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Burning sensation in eyes
I am writing to seek your opinion regarding my father (80 years old).
Chief complaint: Burning sensation in both eyes for approximately one month. There is no eye discharge, but he experiences persistent burning and irritation.
Eye examination findings:
Vision: Right eye – 6/9, Left eye – 6/18
Pseudophakia (status post cataract surgery with intraocular lens implantation)
Medical history:
No history of diabetes
History of hypertension
The following medications were prescribed:
Maxmoist Eye Drops – 1 drop, 4 times daily
Aydrops Eye Drops – 1 drop, 4 times daily
Unfortunately, despite using these medications as advised, his symptoms have not improved. Even frequent splashing of water on his eyes has not provided any relief.
Could you please advise:
What could be the possible cause of his persistent burning sensation?
Whether any additional investigations or examinations are required.
Whether you would recommend any alternative medications ?
Eyes is hereby attached.
Answers (11)
In an 80-year-old post-cataract patient with bilateral burning eyes and no discharge, not responding to standard lubricant drops, the most likely underlying cause is Meibomian Gland Dysfunction (MGD) combined with severe dry eye. MGD is an extremely common and chronically underdiagnosed condition in elderly patients â the meibomian glands in the eyelid margins stop producing the oily layer of the tear film, causing rapid tear evaporation and persistent burning. Standard watery lubricant drops (like Maxmoist/Aydrops) address the aqueous layer of tears but do not replace the oily component â which is why he isn't improving. Another contributing factor: certain blood pressure medications (especially beta-blockers and diuretics) reduce tear production and worsen dry eye in the elderly. Additionally, the significant vision difference between his eyes (R 6/9 vs L 6/18) could indicate posterior capsule opacification (PCO) in the left eye â a common post-cataract complication â which may itself cause discomfort; this is treatable with a simple laser procedure.
Next Steps
Take him back to the ophthalmologist and specifically ask for: (1) Slit lamp examination of the eyelid margins for MGD/blepharitis; (2) Schirmer's test to measure tear production; (3) Evaluation of the left eye for posterior capsule opacification. In the meantime, switch to a gel-based lubricant (Systane Gel or Lacrigel) at night â it lasts longer than drops. Do warm compresses on both eyelids twice daily (a warm wet cloth held against closed eyelids for 5-10 minutes) followed by gentle lid massage â this unblocks the meibomian glands and often provides significant relief. Omega-3 supplements (fish oil or flaxseed) 1-2g daily can help MGD over time. Please consult me directly on Practo for a detailed evaluation.
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The symptoms are most suggestive of dry eye disease/ocular surface disease, though blepharitis, meibomian gland dysfunction, or other ocular surface conditions should be ruled out. Continue preservative-free lubricating eye drops frequently and avoid rubbing the eyes. A detailed ophthalmic examination (tear film assessment, fluorescein staining, meibomian gland evaluation, and IOP measurement) is recommended. If symptoms persist despite treatment, an ophthalmologist should reassess and modify therapy accordingly
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