Ointments at night?

[Julie1]

Hi all,

I'm a little concerned about some information that Dr. Latkany shared a few days ago regarding ointments. I have been using Refresh PM for about two months now, and it has really helped me to sleep comfortably through the night. However, I'm concerned about long-term damage to my oil glands. I did try sleeping with the tranquileyes for a couple of nights prior to starting to use the ointment, and it seemed that ointment was more effective in helping me stay awake all night. I still woke up during the night with the tranquileyes. What are your experiences? How long should I give the tranquileyes before ruling them out completely? I really do not want to add more eye problems to my life, but I also need to be able to sleep through the night or I will not be able to cope with the dry eye during the daytime.

Thanks,
Julie

[Eli]

Damage To Oil Glands

Hi There,
I am not a doctor, so please do not take this as medical advice. However using Refresh PM may contribute to "plugging" the glands being as how its so thick and greasy. Having the gland openings blocked up can I am told in the long run lead to the obliteration of the gland itself. It is not that difficult to clean of your eyelid margins in the morning and gently express your meibomian glands though, which i would think would get rid of most of the ointment. Consider asking Dr. Latkany for some more info on this one. Again-I'm not a doctor, but you're right-you've got to sleep and you've got to be able to function the next day.

[kitty]

You might also consider a gel product to use at night. Many people here like the Genteal Gel.

[Julie1]

Thanks for your replies, Eli and Kitty.

Is the Genteal Gel safer to use than the Refresh PM? Is it less likely to cause obliteration of the glands?
Is it better to sleep without anything and just use the tranquileyes?

-Julie

[Mika]

Julie
well i use ointment both at night and in the day....yeah its a very bad thing but for the time being, wit my bad situation of availabilty of a @#% good eyegel here(the ONLY eyegel here is Lacrinorm and it contains BAK), I can't do otherwise...

but i have combined it with artificial tears nevertheless...and i feel some ....comforts!!

BEFORE wen using ointment i did notice som burp on the eyelid and small "clots" of the white substance

but NOT now coz since doing rice compress (yeah thx for the one who invented it here..thx buddy )...well i dont have it anymore for 2months ..... but still i don't know if it is 100% cleaning and uncloging the eyelid.......coz i wana ask the doctor how he would advice us to "clean" the ointment from the eye??......is it by using saline wash?? coz i do some times....and its not bad....but for now i usually used already boiled water (which is cool -naturally) to wash my eye after the compress..

hey guys could u ask dr latkany plz, about HOW TO CLEAN THE EYE FROM OINTMENT ...coz i CAN'T post in the already opened post of Bunny

[AccutaneJay]

I like TheraTears Liquid Gel for night time use. It is thicker, preservative free (essential - the only one that is preservative free, I think), and has the patented electrolyte balance that is supposed to mimic that of human tears. Personally, I avoid any and all ointments that contain mineral oil or petrolatum ingredients. Don't be afraid to use a drop or gel throughout the night as you wake or turn - I do and think that it is what keeps me from burning.

I approach night as the absolute best time to address inflammation and repair (for lack of a better word) of the ocular surface, and keeping the eyelid skin off my eye surface is crucial to help ease corneal inflammation/damage. But to be honest, the thought of putting any of those goopy thick ointment products in my eyes makes me cringe because they used to irritate me so much.

Just wanted to share my opinion/experience! Take care,

[Mika]

btw hmm living in a country like mauritius i can't get trankil eye and i dont fink i can replace ointment without an appropriate eye gel.....
and swiming google....(tho small or big) prevent me from sleeping well...... i have bad sleep with it everyday....
so...
hmm i fink if u use ointment, and u unclog it everyday with compress it MAY not affect the eye so badly after all.....

(btw) i can't order online (if u are wondering y I dont order) and just an e.g : getting my wileyx Ink make me pass a series of problem with the customs.....and i only got it coz someone from a freight forwarding centre has a good contact .....hmm but im considering to order in sometimes...

[Rebecca Petris]

Thanks for your replies, Eli and Kitty.

Is the Genteal Gel safer to use than the Refresh PM? Is it less likely to cause obliteration of the glands?
Is it better to sleep without anything and just use the tranquileyes?

-Julie

Genteal Gel is a totally different animal. (Genteal also makes an ointment, by the way.) Dr. Latkany was referring to the "vaseline" type ointments made of petrolatum and mineral oil. Genteal Gel is just a polymer based lubricant gel, meaning it's similar to lubricant eye drops although in higher concentration.

Personally, my recommendation is, use Tranquileyes plus a strong lubricant that has historically performed better for you than other lubricants. Many on the board favor Genteal Gel or Dwelle. Expect the Tranquileyes to take some time - possibly several weeks - before showing noticeable results. I would NOT use Tranquileyes to replace a lubricant. More night-time tips at this link .

[Julie1]

Thanks everyone!

I've discovered that I lost my original tranquileyes, so I just ordered another pair. It comes with Dwelle, so I'll give that lubricant a try.

I am going to try using Systane tonight, and if that does not work, I will put some Genteal Gel (w/ Hypromellose) in. As long as I am not using products that have petrolatum and mineral oil, I should be okay, right?

Maybe once I start using the tranquileyes, Dwelle will be enough for me so I don't have to use a thicker lubricant. I do think that I sleep with my eyes partly open because I wake up with extremely puffy eyelids every morning.

Thanks everyone for all your advice!

[Julie1]

Mikastef,

I'm sorry that I missed the question that you wanted us to ask Dr. Latkany. I see that Rebecca posted the question and that Dr. Latkany has already responded. It sounds like a good answer! I hope that it helps you!

-Julie

[cristinalatina]

There is something here I don't understand. Is it the petrolatum that's bad for you, or the mineral oil?

I remember using eye drops with mineral oil (Soothe) for many months, possibly more than 6, after LASIK, and they had worked well back then. They contain about 5% mineral oil as the main ingredient. Would they be irritating as well?

[calli66]

I think Soothe is OK. It's an oil/liquid emulsion--low %-not like ointments that are 50/50 oil/petrolatum. I use Soothe at night only--that's what I usually put in my eyes when they wake me up 2-3 times a night with dryness. I start out with Genteal Gel and Tranquileyes and add more of Gel or Soothe as needed.

Since I wear contacts most of the time, I can't use the greasy ointments--can't wash it off well enough not to contaminate soft lenses.

I used blephamide ointment for a couple of weeks once--the lanolin in it actually felt good. But good grief, it has a mercury compound for a preservative.

C66

[cristinalatina]

Calli66,

thanks for clarifying that. Regarding preservatives, I agree that one should be careful and avoid the obvious offenders, but...I personally prefer (and use) mostly drops with mild preservatives. I feel much safer with them. Especially when I hear about various recalls of various unpreserved products, and also knowing how easy would be for me and anyone else to suffer an infection, for various reasons.

[jimmy]

My eyes were drying out painfully at night, so I began using a PM ointment (petrolatum and mineral oil) at bedtime. For me, it lasts only two or three hours, and when the irritation or pain wakes me up, I have to add more lubricant. This performance is not much better than with Systane, Refresh Liquigel (which, however, leaves an unpleasant adhesive residue), or Refresh Dry Eye Therapy (which works best for me at night, though not during the day). So I've about given up on PM ointment, as there seems no benefit to offset the greater difficulty of applying it, and also the hypothesis about damaging the glands is a source of concern.

[kakinda]

Regarding preservatives, I agree that one should be careful and avoid the obvious offenders, but...I personally prefer (and use) mostly drops with mild preservatives. I feel much safer with them. Especially when I hear about various recalls of various unpreserved products, and also knowing how easy would be for me and anyone else to suffer an infection, for various reasons.

The problem is very few people really know what are the obvious offenders? how do you define mild from obvious offenders? for instance what are the mild ones you mention? what are the obvious offenders (OK there's BAK and then where you classify EDTA, thiomersal)?
what's your method to define which is what?
If you have studies to support the innocuity of some of them, then I guess you are right. But do you have these for the ones you use?
The thing is that there is limited pharmacovigilance work being done on the impact of the different preservatives in ointments or drops. To answer those questions one would need studies on every preservative available (long term use on the ocular surface). The issue is far more serious for ointments than drops because a preservative stays in contact with the cornea for at least 7 or 8 hours if not more for those who spleep more.
Preservative from ointments will not protect you from infections you may develop in your eye for other reasons, there just there to avoid contamination of the product. And it has been proven that some ointments don't need that. I have used a non-preserved ointment since mid 94. No problem. I have had verious serious problems with other preserved drugs.
It's not because you FEEL safe that you ARE safe (some preservatives are also used as spermicides, as pesticides... does that makes you feel safe?). If you mention the mould spores in Systane, these we already in the product from what i've read.
There have been several issues of contamination with products using preservatives including lens decontaminating products over the years.
So beware of long term consequences of preservatives in ointments, safety may not be what you think...
It's worth discussing this issue with your doctor anyway.
Cuidate