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Pink Eyes, Sinus Infection, Sulfa Eye Drops, Uveitis, Immune Disorder. Treatment ?

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Posted on Sat, 26 May 2012
Question: My son has very stubborn pink eyes. Had sinus infection last week treated with sulfa. Pink eyes started and he was given a sulfa eye drops, then the eyes got worse. They took him off those and treated for viral pink eye with steroid drops. Still having issues. There was concern with uveitis as he has an immune disorder, but the opthamologist determined he did not have that. But he still has the terribly red eyes. Any suggestions? Poor guy has a job interview. Also can you use home remedies with the prescribed drops?
doctor
Answered by Dr. Robert Galamaga (4 hours later)
Hello,

Thank you for your query.

As you have reported it looks like he has a stubborn case of conjunctivits. Now whether this is allergic, bacterial or viral remains to be seen. I think at this point since he has completed courses of antibiotics and anti-virals that I would lean more in a direction to address this aggressively from an anti-allergy standpoint.

I know he has an interview coming up so what I would recommend in the meantime would be to have him start taking over the counter zyrtec daily at bedtime. In addition there is a prescription eye drop called Optivar which often works wonders in this setting at calming down inflammation to a manageable level. This can be obtained from a physician or nurse practitioner.

Anither thing I recommend is that you purchase XXXXXXX and Johnsons baby shampoo and have him wash his eyes thorougly daily with this shampoo. This will help remove oil and dead skin cells from around the eye while not irritating the eyes.

I cannot recommend any home remedies as I no of none which work reliably. Lastly he could use some warm compresses over the eyes three times daily for 5 minutes to again help with inflammation.

Again I thank you for your query. I hope you have found my answer to be both helpful and informative. Should you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Robert Galamaga (6 hours later)
How does one know the difference of viral, bacterial or allergy? The two opthamologists both said viral when he was seen. The initial bacterial diagnosis was given over the phone with the doctor for a consult. Also the opthamologitst ruled out uveitis which was NIH's question regarding ALPS patients. I guess this is kind of confusing.

Thank you for the tips as I will present those to him. All we can do is try.
doctor
Answered by Dr. Robert Galamaga (12 hours later)
Hello and thanks again,

The only true way to make the diagnosis without a doubt would be to perform cultures of eye secretions to see if bacteria or viruses are isolated. In the absence of doing that it is more of a clinical impression on the exam.

Bacterial infections tend to produce more yellowish or XXXXXXX drainage while viral and allergic tend to generate more copious amounts of typically clear secretions. All of these - allergic or infectious can cause redness of the eye itself. Viral infections can sometimes get behind the eyeball and cause clouding of the cornea (the clear covering of the eye).

My one last question which you might bring up to his physicians is whether patients with ALPS have any problem with immunoglobulin deficiency. If there is a concern for that they could check quantitative levels of these at some point in the future. Just a thought there on that.

Thanks again for submitting your query. I hope you found my response to be both helpful and informative. Should you have additional concerns, I would be happy to address them.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Pink Eyes, Sinus Infection, Sulfa Eye Drops, Uveitis, Immune Disorder. Treatment ?

Hello,

Thank you for your query.

As you have reported it looks like he has a stubborn case of conjunctivits. Now whether this is allergic, bacterial or viral remains to be seen. I think at this point since he has completed courses of antibiotics and anti-virals that I would lean more in a direction to address this aggressively from an anti-allergy standpoint.

I know he has an interview coming up so what I would recommend in the meantime would be to have him start taking over the counter zyrtec daily at bedtime. In addition there is a prescription eye drop called Optivar which often works wonders in this setting at calming down inflammation to a manageable level. This can be obtained from a physician or nurse practitioner.

Anither thing I recommend is that you purchase XXXXXXX and Johnsons baby shampoo and have him wash his eyes thorougly daily with this shampoo. This will help remove oil and dead skin cells from around the eye while not irritating the eyes.

I cannot recommend any home remedies as I no of none which work reliably. Lastly he could use some warm compresses over the eyes three times daily for 5 minutes to again help with inflammation.

Again I thank you for your query. I hope you have found my answer to be both helpful and informative. Should you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga