Eye Discomfort: Causes and Solutions for Dry Eyes

Q: Eye Discomfort: Causes and Solutions for Dry Eyes

Hello： 1. Neostigmine may cause miosis. You can reduce the frequency or temporarily discontinue its use. 2. Once the medication is stopped, the metabolism will naturally return to normal. 3. You can observe the situation; discontinuing the medication may r

The eyes feel tight and uncomfortable, with symptoms of dry eye syndrome?

Hello Doctor: I have visited an ophthalmologist several times due to discomfort in my eyes.
The doctor diagnosed me with three issues: entropion (inward-turning eyelashes), eye allergies, and dry eye syndrome.
The entropion and eye allergies exacerbate my dry eye discomfort.
(I have a few ingrown eyelashes that have previously scratched my cornea.
I underwent surgery in early 2022 to remove some tissue from my lower eyelid, but the problem persists.) From late 2022, around September to December, I still experienced discharge, heavy eyelids, tightness in the muscles around my eyes, occasional blurred vision, and felt more sensitivity to light (things appeared brighter).
I also found my glasses uncomfortable regardless of how I adjusted them.
I consulted two clinics where I underwent fundus examinations, intraocular pressure tests, and other assessments, all of which indicated no significant issues, and my fundus appeared clear.
Therefore, I continued using the medications prescribed by the doctor, which are intended to alleviate dryness, fatigue, and provide artificial tears.
However, in the past few days, I suddenly felt extremely uncomfortable.
After applying the eye drops in the morning, I experienced intermittent narrowing of my vision, with my eyes surrounded by dark circles, similar to looking through a paper tube.
After an urgent visit to the doctor, I discovered that my pupils were constricted, and the medications prescribed by the clinic included neostigmine.
Since I had been feeling unwell, I had been prescribed this medication regularly.
The doctor advised me to temporarily stop using the clinic's medications.
My job requires prolonged computer use, and I am now hesitant to use medications for fatigue and dryness.
I perform warm compresses for 10 minutes twice a day, which provide some relief, but I still experience indescribable discomfort when using the computer and need to lower the screen brightness.
However, when I am outdoors, I would like to ask the following questions: 1.
With both pupils constricted, I felt much better the day after stopping the medication.
Should I consider this a case of "drug overdose" or "drug allergy"? 2.
If it is drug toxicity, what should I do? 3.
If my eyes continue to feel uncomfortable, should I go to a major hospital for a more detailed ophthalmological examination? 4.
I also feel anxious and tense due to my discomfort.
If the clinic's examinations show no issues, would you recommend that I see a family physician for further evaluation, or should I consider consulting a mental health specialist? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2023/01/11

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Neostigmine may cause miosis.
You can reduce the frequency or temporarily discontinue its use.
2.
Once the medication is stopped, the metabolism will naturally return to normal.
3.
You can observe the situation; discontinuing the medication may resolve the issue.
If discomfort persists, further examination may be considered.
4.
If there is anxiety or tension, it may be worth consulting a psychosomatic specialist to rule out any psychosomatic issues.

Reply Date: 2023/01/11

More Info

Hello! Thank you for sharing your concerns regarding your eye discomfort. Based on your description, it seems that you are dealing with multiple issues, including entropion (inward-turning eyelashes), allergies, and dry eye syndrome. Each of these conditions can contribute to your overall discomfort, and it’s understandable that you are feeling anxious about your symptoms.

Understanding Your Symptoms
1. Entropion: This condition can cause your eyelashes to rub against the cornea, leading to irritation, redness, and potential corneal abrasions. Since you mentioned having had surgery to address this issue, it’s important to monitor it closely. If the problem persists, further surgical intervention may be necessary.

2. Allergies: Allergic reactions can exacerbate dry eye symptoms, leading to increased tearing, redness, and discomfort. Identifying and avoiding allergens is crucial. Over-the-counter antihistamines or allergy eye drops may help alleviate these symptoms.

3. Dry Eye Syndrome: This is a common condition where the eyes do not produce enough tears or the tears evaporate too quickly. Symptoms include dryness, a gritty sensation, and blurred vision. The use of artificial tears, as prescribed by your doctor, is typically the first line of treatment.

Addressing Your Questions
1. Pupil Constriction: The constriction of your pupils after using the medication containing neostigmine could indicate a reaction to the drug. This may not necessarily be classified as "drug overdose" or "allergy," but rather a side effect. It’s crucial to follow your doctor’s advice and discontinue the medication if it causes discomfort.

2. If You Suspect Drug Toxicity: If you believe you are experiencing toxicity from the medication, it is essential to stop taking it immediately and consult your healthcare provider. They may recommend supportive care and monitor your symptoms. In severe cases, they might consider alternative treatments.

3. Further Evaluation: If your symptoms persist despite stopping the medication and using artificial tears, it would be wise to seek a comprehensive evaluation from an ophthalmologist at a larger hospital. They can perform detailed tests to rule out any underlying conditions that may not have been identified in previous visits.

4. Mental Health Considerations: It’s understandable to feel anxious when dealing with persistent discomfort. If your anxiety is affecting your daily life, it may be beneficial to speak with a mental health professional. They can help you develop coping strategies to manage your anxiety related to your eye condition.

Additional Recommendations
- Screen Time Management: Since your work requires prolonged computer use, consider implementing the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. This can help reduce eye strain.

- Environmental Adjustments: Ensure your workspace is well-lit, and consider using an anti-glare screen on your computer. Adjusting the brightness of your screen to a comfortable level can also help.

- Warm Compresses: Continue with the warm compresses, as they can help improve oil gland function and provide relief from dryness.

- Hydration and Humidification: Stay hydrated and consider using a humidifier in your workspace to maintain moisture in the air, which can help alleviate dry eye symptoms.

In summary, your symptoms are multifaceted and may require a combination of treatments and lifestyle adjustments. It’s essential to maintain open communication with your healthcare providers and advocate for your health. If your discomfort continues, don’t hesitate to seek further evaluation to ensure you receive the appropriate care. Wishing you the best in your journey toward relief and recovery!

Similar Q&A

Common Eye Issues: Causes of Tearfulness and Eye Discomfort

Experiencing frequent eye discomfort, such as a burning sensation and excessive tearing, may indicate a condition known as dry eye syndrome or other underlying issues such as allergies or conjunctivitis. These symptoms can lead to visual disturbances, but they do not typically ca...

Dr. Wang Zhishun reply Ophthalmology
There are too many reasons; a medical consultation is necessary.

Dealing with Eye Discomfort: Contact Lenses and Dryness Solutions

Hello, doctor. My eyes often feel sore and uncomfortable, not just when I overuse them; sometimes, even when a fan blows on my eyes, they feel sore. I can feel this discomfort from the morning until noon. Wearing contact lenses makes it even worse, and my eyes feel very dry. I us...

Dr. Ke Meilan reply Ophthalmology
Hello: You clearly have dry eye syndrome. You may consider punctal occlusion to retain tear fluid and avoid wearing high-water-content contact lenses. Sincerely, Dr. Mei-Lan Ke, Ophthalmology Department.

Understanding Dry Eye Symptoms and Home Remedies for Relief

The symptoms you described, such as dryness, discomfort, and light sensitivity in your left eye, could indeed be indicative of dry eye syndrome. Additionally, experiencing visual changes like seeing bright or dark spots when blinking can also be associated with dry eyes. Dry eye ...

Dr. Gao Pilin reply Ophthalmology
Hello: Based on your description, the symptoms in your left eye, such as dryness, pressure, light sensitivity, and visual changes, could indeed be indicative of dry eye syndrome. Prolonged exposure to the airflow from a fan can accelerate tear evaporation, leading to dry eyes. ...

Understanding Discomfort in the Eye: Causes and Solutions for Pain and Tears

I would like to ask about my recent discomfort in my left eye, which feels sore and painful (the pain is not constant and sometimes disappears after resting). My eye often waters and feels moist. I visited an ophthalmologist, who found that I have +1.50 diopters of hyperopia and ...

Dr. Zhuang Yamin reply Ophthalmology
Dear Ching, Generally speaking, patients with +150 diopters of hyperopia who do not wear corrective lenses typically do not experience frequent discomfort unless they engage in prolonged near vision activities such as reading. Have you been overusing your eyes recently, leading ...