[57F] Experiencing dry itchy eyes, fatigue, and headache

Patient Description

A 57-year-old female presents with moderate to severe itchiness in her eyes, specifically from the eyelid to the eyelash line, which has been ongoing for 14 days. The itchiness extends to under the eye and has resulted in scaliness and puffiness, potentially from rubbing. She has found some relief using hydrocortisone cream. Accompanying symptoms include an aching headache across the forehead with an intensity of 6.5 out of 10, which worsens in bright light, and morning vision blurriness. She also reports fatigue. The patient has been taking Allegra (180 mg daily) for allergies, and supplements including Vitamin D3 (5000 IU) and Vitamin K2 (100 mcg). There is no known personal or family history of autoimmune diseases, but there is a family history of seasonal allergies. No other medications or known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on the information provided, possible explanations for your symptoms include:

  • Dry Eye Syndrome: This condition occurs when your eyes don't produce enough tears for adequate lubrication. It can cause a range of symptoms including itchiness, redness, and a sensation of having something in your eyes. Dry eye can also cause light sensitivity and blurred vision.

    • Treatment typically involves over-the-counter or prescription eye drops to help increase tear production or decrease tear evaporation.
  • Allergic Conjunctivitis: This is inflammation of the conjunctiva (the thin layer that covers the white part of the eye and the inside of the eyelids) due to an allergic reaction. It can cause itching, redness, and tearing.

    • Treatment usually involves avoiding the allergen and using antihistamine eye drops.
  • Blepharitis: This is inflammation of the eyelids, often where the eyelashes grow, causing red, irritated, itchy eyelids and the formation of dandruff-like scales on eyelashes. It can also cause blurred vision.

    • Treatment usually involves good eyelid hygiene, including warm compresses and eyelid scrubs.

Your headache and fatigue could be related to your eye symptoms, particularly if you are straining to see or if the discomfort from your eyes is causing stress or interrupting your sleep.

What you can do

While it's important to seek care from a healthcare professional for a formal diagnosis and treatment, here are some general suggestions that might help:

  1. Try over-the-counter lubricating eye drops (artificial tears) to help with dryness and itchiness.
  2. Avoid rubbing your eyes as this can worsen your symptoms.
  3. Apply a warm compress to your eyes for a few minutes a couple of times a day.
  4. Practice good eyelid hygiene. This includes gently washing your eyelids with a mild soap and warm water.
  5. Take breaks when doing activities that can strain your eyes, such as reading or using a computer.
  6. Ensure you are getting enough sleep and maintaining a healthy diet to help manage your fatigue.

What you should look out for

Please seek immediate medical attention if you experience:

  • A sudden increase in the severity of your symptoms
  • Pain in your eyes
  • Sudden loss of vision or double vision
  • Symptoms that do not improve or worsen despite self-care measures

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


What are the common causes of itchy eyes and how can they be treated?

Common causes of itchy eyes include dry eye syndrome, allergic conjunctivitis, and blepharitis. Treatment varies depending on the cause: dry eyes can be managed with lubricating eye drops, allergic conjunctivitis with antihistamine drops, and blepharitis with good eyelid hygiene and warm compresses.


How can I differentiate between dry eye syndrome and allergic conjunctivitis?

Dry eye syndrome often presents with a gritty feeling, light sensitivity, and blurred vision, while allergic conjunctivitis typically involves redness, itching, and tearing. A healthcare provider can help differentiate between the two through a detailed examination.


What are some effective home remedies for managing blepharitis?

Effective home remedies for blepharitis include applying warm compresses to the eyelids, gently scrubbing the eyelids with a mild soap or baby shampoo, and maintaining good eyelid hygiene. Avoiding eye makeup and using artificial tears can also help.


When should I seek medical attention for eye-related symptoms?

You should seek medical attention if you experience a sudden increase in symptoms, eye pain, sudden loss of vision, double vision, or if symptoms do not improve with self-care measures.

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