What could be causing my mother, who has Alzheimer's, to obsessively rub her eyes?

Dinah asked...

Is it common for Alzheimer's patients to have an obsession such as rubbing eyes that "itch and burn"? My mother thinks she must have been allergic to lens implants that were inserted over a year ago. Eye doctor says nothing is wrong ..but, she gets puss in her eyes and rubs and picks constantly.

Expert Answer

Lylas Mogk, M.D. is an ophthalmologist and director of the Henry Ford Visual Rehabilitation and Research Center in Grosse Pointe and Livonia, Michigan, and the author of Macular Degeneration: The Complete Guide to Saving and Maximizing Your Sight.

Dear Dinah,

First, you can reassure your mother than the lens implants are not causing the problem, as lens implants inside the eye do not produce allergic reactions on the surface.

If the itching and burning in your mother's eyes is from an allergy, it would be an allergy to something external to which she is exposed. The most common reason for itching, burning and the need to rub is dry eyes, however, is a solid consistency of what should be liquid oil coming in oil glands in the eyelids. What's supposed to happen is that when we blink, oil is milked out of those glands and coats the surface of our eye with oil so that the water in our tears doesn't evaporate. However, f the oil in those glands is thick, like crisco, it doesn't flow out of the gland openings so there is no oil slick on the surface of your eye, the tears evaporate quickly and the surface gets dry and burns. When the solidified oil at the opening of the glands is exposed to room temperature it crystalizes in little crusty bits of it collect on the edges of the lids and make them itchy. 

If this is the problem with your mother's eyes, the following three things should help:

1. Hot wet compresses on closed eyelids for 10 to 15 minutes at a time three or four times a day, for a couple of weeks. Then gradually taper to once in the evening and if everything is fine, then maybe just a few times a week. The point of this is to melt down the "crisco" inside those little glands and turn it into oil. A funny but effective way to keep the hot wet washcloth hot for 10-15 minutes is to microwave a potato, cut it in half , have your mother lie down and put  the hot wet washcloth over her eyes and 1/2 of the hot potato on the washcloth over each eye. The hot potato will keep the washcloth hot.

2. Take a 1000 to 2000mg capsule of fish oil a day, as the omega-3 fatty acids in fish oil, help normalize the consistency of the oil.

3. Use artificial tears to lubricate her eyes to decrease the burning. This doesn't solve the problem, but just makes the eyes more comfortable while numbers 1 and 2 are hopefully solving it.

If you do all this and nothing changes, then you might want to explore the possibility of allergies with her doctor. Best wishes to you and your family.

L.Mogk, MD