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Painful, burning sensation in eye with redness and pus.

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I have had ongoing eye trouble for the past year. Every time is begins the same way. Day 1 - My eyelids will become very red (nearly purple) and i'll feel a burning sensation all day long, usualy a few small styes as well..This is very painful. Day 2 - I'll wake up and my eyes will be so inflamed that i can barely open them. Redness, Puss, and usually a lower lid that is 3x larger than it typically should be. Day 3- It gets even worse . Day 4 - It starts to go down a bit. Day 5 - It's usually gone.

This has happened 15+ times over the past year. I've seen 3 eye doctors and one lid specialist. I've been told it's an issue with my oil glands not producing enough oil and every doctor told me the same thing - 1) Doxycycline 2) Tobradex drops 3) Warm compresses...

I've done this combination of drugs and home care 4 different times over the past year, and the problem STILL occurs just as bad as it did 1 year ago! It seems if i'm not constantly using tobradex drops, The problem occurs more frequently - I know i can't stay on tobradex forever....

I need help. There must be some drug to fix this long-term or some way i can get rid of this problem. It's taken over my life - I cannot make advance plans to do anything as if my eye acts up, I literally can't leave the house. I've attached photos. Please get back to me ASAP.

Category: Ophthalmologist

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Category: Ophthalmologist
Dr. Neeraj Jain is online now

Expert:  Dr. Neeraj Jain replied 4 Days.

Dear Sir,
Thank you for your query at DoctorSpring.com
I understand your concern.
First of all, please recheck if you are using TOBREX OR TOBRADEX. If tobradex, then should stop using it. Now coming to the problem: have you ever got an eye power check? I mean do you require glasses , hope the place you stay at you are not allergic to something.
If the issue is cyclical, you are probably allergic to something in the environment .

Feel free to discuss further,

Dr Manish Malhotra
Consultant Eye Surgeon

Patient replied :

I am using tobramycin dexamethasone ophthalmic. I'm quite certain it is not allergies and again, all of the doctors i've seen have said that it is an issue with the oil glands in my eyes. This problem has been happening for over 1 year consistently every few weeks. I've moved apartments since this started so i doubt it's something in my home.... Yes - I wear contacts but currently am wearing glasses since this problem occured again a few days ago.
Did you look at the photos?
I'm looking for a solution or recommendation here... You didn't really give me any.
Please advise as to what i can do to stop burning + massive / chronic inflammation due to oil gland disfuction / disease.

Expert:  Dr. Neeraj Jain replied 3 Days.

Thanks a lot for your query at DoctorSpring.com
I understand your concern.
I have gone through the entire history, and I have also reviewed the images and the specialist reply.
Now, let me tell you, why he wants you to stop using Tobradex. It is because of the steroid component in it, which if taken for a prolonged time can cause glaucoma and other problems with the eye.
You do seem to have Meibomian Gland Dysfunction, and due to reduced oil the chances of getting frequent infections and blepharitis is common.
I will advise you to get your sugar levels checked, as uncontrolled sugars can also lead to repeated infections or styes, and the power check has been mentioned, as it is also a cause of repeated blepharitis.
You need to start using supplements like flaxseed or omega 3 fatty acids as this is the only way you can increase the oil secretion. A consistent treatment of 6 months is required for good results.
Also, you need to regularly clean your eye lids with soft johnson's buds using johnson's shampoo ( baby shampoo ), this reduces the chances of infection, by keeping the lid clean. This can be done once everyday in the morning, and it will significantly improve your eye health. Please use Tobramycin drops instead of Tobradex and you can also apply Tobramycin ointment locally once in the night.
Hope this was helpful,

Patient replied :

Thank you doc. That was helpful. You mentioned not to use tobradex, but to use tobramycin.... I'm using tobramycin dexamethasone ophthalmic, is this OK? I have been using every time this flare up has occurred (7 different times in the last 12 months) , and usually go through the drops each time...
You mention baby shampoo in the morning . How should I apply this ? Do I put on lids and then rub off or do I keep on lids and let it dry ? It seems leaving it on would be uncomfortable . I bought fish oil / omega 3 tablets - how much should I take each day and for how long?
My final question - is there any other cure other than constant home care? My eyes are literally on fire right now and look horrible prohibiting me from work, etc. - constant flare ups need to stop. I'm looking for the most permanent solution . Thanks

Expert:  Dr. Neeraj Jain replied 2 Days.

No, Tobradex has steroid component in it, I want you to talk to your primary ophthalmologist who can give you plain Tobramycin. Steroids can lead to glaucoma later on.
For the baby shampoo, you should apply the shampoo in the bud, and then apply in the lid, just like cleansing it. You need to wash it off once you apply the bud. You can do it once everyday for 3 months, and see the effects.
Yes, the solution can be improving your oil levels which can be done through supplements as I mentioned.
Hope this was helpful,

Dr. Neeraj Jain
Category: Ophthalmologist
MD, ophthalmology, All India Institute of Medical Sciences, 2001 – 2003
MBBS - RNT Medical college
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