AzaSite and MGD!!!!!!!!!!!!!!!!!

[clairvoyant]

The allergy/ocular rosacea/blepharitis/mgd patient is probably a typical population group he sees. They all probably share a similar eitology, signs, symptoms, problems and maybe even treatments. This would explain lotemax use for NYer because it probably adresses multiple problems while being a weak steriod in nature. It is probably not a good idea for long term use but finding a regimine that works for this particular patiet group could probably take some time (for a good reason or not) and may even involve periodic lotemax use. I think with this particular combo it can be troublesome, especially w/ the given treatment options and with patient's inability to fully comply e.g. w/ diet and computer and the sometimes unavoidable environment.

These terms have alot of different connotations you have to remember too. Sometimes people use them as "umbrella" terms and other times they can use them in a more specific sense (for some reason).

I do not understand the whole ocular rosacea thing, unless this is his way of saying you are a very sensitive patient with multiple problems like the aforementioned allergies.

For example he called me this type of patient and I am not your normal white freakedly rosacea person. I am more the acne rosacea patient. Of course once you have one you will probably have the other but I would think, depending on your etiology, you could have more of an affinity to one than the other.

Now while I do have this "ocular rosacea" which I believe involves those red veins on and possibly around the eye (not the case for me with the latter), I do not believe that I should stop warm compresses. Which probably in theory and practice could make this "ocular rosacea" worse. In effect making the whole situation worse including the MGD and could maybe even cause direct ocular surface inflammation.

I have seen he has suggested that for some people.

I think for me it is more a matter of not doing hot or too warm of a compress. And I think it may be this way for others. He probably overly simplifies things. Doctors tend to do that.

About azasite- the jury is still out it seems. He probably knows the truth but may not overly share it. For example maybe it is bad for ocular rosacea like NYer says, maybe it causes corneal erosions, maybe it needs to be refrigerated to help mitigate some of that stuff or maybe there are other ways to circumvent the problem.

It could also be more important to get those glands flowing since that is probably the hardest part at this point and time.

That is my 2 cents...

Honest to god though, the more I think about it Dr. L impresses the heck out of me. I have been to a TON of GOOD doctors and although I was a lil angry with his initial treatments b/c of how long I have struggled with this, I am now thinking his expierence and skill escalates him to an upper echelon. Except I think occasional scrubs are not a bad idea for this group.

[NYer]

Actually, I never said that Azasite isn't good for people with Rosacea. I simply said that when I used it, it caused a terrible reaction, within two days, of burning, soreness, dryness and irritation and it took 5 days after I stopped it to go back to my regular level of dry.
But also, he didn't prescribe it to me for Rosacea. He prescribed it for MGD.

[Meebo]

Keep in mind the way we discuss, whether disagree or agree, etc. allows us to more easily "connect the dots."

I am in the ocular rosacea club, but I have 0 acne and very mild facial rosacea. Interestingly enough, my left side is where the visible red blotches are and is actually the worse eye.

I believe NYer is onto something in regard to allergies. I am going to do more research and hook up with some allergists that are familiar with ocular issues.

This past weekend i refrained from showering and ate one meal a day towards the end of the day. I drank two large coffees from starbucks and it did not affect my conditions. I will say I felt very good both days. So, with that said, I am having a feeling there i a direct connection between the rosacea and possible allergies.

It all comes down to inflammation. I would not be surprised if chemicals in soap coupled with possible food allergies over time has caused this.

I also believe this is true because i have used dermatologist reccommended soap for the last 4 days and symptoms have subsided. The kicker is this: when i use pataday my eyes become increasingly clearer. Pataday flushes allergens from the eyes.

There has to be SOME kind of connection. Kudos to NYer to sticking to her gut as it is going to make me pursue some professional advice in the allergy arena.

[NYer]

Thank you, Meebo! I appreciate the acknowledgment.

[clairvoyant]

What soap is that?

[clairvoyant]

Let me clarify some things. I should have been way more clear.

I was validating your hunch about allergies. Like you, I use to underestimate that aspect of the condition. Only until I saw Dr. latkany did I started to connect this dot, so to say. Well truthfully I always use to think it was possible but never thought that it was that big of a deal b/c of the itch misconception. That is why I proclaimed him head and shoulders above the others. No other doctor had made that connection because I have no itching symptoms- the classic sign of allergies.

You see I think there are a group of patients that fall into the diagnosis of ocular rosacea, allergies and the usual blepharitis, mgd and dry eye.

Dr. Latkany helped me realize this like he did you-according to your post at least. Since then I have done some research and have read that allergies will exacerbate the MGD.

Well after all this I did some testing that seemed to support his diagnosis. I had also previously been diagnosed with gpc but didn't find that out till later. So the logical equation will be clear the allergens then treat the mgd. And that is diet dependant so if you wanna do it right you gotta stop using the computer, clear the allergens and eat the correct diet.

So I was trying to aknowledge your hunch and how you are a veteran around here but apparently I failed.

Now, I did infer that you meant the azasite exacerbated your ocular rosacea. If my memory serves me right you said it irritated your eyes and made them more dry?

Why did you think it was bad because of the burning or something else? Cause I interpurted it as it excacerbated the ocular rosacea, not the facial stuff.

Cause while it burns my eye too I think it is far more beneficial than any pill will be. You can feel the drop getting into the meibomian glands which is what the doctors prescribe it for, not ocular rosacea which is an umbrella term, as I said. I think you would need anti vegf treatment to treat that. The azasite also adresses the anterior blepharitis, which I have. I am not sure if you have that or not. And I figure it that if you get those glands flowing then the eye can actually function normally and then healing will happen much faster and heal whatever damage the azasite is doing to the eye. I hear the doxy drops burn too but maybe they are less irritating? Admitedly oral azith might be decent too but I'm sure the topical is better. You can do what meebo is doing and do the oral and topical at once. Mix and match it could be fun!

[NYer]

MG, are you addressing me or Meebo here? I'm totally confused by your post. If you are asking this of me, let me start this over from the beginning, so there is no confusion.

I tried Azasite and had a terrible reaction to it. It didn't exacerbate any of my current conditions (MGD, Rosacea). It caused severe soreness, burning, and irritation of both of my eyes after I had been using it for two days. I don't mean that when I instilled the drops I had a slight burning sensation, like some people experience. In fact, for the first day and a half, I didn't feel anything unusual when I instilled the drops. Dr. Latkany told me to stop taking it as soon as this became a problem. It took almost a week for my eyes to get back to normal (normal for me, which is just simply dry).

This was not a reaction to preservatives, as I don't have a problem with them in other drops.

Also, my thank you to Meebo's comment, was in no way meant to sound like it was a challenge to you in some way (??). I was simply thanking him for his comment. This is an interesting thread and there is no argument going on - we each have had different experiences with this stuff and it's helpful to compare notes.

[Meebo]

I just and dont have time to write my major reply post, but did want to clarify something.

My post about allergies was directed to NYer because I initially did not think it was possible because, interestingly enough, Dr. L said he was sure mine was caused by ocular rosacea.

However, I am researching to see the connect between allergies and ocular rosacea (does allergic reaction exacerbate ocular rosacea?) If so, i am on to something.

Soap I was using was some overpriced face cleanser and irish spring soap. I started using cetaphil for everything (google it, it is dermatologist recommended). My eyes feel better.

I will respond about the azasite later.

[clairvoyant]

Some of that was addressed to you NYer and the end was just in general. I was a lil aggitated the other day, didn't mean to come off the wrong way. The whole condition is annoying.

And even those soaps irritate the meibomain glands for me I think. Same with elidel a little bit!

[NYer]

LOL, MGD, Not a problem.

Happy Holidays to all.

[paintgirl]

I also feel there is an allergy compenent, and that it may be related to food. I began to have terrible digestive problems concurrently with the abrupt flareup of my roscaea two years ago. Both have continued... And unfortunately I have not taken the steps to completely reevaluate my diet. Think I feel a New Year's resolution coming on. Also other allegies may be to blame. Strangely, my right eye is very red and bleph is very bad around it, and the right side of my nose is covered in broken capillaries... The left side and eye are visibly better even though my left eye according to tests is drier! Perhaps its demodex? Bed allergies? Anyhow, I appreciate hearing all your perspectives... I am curious to try azasite as well as pataday... At this point I'll try anything! It seems to me that everyone's condition and response to treatment is very indiviual, although certainly good nutrition and hygeine are always a plus. Like others, I do believe there is an underlying systemic issue with inflammation. But managing inflammation is like trying to solve an equation with endless variables -- our bodies are so complex it's a wonder they work at all! Anyhow, you all make me wish I could see Dr. L but it is good to hear about his perspective through your experiences. Thanks all for taking the time to share! Happy holidays!

[sazy123]

In my experience, Azasite helps with blepharitis but does nothing for the MGD itself...

One could also use other existing anti-inflammatory agents ahort term such as Lotemax to calm down the eyelids so I do not really think there's something special about Azasite at all.

Of course, now they are trying to get it approved for posterior blepharitis as well because they wanna make more cash out of it (and out of the desperate longing of dry eye folks to get a drug with an indication for that condition). What's interesting is that Azasite Plus will also have a steroid compound in it...

Note that Azasite is not indicated for MGD and probably never will be...

Id agree with that phillip.

I have MGD but not blepth and im the same as meebo.. MGD caused by ocular rosacea.. But this will get touted as the answer to MGD no doubt. I think it works great for MGD caused by blepth/bacteria.. But not for MGD caused by inflammation, ocular rosacea etc. Unless the ocular rosacea is secondary to straph/bacteria etc.

However, its the best lubricant i have used as it stays on the eye for ages and takes away some pain for the next 1/2 an hour.. Why cant they make A tears like that? I need to try it for longer since ive had reacurring throat probs which always makes my eyes better.. it did feel good for the symptomtic reasons for the following hour if nothing else.

[sazy123]

While I believe there may be an allergy component, I feel that the rosacea is the most likely culprit. It would be hard to believe an allergy would cause the meibomian glands to cease working.

With the fluctuations you get... do you notice anything at the time?

The main thing i wanted to ask is how do you feel overall when your eyes are feeling good? flu, or run down for example? the reason i ask this is because your diagnosis sounds very similar to mine, and my eyes fluctuate (only) when im ill or there's something else wrong with me.. the latest thing was tonsilitis/throat inflammation which has been going on since may- my eyes are practically normal during these times, inflammation of inner eyelids goes away.

Or maybe the flucuations are related to allergies, you can only be sure if you eliminate the allergies from surroundings i.e dust and foods and take allergy tests. All of this did nothing for me (along with drops), so i came to the rosacea conclusion.

What did Dr teusng say about IPL?

[Meebo]

Changed Soap

I read a post on here about a member that stopped using soap and he got better.

So, I stopped using soap and started using cetaphil (dermo reccommended cleeanser) and I almost want to bet money that it contributed to the reduction of redness in my eyes.

Also, there are time that I use pataday and my eyes get whiter, which means the cleansing of the allergens of my eyes are working.

We WILL get to the bottom of this.

[skygoddess]

I just wanted to jump in here and add my observations about allergies.
I read somewhere that people with rosacea have a much higher tendency towards allergies than the general population.
They also tend to be hyper sensitive to cosmetics.
Since I was diagnosed with ocular rosacea, reading that led me to get tested for contact allergies.

Discovered , I am extremely allergic to most hair care products.
They contain a preservative called NA22. Cocamidopropyl betaine. There are abut 15 other mile long names for it also.
It is in most cosmetics and BABY SHAMPOO!.
It is not in Cetaphil gentle skin cleanser.

I have a "approved " shampoo and conditioner the Dr. allows me, but I sometimes cheat.
I am stopping the cheating however, because I finally realized I have a awful reaction every time I use conditioner with the dreaded ingredient.

I kept having "bad" days in one eye or another. I kept wondering why just one eye at a time?
I mean if Rosacea is a systemic condition, shouldn't it be afflicting both my eyes ? or neither?

Then it hit me. I constantly change which side I part my hair on.
The eye close to my hair was the troubled one.

Allergic reactions can sometimes take days to manifest
So it may not be obvious but ask yourself, what comes in contact with my face or eyes.
Direct contact may not be necessary. You can "transfer " a allergen indirectly just by touching an item , then touching your eyes.
The nurse told me Black rubber is a common eye allergen.
( escalator handrails, tires, sports equipment all make my eyes swell.)
Nail polish and acrylic nails are also culprits.

I am not exactly sure how MGD, blepharitis, rosacea , and allergies all tie together. In my case I have them all.
When one acts up for me they all seem to join in the party, and nothing helps put a end to a bad episode for me like azasite
Just my anecdotal experience.