Mucus fishing syndrome is something that affects many people who have dry, irritated eyes. This syndrome is characterized by the continuous extraction of mucus strands from the eye, and anyone who suffers from this will identify with this simple explanation. Usually, this condition begins due to irritation of the ocular surface, whether it be from dry eye disease, allergies, or infection. When the cells of the eye surface become irritated, they produce extra mucus. When someone is suffering from this condition, they will often become irritated by the mucus and begin “fishing” for the strands, pulling them out. This leads to the continuous cycle of irritation, mucus, and fishing.
What is Eye Mucus?
The cells of the eye produce mucus naturally, but the amount can depend on many things. If the eyes are irritated, such as from dry eye disease, blepharitis, or allergies, the cells will begin to produce more mucus. The mucus is made of oil, skin cells, bacteria, and dust, and it’s usually not problematic. However, when more irritation occurs, or if there is an infection, more mucus is produced. This may eventually lead to further problems and tons of irritation for the patient.
What are Mucus Threads?
While the eyes naturally produce mucus to coat the surface of the eye, it can become overabundant and eventually begin to form clumps or strands. These mucus threads can be incredibly bothersome, causing the patient to pull them out of their eyes, and leading to mucus fishing syndrome. Common conditions which contribute to mucus threads are allergic conjunctivitis and dry eye disease.
How to Treat Mucus Fishing Syndrome
1. Treat the underlying condition
You absolutely must get rid of the underlying irritant first. If it’s dry eye disease, treat the dry eye. If it’s allergies, treat that. There are many ways to do this, but we highly recommend hypochlorous acid as a first line treatment for dry eye disease. With allergies, this will also work to clean the eyelids and lashes, preventing allergens from building up around the eyes. Eyelid hygiene is so important for those with mucus fishing syndrome because your eyes are obviously irritated. Cleaning them will help ensure that you’re keeping irritants at bay. We’ll get into this in a bit, but if you also have a bacterial infection, antibiotics may be necessary. Whatever the underlying cause, treat that first and foremost.
2. Stop touching your eyes
This is not a suggestion, this is a necessity if you want to get rid of mucus fishing syndrome for good. You absolutely cannot be touching the surface of the eye, causing more irritation. And just so we’re clear, removing the mucus strands with a Qtip isn’t allowed either. It is suggested to use saline or non-preserved artificial tears to rinse the mucus out of the eye.
3. N-acetylcysteine solution
This is a mucolytic agent usually used for respiratory infections, but it can be used off-label to help dissolve the excess mucus in the eyes. Your doctor can prescribe this for you and a compounding pharmacy can fill it. The solution will be diluted to 10% N-acetylcysteine and placed into an eye drop bottle. Usually, you’ll begin with use four times per day and then taper off over a few months to ensure that the condition does not return with a vengeance. Eventually, you’ll use this drop only when necessary.
4. Hypochlorous Acid
We highly recommend hypochlorous acid as a first line treatment for dry eye disease, and it can be very beneficial in treating those with mucus fishing syndrome due to dry eye. Even with allergies, it will work to clean the eyelids and lashes, preventing allergens from building up around the eyes. Eyelid hygiene is so important for those with mucus fishing syndrome because your eyes are obviously irritated. Cleaning them will help ensure that outside irritants will be minimal. It’s recommended to use this spray 2-4 times per day while treating this syndrome. Simply spray the solution onto closed eyelids, rub it in, and let it dry. There’s no need to rinse.
5. Topical Allergy Eye Drops
A topical antihistamine or mast cell stabilizer may also be recommended for you, and may provide some benefit to those with this condition. Because allergies are a very likely trigger, it can be helpful to use these topical drops that are easy to come by.
What Causes Mucus Fishing Syndrome?
Ocular irritation is the first trigger for mucus fishing syndrome, causing excess mucus in the eyes. When this mucus forms threads or strands, it can become bothersome for the patient. Naturally, they’ll want to remove those strands, and they’ll end up fishing them out of the eyes. This causes further irritation and antigen introduction to the eyes, which only leads to more mucus production. As you can see, this is a vicious cycle!
What Are Effects of Mucus Fishing Syndrome?
This condition can cause many common symptoms, including the following:
Redness of the eyes
Watery eyes or excess discharge
Mucus strands in the eyes
Basically, two things are needed for a doctor to diagnose this condition. The first is a report that the patient is constantly pulling mucus strands from their eyes, and the second has to do with the rose bengal staining pattern the doctor can see on the front of the eyes. If we can see that you’ve been touching your eye, and you show us how you’re doing it, the diagnosis is easy.
How Common is Mucus Fishing Syndrome?
Although I couldn’t find an estimate of the number of people with this condition, we know that dry eye disease affects over 30 million Americans. When you add in blepharitis and allergies, it’s probable that there are many people out there dealing with this condition. Of course, not everyone who suffers from dry eyes or allergies will notice mucus strands in their eyes, but many do.
FAQs About Mucus Fishing Syndrome
How do you treat mucus in fishing syndrome?
The first line of treatment for mucus fishing syndrome is to treat the underlying cause. This could be dry eye, allergies, or other irritants, but if you don’t treat the irritant, your eyes will continue to produce excess mucus. Second, you must avoid pulling or “fishing” the mucus strands from your eyes, as this only exacerbates the irritation, mucus, and fishing cycle. Once these are in place and being practiced, mucolytic agents (like N-acetylcysteine) may be used off label.
Why do I get stringy mucus in my eyes?
Stringy mucus may form for many reasons, but it always comes down to ocular irritation. Conditions such as dry eye disease and allergic conjunctivitis can cause the cells of the ocular surface to become irritated and produce more mucus than normal. When this happens, it can eventually begin to clump together and form strands that are difficult to keep your fingers away from.
How do I get mucus out of my eye?
If you find yourself with mucus strands, do not use your fingertips to pull them out. This only creates more irritation on the eyeball due to touching your fingers to the surface of the eye. It’s much better to use a non-preserved saline wash or artificial tears to wash away the strands without making physical contact with the eyeball. If the mucus is due to an infection, antibiotic eye drops may be needed. Much the same, antihistamine eye drops may be needed for allergic conjunctivitis.
Can dry eyes cause mucus?
The cells of the ocular surface are constantly making mucus, and mucus actually forms the third layer of the tear film (along with oil and aqueous). However, when excess irritation occurs the cells begin to produce mucus in overdrive. Since dry eye disease often causes a lot of irritation of the ocular surface, dry eye can be one of the contributors for mucus fishing syndrome.