Hi doctor,
My mother will be 71-year-old in the next four months. She is about 5 feet tall and weighs about 60 kg. She suffered from an ischemic stroke four years ago. Currently, she has the following disturbing health conditions: severe eye pain with gritty feeling in her eyes, forgetfulness, tiredness, and dizziness intermittently, numbness and spiky sensations on the lower legs and arm, distorted speech with unusual eye tears, high blood pressure (152/102 mm Hg as of today), high blood sugar (FBS-154 gm/dl as of today), and intermittent malarial fever. She was given tablet Pregabalin 75 mg, tablet Aspirin 75 mg, tablet Atorvastatin 80 mg late last year, and stopped. She is currently on tablet Amlodipine 5 mg, tablet Ramipril 5 mg, tablet Metformin, vitamins, minerals, and food supplements. She is tired of being on medication for over four years. Her primary complaint is the severe pain in her eyes with irregular eye tears and pain or numbness of her lower arm and leg regions. I have attached a copy of the CT scan she took last year for your review. Current eye complaints include severe pain, hotness, irritation, tiredness while viewing TV or reading for over four hours in both eyes, tendency to shed tears while talking or laughing heavily. Her eye pressure last month was 11 mm Hg. She has been taking ophthalmic and allergen eye drops. Can you please advice me? Your guidance and prescription will be highly appreciated.
Hello,
Welcome to icliniq.com.
Kindly upload a picture of both her eyes. And when she sleeps, do her eyes close entirely or remain slightly open?
I want these details for proper treatment.
Thank you doctor,
I have attached the pictures. Obviously, from the picture, her eyes are completely closed while sleeping. Expecting your response as soon as possible.
Hello,
Welcome back to icliniq.com.
As per the symptoms described by you, she has very severe dry eye disease (DED). I wanted a picture with her eyes open to see if the cornea is healthy. I suggest the following treatment:
1) Warm compresses: Take a cotton napkin, warm it with an iron, and gently do compression over the lids.
2) Lid massage: Gently stroke the upper lid from above downwards and lower lid from below upwards four to five times a day.
Medications :
- Eye drop Fluorometholone three times a day.
- Eye drop Carboxymethylcellulose 1% six times a day.
- Eye ointment Hydrocortisone twice a day over lid margin.
- Eye ointment Genteal gel or Panthegel twice a day.
Also, if possible, get her glass power checked. She should be using glasses atleast for near vision at her age. That will reduce eye strain and pain as well.
Thank you doctor for the prompt response,
I have sent you two pictures, one with the eyes closed and the other with eyes opened. Please check the two attachments. Regarding your prescription, should I apply the Genteal get and Hydrocortisone ointment simultaneously on the eyelid margin? Can I use the two eyedrops at the same time on the eyes?
Hi,
Welcome back to icliniq.com.
I saw the pictures attached (attachment removed to protect the patient's identity).
Her cornea seems fine.
Hydrocortisone needs to be applied on margin.
You should apply Genteal gel inside the eyelids. Pull the lower lid and then apply.
You can use both eyedrops at the same time.
Regards.
Thank you doctor,
You are amazingly good.
Hello,
Welcome back to icliniq.com.
That is sweet of you to take care of your mom.
Dry eyes can be very distressing for the patient. Kindly get back to me after two weeks with the response to the treatment.
I have not given any tablets on purpose as she is already on so many medications. However, we will see if we need them in the future as per her response to treatment.
Thank you doctor,
I will revert to you after two weeks.
Hello,
Welcome back to icliniq.com.
I will be happy to help you.
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