Eye Care (cont.)
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
Which common disorders of the eye can (sometimes) be self-treated?
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Blepharitis: Blepharitis is a common condition that is caused by inflammation of the eyelid. It results in red, scaly, and thickened eyelids and typically some loss of the eyelashes. Blepharitis may be due to either Staphylococcus epidermidis or Staphylococcus aureus (types of bacteria), seborrheic dermatitis (a type of skin inflammation of unknown cause), or a mixture of the two. It is sometimes associated with rosacea of the face. The most common complaints of blepharitis are itching, flaking of the lids, and a feeling of burning of the eyes. Blepharitis is initially treated by applying hot compresses to the affected eye, followed by an eyelid scrub. If the condition persists, you should see the doctor, who may prescribe antibiotic eye drops, eye ointments, or pills.
Lice: The eyelids can become infested with one of two different lice, the crab louse (Phthirus pubis) or the head louse (Pediculus humanus capitis). Lice in the eyelids cause symptoms and signs that are similar to those of blepharitis (red, scaly, and thickened eyelids, usually with some loss of the eyelashes). It is common in young school-age children. One can sometimes see movements of the adult lice at the base of the lashes. Petrolatum or a nonmedicated ointment is applied to the eyelid and suffocates the lice eggs. RID, NIX, A-2000, or any other preparation that is designed for lice eradication in the hair should not be used near the eyes.
Contact dermatitis: Contact dermatitis is an inflammation of the skin that causes swelling, scaling, or redness of the eyelid with intense itching. This condition usually is triggered by the use of a new product (soap or makeup) or exposure to a foreign substance. If both the upper and lower eyelids are affected, the cause of the inflammation is likely to be an allergic reaction. Even if the foreign substance has previously been used for many years without reaction, allergy can result. Antihistamines that are taken by mouth can be used to treat contact dermatitis of the eyelid. Discontinuation of the offending agent is necessary to minimize recurrences.
Superficial foreign bodies: Lint, dust, an eyelash, or other foreign matter can become stuck in the eye. When the substance cannot easily be removed either with your finger, water, or an eye irrigating solution, a doctor should be seen.
Thermal damage: Thermal damage is a burn injury to the eye itself. Exposure to the sun's UV radiation during outdoor activities is an example of minor ocular thermal damage. An eye lubricant can be applied to soothe the eye. If there is no relief to the eye after 24 hours, a physician should be seen. A more severe thermal injury to the eye, for example, from a welder's arc or from sunlamp exposure, warrants the immediate attention of a doctor.
Conjunctivitis: Bacteria, viruses, fungi, allergic substances, or inflammation-promoting agents can cause inflammation of the palpebral and bulbar conjunctiva, also known as conjunctivitis. The inflammation causes enlargement of the blood vessels in the conjunctiva ("congestion") and causes the conjunctiva to become red ("bloodshot"). Itchy eyes may or may not accompany the inflammation. The eyelids may be stuck together in the morning and there may be tearing or discharge from the eye or eyes. The congestion and itchiness can be temporarily treated with ocular decongestants, but the underlying cause may need treatment from a physician as well.
Dry eye: Dry eye is characterized by a white or mildly reddened eye combined with a sandy, gritty, dry feeling. Paradoxically, dry eye can sometimes be accompanied by excessive reflex tearing. The dryness itself can stimulate an increase in the production of tears. Dry eye, also known as KCS or keratoconjunctivitis sicca, is very common and is increasing in frequency due to an aging population and increased pollution in the air. Dry eye symptoms are worse at high altitudes and in low humidity situations, such as in airplanes. Dry eye is more common in females. It is sometimes associated with dry mouth (Sjögren's syndrome) or other autoimmune diseases. Other factors thought to contribute to dry eye are some drugs such as antihistamines, antidepressants, or diuretics (water pills). There are many OTC eye drops available for the self-medication of dry eyes. These vary in their formulations, consistency, and preservatives used. Although these lubricants are effective for treating many cases of dry eye, a physician also should be consulted.
Hordeolum: Commonly referred to as a sty, a hordeolum is an inflammation of the glands within the eyelid, typically with infection. The primary sign of a hordeolum is a tender, raised nodule on the eyelid. Sometimes, the eyelid is so swollen that the eye appears to be completely shut. A hordeolum is usually caused by the same bacteria that are linked to blepharitis. Recurrent hordeolum can be associated with rosacea. Treatment usually is with hot compresses several times per day, but if the problem worsens or does not clear within a week, a physician should be seen. Antibiotics may be necessary.
Chalazion: A chalazion looks similar to a hordeolum. A chalazion is a raised nodule without the tenderness of a hordeolum. It usually does not harbor any infection. Like a hordeolum, it is treated with hot compresses. If the chalazion persists, a physician should be consulted. Although this is not a tumor, sugical removal may be necessary for cosmetic or comfort reasons.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 9/28/2012
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