Red Eyes

[royerin]

Being fair-skinned with blue eyes, I've always had an issue with redness, but have been able to control it with Bausch & Lomb Opcon eye drops. However,  a couple of years ago it got to the point where that wasn't working any more, so I went to an ophthalmologist in Orlando who examined me and said there was nothing wrong. I was prescribed Lotemax drops to use in conjunction with Opcon A, and this worked for a while, but after a year or so it happened again, so I went to another ophthalmologist in Phoenix where I now live. He also found nothing wrong and gave me the same prescription for Lotemax. Again, this worked for a while but the redness came back, so I went to see him again at the beginning of August this year. Once again, nothing was found and I was given yet another prescription for Lotemax, only this time it's not making any difference whatsoever. I now have a slight film in each eye, and chronic redness, although there is no pain or itch(nor has there ever been any pain). I've tried every redness reliever eye drop on the market to no avail. My eyes are bloodshot every morning despite getting 8 hours of sleep, and I do not drink alcohol or smoke anything. ANY help would be appreciated at this point! I'm at my wit's end...

[Michael J Kutryb, MD]

You could have some combination of a few different problems, possibly some degree of dry eyes. or allergies, or atopic conjunctivitis.  Might also want to rule out thyroid disease.  Lotemax is probably not something you want to be on long term since it is a moderately strong steroid. I suggest looking in to taking a daily multivitamin, adding a good amount of fish oil and flaxseed oil supplent, avoid lots of wind, dust, sunlight,ceiling fans, and dry hot air.  Look into allergy drops like Pataday, frequent use of preservative free artificial tears, and possibly punctal plugs and restasis drops long term.  Part of your problem may also be from using Opcon (a vasoconstrictor) for too long.  You can get a lot of rebound redness when you stop it.  I've taken posts from people who said it tooks months and months to be able to get off the stuff without lots of redness problems.   Consider getting a second opinion.

MJK MD

[royerin]

Thank you so much for the prompt response and advice. The second ophthalmologist I visited concluded that I was allergic to something but he didn't know what. I had animal allergies as a kid but had ruled that out because it usually involved itchiness which I don't have. The same doctor also told me there was no limit to the amount of opcon I could use - despite it saying otherwise on the box. I'm going to heed your advice and stop taking the opcon as much, although I feel I will have to use them on occasion as I interact with clients regularly, and I really don't want to have bloodshot eyes when doing so. I'm also going to take your advice on seeking another opinion, which, including yours, will be the fourth! Thanks again.