Uncomfortable Conjunctivitis in right eye.

[fishhooks]

What started out as apparently a mild case of Red-Eye, has worsened to Fungal Conjunctivitis.

Have had this for around a week now and originally thinking it was a very mild infection, trusted my well known to me Pharmacist in Bangkok, who gave me TobraDex.

No change after a few days, so now in Korat visited the Eye Clinic at Bangkok Hospital a few days back.

After an inspection with his mountain of gear, the doctor advised that I had a Fungal Infection and prescribed VIGAMOX.

I may be too impatient about this, but still no improvement. As well as the eye being very red, the eyelid appears partly closed.

Whilst not a believer of getting nervous about what info is out there on Google, this VIGAMOX has many horror stories about it as being a very heavy duty drug to be only used in extreme cases.

I cannot remember ever having Conjunctivitis before, so looking for some extra info if possible, am in age mid 60's.

[Sheryl]

I'm in no position to second guess the opthalmologist who rexamined you and neither is anyone else reading this.

Tobradex contains a steroid (dexamethasone) and fungal infection is a known risk with steroid eye drops.

Suggest you follow the advise given by the opthalmologist and in future, never ever use eye drops containing a steroid for conjunctivitis!!!!

[fishhooks]

Thanks for that Sheryl.

Really appreciate your prompt reply.

A bit confused now though as the Ophthalmologist at Korat Hospital who did the examination yesterday and prescribed the Vigamox, suggested that I still use the Tobradex as well? I had the Tobradex with me at the consultation.

Edited February 2, 2014 by fishhooks

[Sheryl]

You should not use drops containing a steroid.

But having now looked up Vigamox I am confused by your statement that the doctor said it was a fungal infection.

Vigamox is not an anti-fungal, it is an antiobitoic (moxifloxacin) so effective against bacteria. Tobradex also contains an antibiotic (tobramycin) but in addition, a steroid.

Are you sure the doctor said the infection was fungal? How good was his English?

Most conjunctivits is viral, though bacterial superinfections can occur.

[fishhooks]

His English was quite good, I'm really hoping that I did not confuse the few things he told me, regarding if it is indeed Fungal.

I have the Medical Certificate, unfortunately the "Diagnosis" refers only to Conjunctivitis Right eye.

I definitely did not confuse his instruction though, to continue using both types of drops.

Edited February 2, 2014 by fishhooks

[Sheryl]

This is just not making much sense. The diagnosis and treatment do not match.

I can only advise you to get another opinion. Suggest you try at Fort Suranaree Hospital, or (if they have an opthalmologist) St. Marys.

[fishhooks]

Sounds like good advice and thank you again.

Hopefully I can report back with a better solution and outcome.

[fishhooks]

Certificate, I just checked again to make sure I wasn't confusing things!

[fishhooks]

Today, Tuesday.

Went to St Mary's here in Korat.

I had an appointment with a lady MD at the Eye Clinic, to me seemed quite experienced and did a thorough examination.

This time the diagnosis was for "Viral Conjunctivitis in Right Eye" as printed.

Meds prescribed: DEX-OPH Eye/Ear Drops, 1 Drop every 2 hours.

GENTEAL Eye Drops, 1 Drop 4 times daily.

MAXITROL OINTMENT, Apply at bedtime.

The DEX-OPH confuses me, everything I can find on the Web says definitely not for Viral Infections?

I've been visiting Thailand often for prolonged holidays up to 3 months since 1975.......This latest episode concerns me!

I will add here though, the gear at St Mary's was much more modern and professional looking than at Bangkok Hospital Korat.

Edited February 4, 2014 by fishhooks

[Sheryl]

Well viral conjunctivitis is a much more probable (and less serious) diagnosis than fungal so I am inclined to believe it.

But indeed, would be best not to use the Dex-Oph, it contains a steroid. Thai doctors often prescribe them nonetheless because they give rapid symptomatic relief. Some Western doctors do as well (always in combination with an antibiotic). You can find a full discussion of the issue of using stopical steroids in viral conjunctivitis here http://bmctoday.net/crstodayeurope/2011/09/article.asp?f=pros-and-cons-of-topical-steroids-for-viral-conjunctivitis

The Maxitrol is essentially the same thing as the dex-Oph (one is drops and one is ointment, she prescribed the ointment for bedtime when it won't matter that it blurs your vision).

If you can tolerate the discomfort I would advise not using either the Dex-Oph or the Maxitrol. They will bring noticeable relief but there is a risk of prolonging/worsening the infection.

The Genteal is just a moistening agent to relieve eye discomfort, may or may not help but certainly safe.

With viral conjunctivitis, like other viral ailments, basically there is no treatment and it will usually resolve in 2-3 weeks. Some people use antibiotic drops/ointments to prevent development of a secondary bacterial infection, the Vigamox you already have would serve that purpose. When the discomfort is really unbearable, preparations containing steroids may be resorted to (e.g.. the Dex-oph/Maxitrol)- you'll have to decide if this is necessary in your care.

[fishhooks]

Appreciate the advice greatly and I must say with my limited reading of what I have, your theory goes along exactly with that.

Mainly, in that time with this particular Viral Infection is most likely the best method, together with something like the Genteal or Tears Naturale etc., to relieve some of the discomfort.

So, I am already about 5-7 days in and I don't think I will find it too hard to wait it out. (Still looks bad though and quite red)

[tim armstrong]

Maybe a silly question - do you wear contact lenses ? If so leave one out of the affected eye. I get conjunctivitis from time to time and usually in the same eye. If I leave the lense out and use eye drops it clears in a few days.

[fishhooks]

Hi Tim, sorry for the late reply, have been on the move on not on-line much.

No don't have contacts and the condition appears to have improved greatly over recent days.

I'm retired, but worked in TV for 40 years mainly to do with technical quality control of live pictures, so the ol' eyes did suffer.

Even so, I only needed very mild medication, mainly "SYSTANE EYE DROPS" over the years and still find I need to use a couple of times a day.

I've been assured by a few specialists that these are a very mild drop, mainly for cleaning and lubrication and can be used as often as required.

Thanks also Sheryl, your advice helped a lot and all now back to normal.

Edited February 24, 2014 by fishhooks

[Fookhaht]

Are TobraDex and "Tobrex" related?

I live in a very dusty town, ride a motorbike daily, and conjunctivitis is a common ailment I deal with 2-3 times a year. Also wear contacts, and have to be very careful to keep the virus from spreading to the other eye, in my handling of the lenses.

I was recently given Tobrex at the pharmacy which cleared up my latest bout of red-eye in just 2-3 days. I looked it up and it is used to treat BACTERIAL eye infection (so now there are three types of red-eye: viral, fungal, and bacterial?). I noticed no mention of it containing steroids, but can anyone confirm? The similarity in the brand name has me a bit concerned.

[Sheryl]

Are TobraDex and "Tobrex" related?

I live in a very dusty town, ride a motorbike daily, and conjunctivitis is a common ailment I deal with 2-3 times a year. Also wear contacts, and have to be very careful to keep the virus from spreading to the other eye, in my handling of the lenses.

I was recently given Tobrex at the pharmacy which cleared up my latest bout of red-eye in just 2-3 days. I looked it up and it is used to treat BACTERIAL eye infection (so now there are three types of red-eye: viral, fungal, and bacterial?). I noticed no mention of it containing steroids, but can anyone confirm? The similarity in the brand name has me a bit concerned.

Tobrex = tobramycin, an antibiotic

Tobradex = tobramycin plus dexamethasopne, a steroid.

So what you have is only antibiotic.

BTW the generic name(s) of medication will be written on the bottle but in smaller letters below the brand name.