From the Guidelines
The most effective treatment for a patient waking up with eye drainage is to start with gentle cleansing of the affected eye using warm compresses and eyelid cleansing, as recommended in the blepharitis preferred practice pattern 1. This approach is crucial in managing symptoms and preventing further complications.
- Warm compresses can be applied to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions.
- Eyelid cleansing can be accomplished by brief, gentle massage of the eyelids, and eye cleaners with hypochlorous acid at 0.01% have a strong antimicrobial effect.
- Vertical eyelid massage can be performed to express meibomian secretions, and rubbing the eyelid margins from side to side removes crusting from the eyelashes. It is essential to note that the optimal treatment regimen often requires persistence and a trial-and-error approach, and the ophthalmologist should consider the patient’s ability to perform this treatment and tailor the therapeutic plan accordingly 1. In some cases, additional treatments such as topical perfluorohexyloctane, antibiotics, antiparasitic medication, or topical anti-inflammatory agents may be necessary, but these should be determined on a case-by-case basis, considering the underlying cause of the eye drainage and the patient's overall health status.
- Patients should avoid touching or rubbing their eyes, wash hands frequently, use separate towels, and replace eye makeup to prevent spread or reinfection. If symptoms worsen, vision becomes affected, or there is significant pain, immediate medical attention is necessary as these could indicate more serious conditions like corneal ulcers or acute glaucoma.
From the FDA Drug Label
In the treatment of superficial ocular infections, erythromycin ophthalmic ointment approximately 1 cm in length should be applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection. For a patient waking up with eye drainage, erythromycin ophthalmic ointment could be prescribed if the drainage is due to a superficial ocular infection. The dosage would be approximately 1 cm in length applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection 2.
From the Research
Possible Causes of Eye Drainage
- Infectious conjunctivitis
- Keratitis
- Endophthalmitis
- Periocular cellulitis
Treatment Approach
- Careful evaluation of distinctive clinical signs to determine the level of ocular involvement 3
- Knowledge of common microorganisms causing various eye infections to guide appropriate laboratory investigation and initial therapy 3
- Consideration of ophthalmologic consultation to assist in diagnostic investigations and to monitor potential ocular complications 3