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7 months on Dr. Holly drops: the numbers are in

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  • dryeyes2
    replied
    using Dr. Holly's drops with other drops- Rojzen

    Hi Rojzen,

    I posted the question on Dr. Holly's area, but have not heard yet. You mention that using Dr. Holly's drops with other OTC drops might not work well. I do notice that Theratears and Genteal gel are starting to be more drying than before. I didn't have to use them as much when the DHEA was working, but as you know dry eyes are a real balancing act of many things. Like you, I have noticed that when I was wearing my goggles over my glasses my eyes were less dry and when I first started the DHEA I had a good result in 3 weeks and I didn't have to wear my goggles as much. I think looking back, the reason was probably because my corneas were in better shape because of wearing the goggles most of the time. When I cut down on the DHEA drops per doc's instructions, I didn't start wearing the goggles again until recently because I couldn't tolerate the air anymore. So I think this is making a difference why I my eyes are not feeling as good even though my oil glands are producing more oil.

    I am up on the DHEA drops again, but I am wearing the goggles most of the time. I am hoping that they are like a bandaid so things can get back to the way they were when I first started the drops.

    The DHEA drop has either Tears Naturale (preserved) or carboxymethylcellulose (unpreserved). I am down to 1 drop of Restasis a day, but I want to get off of that if I can. (I have to put in a drop of PF Theratears or similar to tolerate the Restasis now- my doc thinks I may have an allergy to it.) Do you know if Dwelle would work ok with these drops?

    Thanks
    dryeyes2

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  • Rory
    replied
    Originally posted by Rojzen View Post
    Good question, Rory, about whether using Dwelle or other high-oncotic pressure drops along with something like Refresh makes good sense. . .

    I recently contemplated using Systane and or Bion Tears along with Dwelle or FreshKote, in a regimen that would have alternated all of these, for the purpose of getting ALL of their purported "benefits." I liked the idea of zinc in Systane and the idea of bicarbonate in Bion Tears. . .and it seemed interesting to try to maximize benefits by using a whole panoply of drops. . .

    Then Dwelle's effects on me started kicking in, and every time I tried a drop of Systane or anything else, besides Dwelle, my eyes got raw and cold again. . .I basically gave up on the rotation approach, and did great, sticking with Dwelle or FreshKote exclusively. . .

    It was really only after this happened that I started studying Dr. Holly's principles carefully. . .After I did that, I decided it could only set me back to use products that were not advancing my eye health the way the Dr. Holly drops do. . .Now I can't say this is true for everyone, but if high oncotic drops help you significantly, it may actually set you back to use anything but these. . .In other words, if your corneas and tear film are normalizing through the use of high oncotic pressure drops, then throwing hypotonic or other non-high-oncotic drops into the picture may be counterproductive. . .
    Rojzen,

    Can you explain very simply the difference behind oncotic and hypertonic drops....and why using both would be counterproductive?

    I recently discovered Refresh contacts ...merely because i needed a drop i could use with contact lenses...they and Refresh "soothe and protect" (i think virtually the same thing!)...are the most soothing drop I have found for a while. So whilst I am very keen to give Dwelle and Dakrina a go...I would be loathe to stop using Refresh (especially with contacts).

    I have yet to try using Dakrina with contacts, as although it would probably be fine..it doesnt have approval.

    Leave a comment:


  • Rojzen
    replied
    combining drops having very different properties

    Good question, Rory, about whether using Dwelle or other high-oncotic pressure drops along with something like Refresh makes good sense. . .

    I recently contemplated using Systane and or Bion Tears along with Dwelle or FreshKote, in a regimen that would have alternated all of these, for the purpose of getting ALL of their purported "benefits." I liked the idea of zinc in Systane and the idea of bicarbonate in Bion Tears. . .and it seemed interesting to try to maximize benefits by using a whole panoply of drops. . .

    Then Dwelle's effects on me started kicking in, and every time I tried a drop of Systane or anything else, besides Dwelle, my eyes got raw and cold again. . .I basically gave up on the rotation approach, and did great, sticking with Dwelle or FreshKote exclusively. . .

    It was really only after this happened that I started studying Dr. Holly's principles carefully. . .After I did that, I decided it could only set me back to use products that were not advancing my eye health the way the Dr. Holly drops do. . .Now I can't say this is true for everyone, but if high oncotic drops help you significantly, it may actually set you back to use anything but these. . .In other words, if your corneas and tear film are normalizing through the use of high oncotic pressure drops, then throwing hypotonic or other non-high-oncotic drops into the picture may be counterproductive. . .

    Leave a comment:


  • Rory
    replied
    Originally posted by Rojzen View Post
    Rory - - I think it is possible for a patient to be unaware that his/her corneas are, in fact, compromised to some degree. Anyone with low tear production or abnormal tear film quality runs a good chance of getting stressed corneas. . .The stress may be insufficient to cause erosions or more serious changes, but it is pretty universally understood that defective tear films go along with changes in, for example, the goblet cells that sit pretty closely over the corneas . . .Also, some features of corneal change are not generally measured in a doctor's office. . .It's only the gross abnormalities that most docs feel are worth addressing. . .

    I mention this because if you are thinking that Dwelle and the other Dr. Holly drops are not right for you because patients often cite these drops for their remarkable record in healing pretty serious corneal conditions that you don't have, go ahead and try the products anyway. . .To the extent that your corneas could probably get even healthier, and to the extent that improved corneal epithelium can make a TREMENDOUS difference in how dry eye patients feel, you may get some benefits you didn't even believe possible. . .I switched from Restasis to FreshKote and Dwelle at a time when I had no detectable corneal damage; What I got, as a result, was nearly complete resolution of my 10-year long problem with a zero-second TBUT. . (:^)

    Thank you all for very informative responses,

    I think that I will certainly use either Dwelle/Dakrina every morning...as I see how easy it is now to wipe the residue before it crystallises..

    I will then use either Refresh or Nutratear as needed during the day.

    I am seeing my regular optomerist next week and will discuss using these drops with soft contact lenses...I think they would be very useful prior to contact lens insertion...but I would also like to use them occasionally whilst wearing them.

    I imagine that Refresh and Dr Holly drops can be used together... ie not at the exact same time...but same day?

    Leave a comment:


  • Rojzen
    replied
    Rory - - I think it is possible for a patient to be unaware that his/her corneas are, in fact, compromised to some degree. Anyone with low tear production or abnormal tear film quality runs a good chance of getting stressed corneas. . .The stress may be insufficient to cause erosions or more serious changes, but it is pretty universally understood that defective tear films go along with changes in, for example, the goblet cells that sit pretty closely over the corneas . . .Also, some features of corneal change are not generally measured in a doctor's office. . .It's only the gross abnormalities that most docs feel are worth addressing. . .

    I mention this because if you are thinking that Dwelle and the other Dr. Holly drops are not right for you because patients often cite these drops for their remarkable record in healing pretty serious corneal conditions that you don't have, go ahead and try the products anyway. . .To the extent that your corneas could probably get even healthier, and to the extent that improved corneal epithelium can make a TREMENDOUS difference in how dry eye patients feel, you may get some benefits you didn't even believe possible. . .I switched from Restasis to FreshKote and Dwelle at a time when I had no detectable corneal damage; What I got, as a result, was nearly complete resolution of my 10-year long problem with a zero-second TBUT. . (:^)

    Leave a comment:


  • Rebecca Petris
    replied
    Originally posted by Rory View Post
    1. Do they all have the same science behind them?... I obviously want to use the most effective one.
    The Dwelle and Dakrina are distinct for the very high oncotic pressure.

    If one of the three were the "most effective" full stop, then there would be no need for the others, but as a practical matter each has a distinct 'niche'. I've followed these drops for more than 6 years and known hordes of people using them and while some, like me, use a combination, many either use just one which is the only one that works best for them, or they start with one and 'graduate' to another for longer term maintenance.

    I'm definitely a 'less is more' person myself. If I could manage on NutraTear, I absolutely would use only NutraTear, and in fact there have been periods where I've been able to. But most of the time my right eye needs Dwelle morning and night.

    2. Normally preservative containing drops say to discard after 30 days, is it the same with these?
    No. I'm not sure about that 'normally' either? At least in the US, there is no statement of that sort on the vast majority of preservative containing drops - the opposite actually, it's unpreserved products in a bottle (like unisol 4) that say to discard within 30 days. As long as you take proper care of the bottle and keep it tightly capped when not in use, store it at room temperature, keep it clean, etc, there's no reason why it can't last far longer. I'd be embarrassed to admit how long I keep bottles around.

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  • Rory
    replied
    Thank you for the very helpful replies...just a couple more Qs;

    1. Do they all have the same science behind them?

    I obviously want to use the most effective one. I am sure that I could as you say wipe the lids after appyling to ensure no flakiness...and would be happy to do this if I thought that either Dwelle or Dakrina were more effective than Nutratear. I see that it is about 20% as concentrated as the other two.

    However as I dont need to heal any corneal layers, perhaps Nutratear is strong enough for my form of dry eyes?

    2. Normally preservative containing drops say to discard after 30 days, is it the same with these?

    Thanks.

    Leave a comment:


  • Rebecca Petris
    replied
    Originally posted by Rory View Post
    I am still confused as to whether I should give Dr Holly's drops a real go.
    Rory, if you have enough of a problem to still be on DEZ, seems to me you don't have anything to lose by trying?

    I have to say that I am very put off by the excessive flaking of Dwelle and Dakrina
    Something to keep in mind: There is no reason to use more than a very small drop at a time, because your eye surface can hold very little. If you apply a very small amount it should be a fairly simple matter to wipe any excess afterwards with a damp cloth or tissue before it has time to crystallize.

    I....only really have bad symptoms in aircon and central heating.

    My favourite current drops are basic.. Refresh soothe and protect...and Refresh contacts (with contacts).
    Usually when I hear this from someone I suggest they start with NutraTear. People who have used almost exclusively the very light drops like refresh or theratears and whose main complaint is they give only brief relief tend to like NutraTear the best of the three. Added benefit, no potential for residue because it's far lower concentration.

    I dont like to use eyedrops at all if possible...and I believe the more that you use the more problems you will have.
    I agree. Another reason in favor of giving it a whirl.

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  • Terri
    replied
    Rory: It might be good to ask Doc Holly if one of the three drops would work better for you than the others. I am fortunate in that I don't have a problem with the flaking you and some others have described. I only use one drop of Dwelle at night before putting on my Tranquileyes, though, and I imagine if I used more than one drop that flaking or crusting might occur.

    Dwelle healed the rough, abraded surface of my dry eye. I can't describe exactly how it did that, but I think it eliminated the edema in my epithelial cells, allowing them to compress into a normal layer with normal functioning. It also provided a smooth, continuous surface over my eye. Within two weeks of starting to use Dwelle, my husband said, "Hey! What happened to your eye? It looks normal!" It was no longer red with areas that looked like they had been roughed up with sandpaper.

    The other great benefit of Dwelle is that it lasts forever. I posted earlier that one drop at night is all I need on most days. I agree with your comment below that using fewer drops is better.

    Leave a comment:


  • Rory
    replied
    I am still confused as to whether I should give Dr Holly's drops a real go.

    I have to say that I am very put off by the excessive flaking of Dwelle and Dakrina (really irritates the inside eyelids...and not always possible to hygienically clear). I am also unclear as to the science behind the drops. What exactly is it that they are aiming to achieve? Are they more than mere lubricants?

    I have reasonable TBUTs and very low schirmers (despite apparently having no serious aqueous deficiency..work that one out?)..but only really have bad symptoms in aircon and central heating.

    My favourite current drops are basic.. Refresh soothe and protect...and Refresh contacts (with contacts).

    I dont like to use eyedrops at all if possible...and I believe the more that you use the more problems you will have.

    Any wise advice? Which of Dr Holly's drops would suit my symptoms?

    Leave a comment:


  • dianat
    replied
    This thread may have been Rebecca's favorite birthday present!

    Leave a comment:


  • Rojzen
    replied
    Terri! So wonderful to have you encapsulate this Dwelle experience so crisply and clearly. . .You've made points that I failed to emphasize sufficiently in this thread. . .

    Like you, I have found that using just two doses daily, with bedtime a must, seems to bring about the finest result. And the contrast you draw with drugstore drops is so key!

    At onset, back in 1998, I happened on TheraTears. . .I used these about every 10 minutes, because I believed that if I just stuck with an artificial tear, my eyes would somehow catch up and normalize, so that I could later cut back on drops and be comfortable. . .That never happened. . .and, in the particular case of TheraTears, the recommended regimen actually involves applying many drops over a period of 5 minutes, each and every time one treats. . .In any case, since that product, and the endless others I tried, were not composed right for me, and necessitated so much trauma to the eye, through frequent dropping (Dr. Holly has been clear about the adverse affects of frequent dropping), I never improved. . .

    Exactly as Terri describes, with Dwelle, and possibly Dakrina and FreshKote, for some of us (and I suspect many), life is not just about keeping up with the constant demand for moisture, but, rather, about gradually improving to the point of feeling amazingly free of a whole slew of bad symptoms. . .

    Rory's questions and needs may be different from those of us who have had to work on restoring corneal health. . .but I can't see how the Dr. Holly drops could hurt anyone with any variety of DES symptoms. . .To answer: I don't believe that accumulation of flakes, from Dwelle/Dakrina, need hamper meibomian function, if one simply washes the flakes away regularly with a nice cleanser. . .I do not, however, Rory, know whether I am getting better because of improved meibum/lipid production or because of improving mucin function, both, or something completely different. . .I suspect that my lipid production has not changed, but that the layers of my cornea have consolidated and strengthened, possibly with some concomitant improvement in goblet cell operation/mucin production. I deduce this because I haven't done anything new mechanically (no more expression or heat) with the MG, and stopped doxycycline years ago, when I was overprescribed it, for periods of years at a time.

    Hope that helps. . .

    And Terri. . .Your analyses here have been fascinating and eloquent, not to mention that the joy of your healing is infectious, and a huge source of cheer to me and others. . .

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  • Rory
    replied
    I have 2 more questions about Dr Holly's drops.

    1. How long are they "fresh" after opening the bottle?

    2. The flakiness of Dwelle, could this contribute to MGD, gland blockages, general irritation? I have yet to open Dakrina, does this have a similar flakiness.. I have not noticed any flakiness with Nutratear.

    Rojzen,

    You clearly have much worse sypmtoms than me, much more severe TBUTs. In normal conditions, my TBUT can be normal... but in drying conditions my TBUT decreases dramatically. I can also not tolerate contact lenses for more than an hour or so. It is also only ever my eyelids that are irritated, never my eyes. Therefore I wonder if Dr Holly's drops are suitable for all of us?

    Have i misunderstood, is it your belief that the mucin production or adhesion of the tear has improved with the drops, rather than the lipid component? As this does not seem to be my problem, i wonder if they would have any use to me at all.

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  • Terri
    replied
    Let me second Rojzen's joy. I've written elsewhere about my love affair with Dwelle (especially), Dakrina and NutraTear. I can't emphasize too strongly what a HUGE difference these drops have made for me. I faithfully use one drop of Dwelle at night before bed, and I might (or might not) need an additional drop of Dakrina or NutraTear during the day.

    That, to me, is amazing. As someone who used to use drugstore drops every 10 minutes (and thought I had made great progress when I got that down to once every two hours), using only one or two drops every 24 hours is remarkable.

    But what is even more remarkable is the condition of my eye. Drugstore drops did nothing to heal my damaged eye; in fact, now I think they greatly contributed to my dry eye problems (even the PF ones I used to swear by). Dwelle has made it impossible for me to tell the difference between my normal and dry eye because they look and feel the same.

    Like Rojzen, I don't think Doc Holly's drops will cure me, but I'll settle for this great feeling of being normal again.

    PS: Thanks to Rebecca for going to extremes to bring these drops back on the market. I cannot imagine going back to life without them.

    Leave a comment:


  • Rojzen
    replied
    more info. on exam after Dwelle/FreshKote use

    Rory - - Thanks for your patience, and for posing such good questions. . .

    First, I am indeed convinced that wearing moisture chambers has helped to stabilize the condition of my ocular surface tissue for all the years I've worn them. They have slowed my tear break-up time significantly, while I wear them. This was once demonstrated by an ophthalmologist who took an interest in how well I felt while wearing the glasses. He found that after I wore the glasses for a few hours, my break-up time would be greater than 5 seconds, even after I took the glasses off. . .Five or ten minutes later, though, my break-up time would revert to about zero seconds. In other words, it could be assumed that while the glasses are on, they slow the break-up time significantly. I believe, because I have suffered only negligible erosions during the years I've worn the chambers, that slowing break-up time has protected my corneas and conjunctiva, to some degree.

    On the other hand, it is noteworthy that I have never regained normal break-up time JUST by wearing the moisture chambers. . .

    RE: the best Dr. Holly drop for MGD-related unstable tear film: I actually don't know the answer to this, except to say that I believe Dr. Holly has, in some places, suggested that Vitamin A is indicated when break-up time (TBUT) is severely reduced from normal. I have therefore deduced that Dakrina might work best for me, as an MGD sufferer with a horrible TBUT; BUT, clinically, results are not in, for me. It seems to be well accepted that Vitamin A can help goblet cells to produce more/better mucin, and that may be why highly unstable tear films, which require normal mucin (among other things), call for Vitamin A (and Dakrina). On the other hand, based on Dr. Holly's writings, I am beginning to understand that tear film instability is probably never due to only one cause, like meibum deficiency; and the fact that my meibomians are still very sluggish at best, but my TBUT has improved nonetheless, tells me that the Dr. Holly drops' action on my corneas is, by itself, capable of affecting tear film stability for the better.

    About the TBUT number: The doctor yesterday would not give me a number on my TBUT, for some reason, even when I pressed him for this. But he said that it took a while for the tear film to begin to break up, and my subjective sense was that this time amounted to at least 5 seconds. I was never able to hold my eyes open, in the past, for more than a second, during TBUT measurement, but yesterday, I had no trouble, even prior to administration of anesthetic.

    Now 5 seconds is not a good TBUT, but for those who live with a tear film so unstable as to produce a zero-second TBUT, those 5 seconds can feel tremendously new and better. Those 5 seconds have, so far, been enough to buy me long stretches without protective eyewear. Will this last? Who knows. . .But the subjective improvement is dramatic, and I am optimistic that this spells real health improvements for my corneal tissue. . .

    If, in fact, NutraTears can beneficially affect the meibomian glands, as Rory suggests, this may complete the picture for patients like me. . .I am aware that B12, which NutraTears contains, has often been used to accelerate corneal healing, but perhaps even eyelid tissues/organs respond to it in some way, too. . .

    I, and others, are hopeful that Dr. Holly will help us to arrive at some paradigm for combining the 3 available drops that he created, based on our diagnoses and symptoms. .

    Right now, I am sensing that for reasons unclear, Dwelle is the best all-purpose drop for me. . .but I'm starting to bring Dakrina in to the picture, and will see what happens...

    Importantly, I've realized something additional in the last 24 hours alone. In other threads, this week, we have been discussing the adverse affects of fluorescein and other drops that the eye docs use during exams. Count me in on that concern, because even with my Dwelle in all day, I'm having lots of menthol wind today, after being subjected to flourescein, Lissamine, and anesthetic yesterday. I believe this means that Dwelle/Dakrina are probably not curing me, in the sense that will some day be healthy and need no eyedrops at all. At the same time, I feel very confident that by tomorrow or the next day, as I continue with Dwelle, I'll be back to where I was earlier in the week. . .In any case, I no longer aspire to "cure," and will be ecstatic if the best I can do is to live comfortably and safely just by using the Dr. Holly drops (:^). . .That would still be way beyond what I ever believed possible. . .I know that others share this outlook. . .
    Last edited by Rojzen; 22-Feb-2008, 19:10. Reason: typos

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