My visit with Dr. Latkany

[dave25]

I flew to New York on Friday to see Dr. Latkany and he diagnosed me with ocular rosacea almost immediately. I was surprised because although I have fair skin I never imagined myself having rosacea. I always thought it was just mild acne. Well, I think this was an important step for me because if I am able to control this skin condition he said my eyes would most likely get better as well.

I was wondering if anyone had any good advice on rosacea treatments? I am going to see a dermatologist asap, however I used to see a derm when I was a teenager and I am a little wary of the endless creams they seem to give people that rarely produce any results.

Anyone really struggling to find a correct diagnosis for their eyes should consider seeing Dr. Latkany. He is very nice and seems to have a really good grasp on how to properly diagnose patients. I have struggled for almost six years knowing that I had bleph/MGD, but not knowing that treating my face properly could provide big improvements for my eyes.

[Brooke]

Dave,
What did he base his diagnosis on? Was it prominent blood vessels near the eyes, redness of the face, etc? I wonder because I too was told I have ocular rosacea but I would not have guessed that I had rosacea either by looking at my face/eyes.

Did Dr. Latkany offer treatment suggestions or just the diagnosis? If so, what did he recommend?

[sandra lee]

Hello

It is wonderful news that you have finally got a diagnosis and I wish you GOOD LUCK!!!!!!!To actually have an answer must be a tremendous relief and to know help is there for you must be such a comfort and stress reliever.I have Dr. Latkany's book and reading it has been very informative and promising to know there is actually a Dr. that has enough concern and compassion to his patients.I have been contemplating making the trip and was curious if he is really as nice and caring as his book portrays(and now you have answered that question)so Thank You!Also I was wondering if you could share your symptoms and treatments you have had.I also was diagnosed with mgd/blepharitis and have had a very rough time but I am concerned that the Dr's I have seen(even one in boston)are missing the real cause.I have facial flushing usually when I have a flare up but they say it is just the inflammation.I would appreciate any info you could share and I wish you well. Thanks P.S. Was it a long wait to get an apptointment?

[dave25]

He looked at my face, which especially under bright lights has a slight reddish appearance. One reason why my face might have been even more irritated is because I have been using benzoyl peroxide for acne and I have been reading that this could make rosacea even worse. I am confused right now because I don't want to break out real bad if I stop using it, but I know I have to stop because it may be making matters worse. I am trying to find a good alternative and right now I don't really know which one to choose because there are several options.

Yes, he did change my regimen quite a bit. He told me to use doxycycline 50mg once a day, Restasis twice a day, Pataday once a day, and Accuvail twice a day. He also told me to use as little artificial tears as possible and to keep drops refrigerated. Believe it or not this regimen is less eye drops all together than what I was using before. So, maybe overuse of some drops and too many preservatives were also contributing to my problems.

[Brooke]

That's good that he gave you a treatment regimen. Why did he prescribe pataday--did he say you have allergies as well? Also, what is accuvail?

Did he say that you have blocked glands as a result of the ocular rosacea? Did he recommend any warm or cold compresses? I may see him myself soon but do not live nearby. How did he say you should follow up with him?

Thanks!

[dave25]

It is wonderful news that you have finally got a diagnosis and I wish you GOOD LUCK!!!!!!!To actually have an answer must be a tremendous relief and to know help is there for you must be such a comfort and stress reliever.I have Dr. Latkany's book and reading it has been very informative and promising to know there is actually a Dr. that has enough concern and compassion to his patients.I have been contemplating making the trip and was curious if he is really as nice and caring as his book portrays(and now you have answered that question)so Thank You!Also I was wondering if you could share your symptoms and treatments you have had.I also was diagnosed with mgd/blepharitis and have had a very rough time but I am concerned that the Dr's I have seen(even one in boston)are missing the real cause.I have facial flushing usually when I have a flare up but they say it is just the inflammation.I would appreciate any info you could share and I wish you well. Thanks P.S. Was it a long wait to get an apptointment?

I got an appointment in like 2 or 3 weeks. It wasn't long at all. All I can say is that I really didn't think I had rosacea, so hearing his diagnosis was surprising. After reading more about rosacea and ocular rosacea I found I have very similar symptoms. The only reason why I didn't think of this before was because my face really wasn't that red. But it turns out I may just have a mild case that spread to my eyelids and caused my eye problems. Hopefully if I can find good treatments for the rosacea, I can see the improvements in my eyes that I have been hoping for.

[dave25]

That's good that he gave you a treatment regimen. Why did he prescribe pataday--did he say you have allergies as well? Also, what is accuvail?

Did he say that you have blocked glands as a result of the ocular rosacea? Did he recommend any warm or cold compresses? I may see him myself soon but do not live nearby. How did he say you should follow up with him?

Thanks!

Yes I do have eye allergies. I haven't really found what I'm allergic to except for dust mites. I don't have allergies anywhere else though. Acuvail is an NSAID, which is mostly for pain. It kind of works like an aspirin or ibuprofen only in eye drop form.

He said my glands look ok and when squeezed they do secrete a clear, runny oil. So that was somewhat good news. I did do 2 warm compresses a day and I told him I also showered twice a day, so he said if I showered twice a day to use cold compresses instead of warm compresses because I was getting enough heat from my showers.

[Brooke]

That's good news about the clear oil. My doc told me that my ocular rosacea caused my thickened oil, blocked glands, MGD. Sounds like you caught it early enough. What does he think your main issue is then from the ocular rosacea--aqueous deficiency, inflammation?

Is the acuvail helpful for pain? I used Xibrom before but didn't think it really helped with pain. How long did he recommend you stay on the acuvail?

[dave25]

That's good news about the clear oil. My doc told me that my ocular rosacea caused my thickened oil, blocked glands, MGD. Sounds like you caught it early enough. What does he think your main issue is then from the ocular rosacea--aqueous deficiency, inflammation?

Is the acuvail helpful for pain? I used Xibrom before but didn't think it really helped with pain. How long did he recommend you stay on the acuvail?

Yeah, my main problems are inflammation and allergies. He said he could see why I was in so much pain. Not sure how long I will be on Acuvail. I will still see my doctor in St. Louis, but Dr. Latkany told me I could email him whenever I wanted and let him know I'm doing. Unfortunately, I can't really afford to fly to New York all the time.

[ringo]

One of my close friends has rosacea. Her dermatologist prescribed for her compounded cream from a pharmacy, which consisted of metronidazole or doxycycline mixed with a neutral cream base.

Her skin redness and inflammation resolved within days of using that.

[ringo]

You are so lucky to live in the US where you can get the ppreservetive free version of Akular- Acuvail. Overseas we are just looking on at the progress medical care is making in the US and can only hope that some day in the future we will have access to it.

[dave25]

One of my close friends has rosacea. Her dermatologist prescribed for her compounded cream from a pharmacy, which consisted of metronidazole or doxycycline mixed with a neutral cream base.

Her skin redness and inflammation resolved within days of using that.

Hey thanks for the tip.

[dave25]

You are so lucky to live in the US where you can get the ppreservetive free version of Akular- Acuvail. Overseas we are just looking on at the progress medical care is making in the US and can only hope that some day in the future we will have access to it.

How long does it take for medications that are available in the U.S. to make it over where you are?

[ringo]

You are most welcome...i think you should be taking low doses of doxycycline by mouth as well....i think i the US it is called Oracea.

[ringo]

forgot to mention- it is used to treat acne as well