When a patient complains of eye pain asking the right questions often helps determine the cause of the pain. This makes the diagnosis and treatment easier. It is helpful to distinguish between eye pain caused by external factors such as a foreign body on the surface of the eye and internal pain caused by elevated intraocular pressure or internal ocular inflammation.
External Causes of Eye Pain
Material such as dust particles, metal fragments, cat hairs, and eyelashes feel like there is a particle in the eye. These are easy to find and remove. They can cause a scratchy feeling in the eye. Sometimes a foreign body is lodged under the inside surface of the upper lid and can only be removed by everting the upper lid. If the foreign body is embedded in the cornea it can cause a corneal abrasion. A corneal abrasion feels like there is something in the eye. Dry eye can also cause external irritation and dry eye patients often complain of burning and feeling something in their eyes. Dry eye, superficial corneal or conjunctival foreign bodies rarely cause blurred vision or photophobia (light sensitivity). External irritation associated with photophobia and/or blurred vision suggest a more serious condition such as a corneal ulcer.A sty can also cause a foreign body sensation.
Internal Causes of Eye Pain
Episcleritis is an inflammation of the outer layer of the sclera, the white of the eye. This often presents with localized redness and tenderness to touch. Uveitis, an inflammation of the inner eye is associated with eye pain. The pain is usually felt inside the eye and does not feel like there is something in the eye. Inflammation of the front portion of the inner eye is called iritis and causes photophobia. Optic neuritis, an inflammation of the optic nerve, is associated with pain on eye movement.
Other Causes of Eye Pain
Migraine, sinus disease, and glaucoma can also cause eye pain. Even eye strain from wearing the wrong eyeglass or contact lens prescription can cause eye pain. Pain following eye surgery can be a sign of infection and requires immediate attention. Pain following trauma to the eye can also indicate a serious condition.
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Eye pain, redness, light sensitivity and decreased vision can be caused by a corneal infection called an ulcer. A corneal ulcer is a collection of white blood cells in the cornea which is sometimes visible as a white dot in the cornea. You can get more information here. If you suspect that you have a corneal ulcer then do not delay getting an Ophthalmological evaluation. Prompt diagnoses and rapid treatment are key to successful treatment and raise the odds of preserving vision. This is an Ophthalmological emergency.
Modern antibiotic drops can treat bacterial corneal ulcers successfully if the diagnoses is made early and the drops started promptly. Corneal infections caused by a fungus or an organism such as an amoeba can be devastating and may require a corneal transplant.
REMEMBER
Avoid sleeping in contact lenses,
always wash hands prior to handling contact lenses,
wash and replace contact lens cases, and sterilize the lenses in a good sterilizing solution.
Replace the lenses on schedule.
Do not try to “stretch” the wearing interval beyond the lens specifications.
The risk of getting a corneal ulcer is not worth it.
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Dry eye is a very common cause of contact lens problems and contact lens intolerance. It causes wearers to feel as if there is something in their eyes, a foreign body sensation in their eyes, as if there is grit or dirt in the eye, and eye pain when wearing soft contact lenses.
Mild dry eye conditions can often be alleviated by contact lens moisturizing drops, but it is important to pick the right one. If moderate or severe dry eye syndrome exists then wearing soft contact lenses will be impossible without treatment of dry eye.
Even patients with very dry eyes can be helped with new treatments. A complete cure for dry eye with very comfortable contact lens is possible.
Some patients come in with contact lens irritation, unable to wear contact lenses. They have been to several other eye doctors Ophthalmologists or Optometrists. I treat them step by step starting with changing the contact lens solution (see here), inserting punctal plugs, and if needed prescription eye drops which can cure the underlying dry eye syndrome. I am as patient as the patients are. If they stick with my treatment program a vast majority of them become happy contact lens wearers. I help patients who have been told they cannot wear contact lenses anymore.
The cure for dry eye is also the road to successful LASIK refractive eye surgery.
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