Freaky Eye Thursday

be ye warned:  there's a weird eye picture below.

i saw a patient at Sam's this week who was having an awful time with his eyes itching.  i just saw him 2 months ago for a contact lens exam, and everything looked great then.  now, his eyes are itching so badly that he can't wear his contacts anymore.  

one of the weirdest tricks i have to do as an eye doctor is "flip" a patient's lids.  i can easily see inside the lower eyelid, but the upper eyelid is tougher.  so, in order to view it, i have to use a sterile, cotton tipped applicator (fancy q-tip) to evert the upper lid.  with any contact lens patient who is complaining of itching, i flip their lids.

when i flipped this guy's lids, i saw something like this:

this is an example of Vernal Keratoconjunctivitis (VKC).  people with severe allergies can develop this allergic reaction under their top eyelids very easily.  instead of the surface being smooth and velvety, the eyelid has developed "cobblestone" appearing bumps.  these bumps make contact lens wear almost impossible.  plus, a thick, ropy mucus is usually present (this guy  had that, too).

so, he's out of his contacts for 2 weeks at least.  i put him on a topical steriod eye drop twice a day, and i'll recheck him in 2 weeks.  once we get this under control, he'll be able to wear his contacts again, most likely with the long-term use of another prescription eye drop to prevent this from flaring up again.

i bet you had no idea that eye allergies could get so bad!  be thankful if you don't have bad eye allergies!