Has anyone ever gotten one of these?

Question

I started with symptoms of a pink eye. Got treated, did not go away. My eye is dripping clear discharge and the white of my eye is completely red and my face is swollen on that side. Any idea what this is. I am seeing an ophthomologist again, I am getting no relief from the Bactrim or eye drop medications. Serious comments only.

Answer 1

Hello,

I'm sorry about this.  My main message is, don't be too worried about the white of the eye, so long as the eye itself (the transparent cornea, and the eye-chamber underneath the transparent cornea) is healthy.

If before starting treatment, you had a swab test taken from your eye, that might now be helpful in telling what the germ is and which antibiotics it's sensitive to.  If not, then it's a bit more speculative what the germ is.  

The common ones are the 'Staph' or 'Strep' pus-formers, but less common germs like Chlamydia (pronounced clam- MID'' --ee- a), Pseudomonas (pronounced syoo-doe-MOE''-nas), and Herpes simplex (causing a 'dendritic ulcer'),  can all be resistant to first-choice antibiotics and need special antibiotics.

I think another consideration, is whether you have an underlying eye problem, which has gotten secondarily infected.  Clearly you don't wear contact lenses, or you'd have mentioned it.  But I think you could do with that eye test where they drop yellow fluorescein dye into the front of the eye, - - because that test will show up any ulceration of the outside lining of your clear, transparent cornea.

I'm afraid I think you need this test again, even if you've already had it.     With an infection of this strength, you might have gotten a corneal ulcer now just from the strength of the infection.

If you are prone normally, to overly-dry eyes, then this can make the front of the eye more vulnerable to infection than usual.  Just an aside.

I think another important consideration now, is to prevent the infection getting *inside* your eye and causing 'anterior uveitis,'  (pronounced yoo-vee-EYE''-tis), I am afraid there is no common name.  The space between the front of the coloured iris and the *back* of the cornea, is filled up with a clear watery fluid which circulates. If the infection spreads into this fluid, you get a suspension of pus in the anterior chamber instead of the clear fluid, (this space is called the 'anterior chamber of the eye').  

Also, anterior uveitis can cause the back of the coloured iris/pupil, to get stuck by pus onto the front of the eye's focussing-lens, I won't bother you with the medical name for that.

I think you need another bacterial test-swab taking, and your eye re-examining with fluorescein and then with a 'slit-lamp,' - - that's the light on a sideways swing-out beam, used to examine the cornea for ulcers, and the anterior chamber for pus.

Your doctor may decide to entirely prevent sticky-iris/lens problem (above), by putting in drops like atropine that dilate your pupil on that side, until you're better. That's called 'dilating you' (dilating me) by doctors.  Oh, all right, that problem's  called 'posterior synechiae,' (pronounced sye - NEE'' - kee - ee), sorry there's no common name.

In the meantime I think you should get an eye bath and a big bottle of sterile eye-wash, from the pharmacy, and then spend 10 minutes, 6 times a day with your eye open and blinking inside the bath, to wash the pus out and to stop your eyelids from sticking together.  I'd be surprised if you don't wake up with them stuck together in the morning.  If you put this bottle into the airing-cupboard when you're not using it, that warms the solution up a bit, makes it less like of an icy shock.  A sticky antibiotic eye ointment, put in at night, may help prevent early-morning stickiness.

I think the face swelling, is probably the germ gotten into your eyelid and cheek tissues, but your doctor may want to consider giving you an antibiotic by mouth too, to get at the soft tissues and to prevent the germ from getting into your sinuses.

I'm afraid this advice is very prescriptive, very 'telling-you-what-to-do.'  This is what I would advise in England, UK, and perhaps USA practice is different, - -  but I wouldn't have thought very much so.

I'm also afraid the eye is one of the most complicated-difficult-language items in the body.  I suggest you might memorize some of the relevant technical words, because the ophthalmologist will recognize them.  They're fun, and very impressive if you can just toss them out in proper context.

I hope this is of some help!

Best wishes,

Belliger  (retired uk gp)  

PS. An infected anterior chamber (anterior uveitis),  also goes under the name of 'irido-cyclitis,' (pronounced eye-ridd-oh  Sye-KLYE''-tis), sorry! The 'irido-'  refers to the iris, and the 'cyclitis' to the focussing-lens inside the eye).