[23F] With right eye pain, pressure, and blurred peripheral vision

Patient Description

A 23-year-old female presents with a two-week history of right eye pain, pressure, a sensation of something being in the eye, dryness, itchiness, and swelling of the eyeball. The symptoms began suddenly and have not been relieved by TheraTears or Pataday eye drops. The patient also reports blurred peripheral vision, light sensitivity, watering of the eye, headaches, and seeing halos around lights. There is no redness, discharge, or crusting noted. The patient's medical history includes Ehlers-Danlos Syndrome (EDS), sinus tachycardia, autism, and ADHD. Current medications include Verapamil 360mg ER QD, Bisoprolol 5mg QD, Abilify 2mg QD, Buspirone 15mg QD, Prozac 90mg DR Qweekly, Vyvanse (1 year), Duoneb PRN, and Melatonin 15mg. The patient has been on Verapamil and Bisoprolol for 3 years, Abilify for less than 1 month, Buspirone for 1.5 years, Prozac for 8 years, Vyvanse for 1 year, and Duoneb for 1.5 years.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Dry Eye Syndrome: Your symptoms of dryness, itchiness, and a sensation of something in your eye are common in dry eye syndrome. This condition occurs when your eyes don't produce enough tears or the right quality of tears to keep your eyes lubricated.

  2. Conjunctivitis (Allergic or Viral): The itching, watering, and sensation of something in your eye could be due to conjunctivitis, commonly known as pink eye. Although you don't have redness, allergic or viral conjunctivitis can sometimes present without it.

  3. Glaucoma: The sudden onset of pain, pressure, blurred vision, halos around lights, and headaches could be indicative of acute angle-closure glaucoma, a serious condition where the pressure inside the eye increases rapidly.

  4. Sinus-Related Issues: Given your history of sinus tachycardia, it's possible that sinus congestion or infection could be contributing to the pressure and pain around your eye.

What you can do

For Dry Eye Syndrome:

  • Use Artificial Tears: Continue using lubricating eye drops like TheraTears. You might need to use them more frequently.
  • Warm Compresses: Apply a warm compress to your eyes for 5-10 minutes several times a day to help with the dryness and discomfort.
  • Humidifier: Use a humidifier in your home to add moisture to the air, which can help alleviate dry eyes.

For Conjunctivitis:

  • Avoid Allergens: If you suspect allergies, try to avoid known allergens and consider using antihistamine eye drops.
  • Maintain Hygiene: Wash your hands frequently and avoid touching your eyes to prevent the spread of infection.

For Glaucoma:

  • Seek Immediate Medical Attention: Given the seriousness of acute angle-closure glaucoma, you should see an eye specialist as soon as possible. This condition requires prompt treatment to prevent vision loss.

For Sinus-Related Issues:

  • Nasal Decongestants: Over-the-counter nasal decongestants or saline sprays can help relieve sinus pressure.
  • Stay Hydrated: Drink plenty of fluids to help thin mucus and relieve sinus congestion.

General Tips:

  • Avoid Eye Strain: Take regular breaks if you're doing activities that require intense focus, like reading or using a computer.
  • Protect Your Eyes: Wear sunglasses to protect your eyes from bright light and reduce light sensitivity.

What you should look out for

Given the severity and sudden onset of some of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Eye Pain: If the pain in your eye becomes unbearable.
  • Sudden Vision Loss: If you experience a sudden loss of vision.
  • Increased Blurriness or Halos: If the blurriness or halos around lights worsen.
  • Severe Headaches: If your headaches become more severe or are accompanied by other symptoms like nausea or vomiting.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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5 mo ago

People Also Ask


What are the common symptoms of acute angle-closure glaucoma?

Common symptoms of acute angle-closure glaucoma include sudden eye pain, headache, nausea, vomiting, blurred vision, halos around lights, and redness of the eye. It is a medical emergency that requires immediate attention to prevent vision loss.


How can Ehlers-Danlos Syndrome affect eye health?

Ehlers-Danlos Syndrome can affect eye health by causing issues such as dry eyes, keratoconus (a condition where the cornea becomes thin and cone-shaped), and increased risk of retinal detachment due to the connective tissue abnormalities associated with the syndrome.


What are the potential side effects of using multiple medications for ADHD and mental health conditions?

Using multiple medications for ADHD and mental health conditions can lead to side effects such as dry mouth, dizziness, increased heart rate, insomnia, and potential interactions between medications. It's important to monitor symptoms and consult with a healthcare provider to manage these effects.


How can sinus issues contribute to eye pain and pressure?

Sinus issues can contribute to eye pain and pressure due to the proximity of the sinuses to the eyes. Inflammation or infection in the sinuses can lead to increased pressure and discomfort around the eyes, sometimes mimicking or exacerbating eye-related symptoms.


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