Eye Pain: Allergies vs. Acute Conjunctivitis

Q: Eye Pain: Allergies vs. Acute Conjunctivitis

Hello： <br>1. <br>Flucason contains steroids and can be used during acute episodes of allergic conjunctivitis; however, it should be used with caution in individuals with special constitutions, as long-term use may trigger side effects such as glaucoma and cataracts. <br>Spersall

Tearing or instilling eye drops can cause a stinging sensation in the eyes?

Dear Dr.
Hu,
I have been using chloramphenicol eye drops daily, but recently I have noticed an increase in discharge from both eyes, and my eyes sting when I tear up or apply the eye drops.
During these episodes, my eyes also appear red.
I consulted two doctors; one diagnosed me with acute conjunctivitis, while the other suggested it was an allergy.
They prescribed the following eye drops: Flucason (fluocinolone acetonide) and Spersallerg (azelastine and phenylephrine).
I would like to ask the following questions:
1.
Do you believe my condition is acute conjunctivitis or an allergy? Which eye drop should I use?
2.
Will these two eye drops have any effect on the retina?
3.
Can I use chloramphenicol eye drops in conjunction with these medications?
Thank you for your assistance.

Xiao Lai, 30~39 year old female. Ask Date: 2009/09/10

Dr. Hu Yusheng reply Ophthalmology

Hello:
1.
Flucason contains steroids and can be used during acute episodes of allergic conjunctivitis; however, it should be used with caution in individuals with special constitutions, as long-term use may trigger side effects such as glaucoma and cataracts.
Spersallerg is a combination of a vasoconstrictor and an antihistamine, which can also be used for allergic conjunctivitis, but prolonged use should be approached with caution, as discontinuation may lead to rebound redness and other side effects.
2.
Please refer to the package insert; short-term use should not pose any issues.
3.
These medications can be used together; however, please space them five minutes apart.
Wishing you peace and good health.

Reply Date: 2009/09/10

More Info

Dear Patient,
Thank you for your detailed inquiry regarding your eye condition. Based on your symptoms and the treatments you've received, let's address your questions one by one.

1. Acute Conjunctivitis vs. Allergies: The symptoms you describe—excessive tearing, redness, and pain when applying eye drops—can indeed be indicative of either acute conjunctivitis or allergic conjunctivitis. Acute conjunctivitis is often characterized by a sudden onset of redness, discharge, and discomfort, typically caused by bacterial or viral infections. On the other hand, allergic conjunctivitis usually presents with itching, redness, and watery discharge, often triggered by allergens such as pollen, dust, or pet dander. Given that two different doctors have provided differing diagnoses, it may be beneficial to consider the context of your symptoms. If you have a history of allergies or if your symptoms worsen in certain environments, allergic conjunctivitis may be more likely. Conversely, if there is significant discharge and discomfort, acute conjunctivitis could be the cause.
As for which eye drop to use, if you suspect an allergic reaction, the Spersallerg (which contains an antihistamine) may be more appropriate. If the symptoms align more with an infection, the Flucason (a steroid) might be indicated to reduce inflammation. However, using steroids without a clear diagnosis of inflammation can sometimes exacerbate infections, so caution is advised.

2. Impact on the Retina: Both Flucason and Spersallerg are primarily designed to treat surface eye conditions and should not have a direct impact on the retina when used as directed. However, prolonged use of steroids can lead to increased intraocular pressure and potential complications such as cataracts, which can indirectly affect vision. It’s crucial to follow your doctor's instructions and not to use these medications longer than necessary.

3. Combining Chloramphenicol with Other Eye Drops: Chloramphenicol is an antibiotic used to treat bacterial infections. It can generally be used alongside other eye drops, but timing is important. If you are using multiple eye drops, it is advisable to wait at least 5-10 minutes between applications to allow each medication to absorb properly and to minimize any potential interactions. However, using chloramphenicol continuously without clear evidence of a bacterial infection may not be necessary and could lead to resistance or other complications.

In summary, it is essential to clarify the diagnosis with your healthcare provider. If your symptoms persist or worsen, consider seeking a third opinion or returning to your eye care specialist for further evaluation. They may recommend additional tests, such as a conjunctival swab, to determine the exact cause of your symptoms.
In the meantime, ensure you are practicing good eye hygiene, avoid touching your eyes, and consider using artificial tears to help alleviate dryness and irritation. If you experience any significant changes in vision, increased pain, or other concerning symptoms, seek immediate medical attention.

Take care of your eyes, and I hope you find relief soon.

Best regards,
Doctor Q&A Teams

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