Mucus Fishing Syndrome


What is mucus fishing syndrome?

Mucus fishing syndrome (MFS) is a cyclic condition which is characterized by extraction of mucus strands from the eye due to irritation [1].

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Pathophysiology

Mucus Fishing Syndrome is usually initiated by irritation of the eye. Due to irritation, the surface cells of the eye produce excess mucus. When the patient tries to extract the excess mucus from the eye, a cycle of irritation begins. By extracting the mucus patient is irritating the ocular surface even more, causing more mucus production.

Mucus Fishing Syndrome Mucus in eye - discharge from baby eyes

Causes

Mucus Fishing Syndrome is usually caused by an underlying condition that results in production of excess mucus, but then the condition is furthered by the patient when extracting extra mucus from the eye. Conditions that can initially cause MFS are:

  • Dry eye syndrome– dysfunction of the tear system which can cause feeling of foreign object, itching, redness, blurry vision, sensitivity to light and excess tearing (in this case tears are mostly composed of water and don’t have the proper function)[2]
  • Blepharitis-inflammation of the eyelids that can be caused by excess growth of normal skin bacteria, allergies, blocked gland on eyelid or hormonal imbalance (read about Prader Willi syndrome). Blepharitis causes symptoms like feeling of a foreign object, burning sensation, redness and/or swelling, dry eyes, crusty eyelashes [3].
  • Conjunctivitis-also known as pinkeye- is an inflammation of the clear membranes covering the white part of eyes. It causes redness of the eye, swelling of eyelids, tearing, burning sensation and excess mucus discharge [4]
  • Allergy

All of these conditions can cause extra production of mucus. Even if the underlying condition has resolved, touching the eye causes more irritation [5].

Symptoms

The main symptom of Mucus Fishing Syndrome is mucus in the lower eyelid that can even obstruct the vision. Mucus is sticky and covers the entire cornea. Other symptoms include:

Mucus Fishing Syndrome


Diagnosis

The diagnosis of MFS is usually made by clinical examination of the patient. However attention also must be paid to the patient’s mental status. Conditions like obsessive compulsive disorder and/or trichotillomania (hair loss due to patient’s pulling of the hair) can severely influence MFS [7].

Treatment

The treatment of MFS consists of several steps:

  • Discontinuing the “fishing” of mucus
  • Reducing inflammation
  • Breaking up the mucus
  • Treatment of underlying conditions

Stop fishing

Irritation of the eye is the most important part of pathogenesis. Stopping the irritation will lead to faster resolution of MFS. For some patients this can be very difficult, because the extra mucus keeps irritating the eye. Some patients use strategies like wearing sunglasses or swimming goggles, or even gloves.

Treatment of inflammation

Inflammation can cause excess mucus formation therefore it is important to reduce it. Methods used for treating inflammation are:

  • Cold compresses
  • Rinsing eyes with cool artificial tears
  • Course of steroid eye drops

Breaking up mucus

Breaking up of the mucus can be achieved by using certain medications. These medications break up the mucus and cause it to become dry and fall off from the eyes. For MFS N-acetylcysteine drops are usually used [6].

Prognosis

MFS usually resolves after irritation of the eye is discontinued. It usually lasts not more than 2 weeks.

ICD-10

In the international classification of diseases and conditions, MFS is classified under code H 57.8- other specified disorders of the eye and adnexa [8].

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References

  1. General information: https://www.researchgate.net/publication/11641928_Mucus_fishing_syndrome_Case_report_and_new_treatment_option
  2. Dry eyes: http://www.webmd.com/eye-health/eye-health-dry-eyes#1
  3. Blepharitis: http://www.webmd.com/eye-health/blepharitis
  4. Conjunctivitis: http://www.webmd.com/eye-health/ss/slideshow-pinkeye
  5. Causes and symptoms: https://www.epainassist.com/eye-pain/what-causes-fishing-mucus-syndrome-and-what-is-its-treatment
  6. Treatment: http://drmalcolmmckellar.co.nz/eye-conditions/mucus-fishing-syndrome/
  7. Diagnostics and associated diseases: http://www.aaopt.org/unusual-presentation-trichotillomania-and-mucus-fishing-syndrome-patient-obsessive-compulsive
  8. ICD 10: http://www.icd10data.com/ICD10CM/Codes/H00-H59/H55-H57/H57-/H57.8

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