but they still sting on application and the specialist has now prescribed a preservative-free version of the drug. I've started using Celluvisc again, but I find it makes my eyes feel very gritty 5-10 mins after I put it in (which is why I've never felt it was very helpful in the past, plus it really dries out the skin around the eyes, leaving itchy salt deposits; this is the less viscous kind too).

I'm sure the lubricant drops + preservatives have been making my eye irritation much worse than it needed to be, but I've found it is very difficult to persuade doctors that all the various drops are unhelpful, they tend to suspect you are just a non-compliant kind of patient (having been through a lesser episode previously with other kinds of lubricants recommended by rheumatologist). Is this the point to ask about autologous serum drops? I've really had enough of messing around with different eye drops, all of which I've found simply increase irritation and give no relief.

Added to say I use absolutely no make-up, moisturiser products and minimum amount of hypo-allergenic washing powders as I have always suffered with skin sensitivity, I'm sure nothing else can be causing additional irritation.

[Rebecca Petris]

I've found it is very difficult to persuade doctors that all the various drops are unhelpful, they tend to suspect you are just a non-compliant kind of patient

Seeing this happen is a tremendous frustration to me. I agree that many doctors are very, very slow to consider the possibility that the drop really is harming the person. And it's not just preservatives. Some people have surprising problems with carbomethylcellulose (think Refresh Whatever, and other brands too) drops or with ointments.

Is this the point to ask about autologous serum drops? I've really had enough of messing around with different eye drops, all of which I've found simply increase irritation and give no relief.

I absolutely would recommend that route. I think that anyone who is consistently having issues with commercial drops ought to pursue this. When you find a doctor willing to arrange this for you, make sure they've read this study so you don't just end up with expensive goo.

[y-gwair]

Thank you so much for your reply, something of a relief to find it's not just my imagination.

[NeedMyEyes]

Allergic to most every eye drop it seems.

I have to say I am allergic to most every eyedrop out there - including, unfortunately, GenTeal. The gel and the ointment feel great in my eyes.

However, I started getting eyelid swelling (and telangectasias on the uppers) after beginning GenTeal. Then after taking steroids for just a week, the swelling and telangectasias almost disappeared.

Then, I began GenTeal again - and sure enough the swelling and telangectasias came back.

I am trying to avoid steroids because of the long term side effects.

I am getting Dermatologic patch testing for contact allergies and I plan to bring every eye drop I have ever tried to get tested. This way I will know which I can use and which I should avoid.

My next idea is to do twice daily rinses with preservative free saline (to wash out all the allergens) then take something like a mast-cell inhibitor (Vividrin) or an antihistamine eyedrop (Pataday) to completely get rid of the swelling.

Not an eye doctor, by the way....

[Pat Baker]

Get a swab done of your eyes - I also had major swelling and itching, along with dry eyes and mucus and terrible pain. After 3 years of misery, I demanded a swab test, and I had an infection, which would only respond to Sulphur - I had tried everything, including steroids, cortizone, penicillin, drops and topical ointments. Nothing helped. 4 days into a course of (cheap) Sulphur tabs, my eyes (and lids) cleared up, and have stayed that way for over 2 weeks now!!!!!!!