Friday 21 October 2016

Ask the GP: A closer look at some common eye problems

Nina Byrnes

Published 30/06/2015 | 02:30


Advice from our GP on two different eye problems.

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Question: My eyes have been getting red and sticky lately. Some days are worse than others. They feel itchy and gritty and are stuck together in the morning at times. What treatment do I need?

Dr Nina replies: Conjunctivitis results in the reddening of the white part of the eye (the conjunctiva). The eye may feel itchy, gritty or burning, and the eye may water. Discharge can occur and may be waxy or crust along the eyelashes.

There may be an urge to rub or itch they eye and this can lead to some swelling of the eye itself. Severe eye pain or a change in vision is not a feature of conjunctivitis. If you have either of these you should attend a doctor urgently.

There are three main types of conjunctivitis: bacterial, viral or allergic.

Bacterial conjunctivitis usually occurs in one eye but may sometimes spread to the other. It can come on quite suddenly and cause redness of the eye along with a sticky discharge that may appear along the lashes causing them to stick together.

Viral conjunctivitis usually starts in one eye and rapidly spreads to the other. Viral causes often occur in combination with other symptoms of the common cold. Viral conjunctivitis is highly contagious and can spread quite easily among those in close contact with each other.

Allergic conjunctivitis usually occurs in both eyes. It is commonly associated with other symptoms of hay fever, eczema and asthma. It often peaks in seasons when pollen counts are higher. It sounds like you may have this kind.

When conjunctivitis first occurs, it is reasonable to start by bathing the eye gently or applying cool or warm compresses to sooth the eye. Taking an antihistamine or buying anti-allergy drops over the counter in the pharmacy may help. Artificial tears can be applied frequently and may also soothe the eye.

If simple methods aren't helping, or if there is persistent discharge or crusting of the lids, it is worth seeing your doctor. Antibiotic ointments and drops are usually prescribed if a bacterial cause is suspected.

Prescription anti-allergy drops or the addition of a nasal spray can help relieve allergic symptoms. Viral conjunctivitis only rarely requires prescription medication.

As many cases of conjunctivitis are highly contagious, it is advisable to avoid close contact with others until treatment has kicked in.

Question: I have yellowish spots around my eyes. They have been there  for a while and aren't going away. Someone said these could mean I have high cholesterol.  Is this true? How can I treat these and will they ever  go away?

Dr Nina replies: Xanthelasma usually appear as a soft, almost velvety, yellow flat plaque on the skin on the upper or lower eyelids. They can indeed be associated with high cholesterol but this is not always the case.

The exact cause of xanthelasma is not fully understood. They do occur slightly more commonly in women than in men, and most commonly appear in the fourth and fifth decade of life.

Once the plaques have grown, they tend to remain the same size and do not go away on their own.

If you have these skin lesions, it is worth attending your doctor for assessment of your cardiovascular risk. This would not only involve having your cholesterol checked but also your blood pressure, a check on your height and weight, diet, exercise and family history. It is likely with mild cardiovascular risk that you will first be advised to make lifestyle changes to reduce cholesterol and reduce your risk of cardiovascular disease. If you are found to have higher risk, your doctor may also recommend you start medication to help reduce cholesterol.

Reducing cholesterol can very occasionally help some of the xanthelasma to regress, but this isn't the norm. It may, however, reduce the chance of new ones appearing.

Those who find the appearance of xanthelasma cosmetically unacceptable may seek other methods of treatment. Methods that have been tried include surgical removal, chemical therapy, laser therapy or cryotherapy.

Xanthelasma may reoccur after any of these treatments and it is also important to remember removal may result in a scar replacing the lesion.

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