Plugs and ocular Rosacea?

[katy]

I consider getting plugs since Restasis hasn't helped my eyes yet (the even got worse).

However I probably have ocular Rosacea (I have skin rosacea since many years and also have blepharitis to some extent).
Would you still consider plugs if you have ocular rosacea or could they make things worse respectively make the eyes even dryer?
I also heard they could cause an infection

I really do want to try plugs though, since nothing else seems to help me.

My dry eyes problem occured after a Keratitis last year and gets worse and worse...

I'd be very happy about your advice.

Thanks a lot in advance,
Katy

[mflores22]

I just asked this question of Dr. Latkany. His response was that once you clear the inflammation from the eyelids and memoibian glands, plugs are OK.

[katy]

Thanks a lot for your reply.

What exactly does he mean with "clear" and how long will it take approximately?

[mflores22]

It depends

He means eliminate all inflammation from the eyelids and memoibian glands before you get plugs. You don't want inflammatory cells floating around on your eyeball any longer than necessary, and plugs will keep them there longer.

And how long does it take? That's the million dollar question. The most honest answer I've gotten is 'Nobody knows, it's different for everybody'. My guess based on my experience and reading other people's experiences is 6-12 months.

Personally, I'm on my second month of doxy, have been doing lid scrubs and warm compresses religiously for three months, take BioTears, Lactoferrin, NAC, and additional flax and fish oil supplements; and I'm still getting rid of inflammation and MGD. It's tough, it's frustrating, but little by little, things get better. I'm still not comfortable in my contacts (some days are better than others), but I can ride in a car, with my glasses on, with the AC on without discomfort. That's something I couldn't do three months ago.

[Natalie06]

Plugs and rosacea

You are right to be cautious...my Lasik surgeon plugged all 4 tear ducts right after my surgery and within 6 weeks I had a full blown, out of control case of bleph due to undiagnosed pre-existing ocular rosacea/MGD.


Almost 2 years later, I am still battling the bleph, severe dry eye, etc. I am still on minocycline, doing lid scrubs and hot packs. I have lower plugs and wonder if that's part of my problem since my rosacea/MGD is clearly not "cured" and I am still keeping inflammatory tears in contact with my corneal surface.

I was told to try Azasite to treat the lid disease but have yet to try it. I have heard some good reports though so you might want to look into that.

Natalie

[katy]

@mflores:
Thanks for your advice. I should do/use these things more often, I haven't had the patience yet unfortunately.
But isn't that sth you need to keep up even if your eyes get better? I could imagine they'd get worse if you stop the treatments...

@natalie:

I have lower plugs and wonder if that's part of my problem since my rosacea/MGD is clearly not "cured" and I am still keeping inflammatory tears in contact with my corneal surface.
I was told to try Azasite to treat the lid disease but have yet to try it. I have heard some good reports though so you might want to look into that.

Can ocular rosacea be cured at all?
I have been having rosacea on my skin for many years and it gets worse the older I get. So I wonder if it really can be cured (or as I wrote above won't it get worse when you stop the treatment) ?

What exactly is Azasite and what have you heard about it?

Are you getting along with the side effects of minocycline?

Thank you so much for sharing your experience!

[mflores22]

Yes, you need to keep up the treatments even when you get the inflammation under control. Bleph/Rosacea patients have to perform warm compresses and lid scrubs for the rest of their lives. Lucky us.

[Natalie06]

minocycline

Minocycline worked better for me than tetracylcine or Doxycylcine. Less than 2 weeks of starting it, my upper lid glands started looking like I had white "pimples" as the accumulated "crud" started coming out..it's not as gross as it sounds but there were a few very uncomfortable days.

I can't say I have noticed a lot of side effects except some stomache issues. But I really don't want to be on antibiotics for the rest of my life either.

If you ask Dr. Latkany, there can be several components to "bleph" and ocular rosacea/MGD like some underlying staff infections. It's not always straight forward (lucky us).

The Azasite was recommended br Dr. Trattler (an ophthalmologist and Lasik surgeon) in FL. It is a treatment for pink eye and there is evidence that it can treat inflammation from bleph/MGD and seems to "soak in" to the lid margins. I am recalling this from a quickly scanned article. If I find it again, I will pm you or post the link if it's not copywrited. You might want to ask Dr. Latkany about it too in his forum.

I believe my "ocular rosacea" is caused by the hot flashes and night sweats due to Lupron induced menopause (one of the causes of rosacea as well as one of the symptoms is flushing and boy, do I flush a lot). Many of my pre-lasik eye issues started at the same time as my hormonal treatments for another condition. So there's that component too.

Makes my head spin just thinking about it. It's sometimes hard to know what came first...In my case, I believe that I had MGD/ocular rosacea with probably some type of mild inflammatory issue due to the increased bacteria colonizing my glands/lid margins/tear film and then bam, Lasik (and 4 punctal plugs)threw me right over a cliff.

Natalie