Question
hello,
I have been having a recurring infection in my eyes since I was 15 years old, I am now 30. The infection starts off as a white discoloration at the corneal rim (junction of cornea and sclera). This is the only area affected. It never shows up isolated over the iris or the center of the cornea. It is always touching the corneal rim. Sometimes its just a small dot, and other times its larger white discoloration following the corneal rim. Occurs most often at the medial and lateral cornea.
Onset: I find it occurs when I am stressed (tests, money problems, etc.), if I am near an open fire, if I work on cars (possibly the carbon/grease mixture), if I dont wash my face (my face gets very oily especially when I sleep), if sweat gets into my eyes and i dont wash my face shortly afterwards, and if the heater is on causing dry air. These are the most common signs prior to onset.
Provocative: Sunlight or bright light, if I think about it, and heat.
Palliative: Lately Ice seems to decrease pain, pain killers do not work, only makes me drowsy but pain is still there. When I was 23 I was prescribed blephamide, it numbed the eye and the pain stopped but the infection came back. I dont think it was the right thing because what I have maybe viral.
Symptomology: Extreme pain 5/10-8/10 at worst. Sharp stabbing pain as if a large pebble is in my eye. Causing reddening of the sclera, becomes very vascular. Pain can radiate causing headaches. Runny eyes, photophobia, blurred vision.
Timing: I usually wake up with it in the morning, lasts about 2-3 days, the second day being the worst in terms of symptomology. Occurs most often in the winter. It keeps me up at night due to pain. If I dont sleep the infection lasts longer.
Medical History: I am generally a healthy active individual, on two occasions I was told that my white blood cell count was just below normal, otherwise blood test have come back normal. I have been to 5 different doctors over 15 years. At UCSF a sample was scraped off for testing, the doctor said I was allergic to the oils I produce on my eyelids. She then prescribed blephamide. My vision is perfect, but I have been told that there is significant scarring on the Iris and getting worst.
My question is what can I do? Where can I find a doctor that specializes in infections? I have looked online with not good results. Do you think this maybe Herpes? if so how can I get tested to confirm of ddx from bacterial infection? please let me know what you think. I am very desperate because it seems to be getting worst. The pain is debilitating, I cant do anything. Your help is greatly appreciated.
Answer
Dear JWD,
No this is not Herepes, but from the history, symptoms and your description seems to fit more as a diagnosis of ocular rosacea.
You will need to see a good skin specialist for this.
You can read more about this on the net (http://www.about-rosacea.com/ocular-rosacea.htm or http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-07-2/9.pdf) but would request you not to go about finding where you fit until you meet a skin specialist and confirm diagnosis.
Hope this helps,
Best
Dr Anand Shroff, MS OPHTH, FICS
dranand@lasikindia.in
Dr Safala Shroff
Refractive and Surgery Coordinator
Shroff Eye Hospital-LASIK
222, S V Road,
Bandra West
Mumbai 400 050
India
Phone: 022 - 66921000/ 66939372
Cell:098211-63901
www.lasikindia.in
Shroff Eye Clinic
Gobind Mahal
86 - B Netaji Subhash Road
Marine Drive
Mumbai 400 002
Phone: 022 - 22814077, 2811863, 22029242
www.shroffeye.org
Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first and only Wavelight Concerto 500 Hz LASIK center- The Worlds Safest and Fastest LASIK.
