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Eye and Vision Care

Pain in one eye after waking

06/08/2007

Question:

I appreciate you can`t diagnose over the internet, but you may be able to give me some clues.

I am a 44 year old male in good general health and wear specs for normal vision, there is no history of eye disorders such as Glaucoma in my family and my maternal side has experienced age related diabetes. I have a good diet, get regular exercise and work in front of a computer.

Periodically, I will experience severe but generalised pain in my right eye which is localised to the left hand part of my right eye. I generally notice this when in the shower but I know that this is not related to soap/shower gel etc (I have specifically eliminated this as a possible cause)I think the shower in incidental, I feel its more related to the period after waking and getting up. I find that while washing my face, I will of course close my eyes and find it extremely painful and difficult to open the right one. After a minute or so, the pain will subside and I am ok and this does not reoccur during the day although the right eye does ache a litte. I am not aware of any foreign object being present.

Episodes of this happen from time to time, say every three to four months but randomly.

I`d be grateful for a few clues. Thanks for your help.

Answer:

You are describing possible recurrent corneal erosion due to transient dry eye. This phenomenon is called ocular neuralgia, which occurs when you first open your eyes after sleep or during a dry spell because the upper lid tugs at and pulls off surface tissue (epithelial cells). It's sort of like painful exfoliation.

Keeping the eyes moist (artificial tears help tremendously) and avoiding direct exposure to air vents can solve much of this problem. You can find non-preserved artificial tears at any drug or grocery store. Look for brands such as Refresh Tears, Thera Tears, GenTeal, or Tears Naturale PF. These are gentler to the eye than preserved multidose versions. Some non-preserved tears also come in multidose containers. Just pay attention to wording such as "disappearing" preservative or something to that effect.

Omega 3 supplements (oral softgels or oil) are also helpful to maintain good "quality" tears. If interested, look for those with both fish and flaxseed oils with vitamin E to keep the oils from spoiling too quickly. These are also found to help with heart, skin, and cholesterol health.

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Response by:

Cynthia Gale Heard, OD Cynthia Gale Heard, OD
Formerly
Assistant Professor, Clinical Optometry
College of Optometry
The Ohio State University