Question: Hi,

My wife had an incident with her right eye five days ago when some cat hair got into her right eye as she was around a cat for an hour or so. The cat hairs caused teariness, pain on top of the eye as well as on the top part of the eyeball. They also seemed to cause redness. There was pain in the centre of the head between and above the eyes.



After the eyes had recovered, there was still another episode of pain in the right eye. When looking further ahead, she feels giddiness and some nausea but when looking near she is mostly ok. If only one eye (either right or left) is used to see, she is ok. The right eye vision when looking far does not appear to match or line up with the vision of the left eye and there appear to almost two objects sighted (although is more like the images don’t merge completely without being completely separate) but near vision, there is only one object sighted.

What could the cause and treatment in her case?


Thank you,
Regards.




Hi,

Sorry I just wanted to follow up to say that my wife's right eye which is irritated is also the eye where the vision is not stable and things appear to be moving from side to side when distant things are viewed.


Thank you,
Regards.

Dear Dr. Harshita,

Thank you for your opinion.

My wife has received the probable diagnosis of 6th nerve palsy affecting the right eye from the eye consultant.

In addition, the optometrist has pointed out dry eyes and allergic conjunctivitis as other conditions.

I am wondering whether dry eyes or allergic conjunctivitis can cause or be related to the condition of 6th nerve palsy or whether 6th nerve palsy can worsen dry eyes or symptoms from eye allergies? What are the best treatments for both dry eyes and allergic conjunctivitis?

For the double vision, a prism was given to cover one eye? Should this prism cover the affected right eye or is it better to cover the unaffected left eye?

Also although a factor reading of 20 was preferred, only 15 was given. Is it a valid point that a lower factor will allow the eyes to adjust on their own? Would you agree with the advice not to cover either eye individually and to let both eyes adjust most of the time?


Thank you,
Regards

Dear Dr. Harshita,

Thank you for your opinion.

Can you recommend eye drops for both dry eyes and allergic conjunctivitis?

Hylo Forte and Systane Complete have been tried for the dry eyes and are quite effective.

We have tried Visine Allergy which had limited effect on the eye pain and also Patanol for the allergic conjunctivitis, which seems to work better but causes immediate and serious drowsiness/sleepiness?

Regarding the use of the prism over the affected eye, would it slow recovery of the eyes if used all the time?

Also just to clarify, the optometrist was referring to completely covering one eye when going out. This would prevent the double vision but would not allow the eyes to recover.



Thank you,
Regards.

Dear Dr. Harshita,

Sorry just to follow up on the eye drops for allergic conjunctivitis, is it also an option to consider separate mast cell stabilisers and antihistamines or vasoconstrictors or combinations of these effects for the drops? I note that Patanol is a combination anti-histamine/mast cell stabiliser.



Thank you,
Regards.