Help!

[member31986]

On Nov 4, I went back to the eye doctor for my dry eye. Last winter I had gone and got erythomycin ointment I was to use and then go back in 5 weeks for possible plugs. My eyes got better so I cancelled the appt. Now it has returned, I think due to the heat coming on again. Anyway, I went back the beginning of the month, saw a different doc in same practice, and he recommended asazite and erythomycin ointment as well. I suggested the temporary plugs and he agreed to try them if I wanted them and I did. My husband lost his job so we are on borrowed time with health insurance so that was why I did this as well. Anyway, I was told to use the azasite in eyes at night, followed by the ointment. All seemed to be going well until this week whereby I have noticed some discomfort coming back through the night. It is not awful but my prescription for the asazite is just about gone. I still have the ointment. I have an appt beginning of Feb. for possible semi permanent plugs to be put it. We have insurance until the end of that month, unless hubby finds a job by then. Anyway, I would like to know any suggestions, comments you all have. This is quite a disturbing disorder as I have found out. I am menopausal which I am sure is part of it as well. I just love getting old!! yeah right.... Thanks in advance for any words of wisdom.

[dianat]

Hmmm...I'm not sure why any doc would prescribe e-mycin ointment for dry eye unless you showed clear signs of an infection. The ointment is petrolatum-based which well-respected scientists and patients on this board agree is very bad for tear film. I'd keep off it and stay off.

There are some good gels out there for nighttime and daytime use that are not made with petrolatum. The name is escaping me right now, but someone will post with it.

I could continue with the azasite as long as you can and begin an eye regimen based on the cause of your dry eye...if you know that.

http://www.dryeyezone.com/encyclopedia/treatment.html

You might also consider reading Dr. Latkany's book The Dry Eye Remedy. There are so many good ideas on this site from nighttime eye wear to humidifiers. Really, most of us just find what works best and manage as best we can. Best of luck to you.

[Rebecca Petris]

Did the word blepharitis come up during the appointment? (Seems likely given the products you were told to take.) Any other information about your diagnosis?

I'd read up about additional longer-term blepharitis prevention/management strategies like warm compresses, Omega 3s, etc and as Diana suggests look into getting some protective gear.

Regarding plugs, before you consider this please find out as much as possible about your diagnosis. Plugs can be excellent tools under some, but by no means all, conditions.

[member31986]

Yes the initial diagnosis was blepharitis. Back in the spring, I was told to use a warm compress at night followed by the enrthomycin ointment at night,. this did help it and I thought my troubles were over. As I said, I think the dry heat is a contributing factor because they were not nearly as painful as they were by the end of winter last year once the heat was off. It is actually 1 eye that is worse. When I went to this office, I thought I was seeing an opthamologist but ended up with supposedly the one doctor that specializes in "dry eye" who is an optometrist. I know the asazite is down to my last drop. Should I call the doctor's office again and ask for a refill if this is not better? Anyone know the long term use of both of these products? I know I don't think I could stand not putting something in my eyes at night for fear of severe pain that usually wakes me. I do have the dry eye book that was mentioned. Perhaps I need to reread it.

[dianat]

It really is important to find out the source of your dry eye. I did not know e-mycin ointment was used for blepharitis, but I know Azasite is, though it may have broader uses now. Lid scrubs are something else you could try... Please don't rely on the emycin ointment to get you through the night. There are gels that can do this for you. Genteel Gel is the one I think most popular here. Try it.

Absolutely continue the warm compresses morning and night.

Diana

[bernmee]

Hi,

Just to second what has already been said here. That Genteal gel pm drop is really good. I use it every night, and it makes a huge difference. It is pres. free in the eye so should be safe enough.

Some day time protection for your eyes is important. It you don't want to go for the panoptx google type glasses, have a look at their panoptx 75 range, ich povides 75% protection.

Also night time slpeeing mask and humidifier should help.

Warm compreses and omega 3's, these are very very important, and I couldn't imagine a day without them.

Berandette

[member31986]

Thanks, I actually was reading Dry Eye Remedy last night and it suggested the "Eye Spa" using warm compress followed by a light massage. I tried the ole rice in sock method in microwave and put it on my eyes, they felt much better and last night in bed was not too bad.

One question...is the erthymycin oinment not good for long term use? I see some have recommended Genteal gel?...

[dianat]

I don't think it' concerning with regard to safety to be using the e-mycin ointment. It's petrolatum that's in it that is not good for tear film, meaning that your comfort is likely compromised. Perhaps the antibiotic is reducing some discomfort, but I don't see how you can tolerate the petroleum. I've had to use e-mycin ointment for a couple of infections. It did clear up my problem, but made me miserable in the process because it made my eyes sticky and uncomfortable.

I think it be be worth trying the Genteel and doing some mild lid scrubs.

D

[Rebecca Petris]

Just my 2 cents fwiw...

One question...is the erthymycin oinment not good for long term use? I see some have recommended Genteal gel?...

I'm not sure the two can be fairly compared. Genteal Gel is intended solely for lubrication - the ointment equivalents of that are all the "PM" products (Refresh PM, Genteal PM, etc). I'm strongly in the camp that believes ointments are a really bad idea as long-term lubricants.

But a medicated ointment is a little different. If you need the antibiotic to get severe bleph under control then... if you can get an antibiotic without that vehicle, great, if not, you tolerate the ointment vehicle (reminds me of Muro 128 for RCE... for some the hypertonicity benefits are enough that you put up with the ointment part). Personally I wouldn't stay on any antibiotic, topical or systemic, for very long periods and I wouldn't stay on anything in an ointment vehicle for very long periods but I also probably wouldn't quit an antibiotic without some really good discussion with my doctor to make sure I could keep the bleph at bay with other treatments.

Keep up the heat... doesn't fix everyone by any means but it's a core part of treatment for many of us.

[bernmee]

Rebecca, I'm not sure if I misread your last post. Is Genteal Gel pm an "ointment" that has all those ointment issues, I didn't think it was.

If you can let me know that would be great, so I can start planning a new night time regime.

Bernadette

[dianat]

I'm quite sure she intended to say, "...the gel equivalents of that are all the..." Genteal is, in fact, a gel and not an ointment.

[bernmee]

Thanks for that.

Bernadette

[Rebecca Petris]

Heh.... sorry for all the ambiguity there. What I was really trying to say was that if we leave drugs (eg erythro-etc which use a lubricant as a vehicle) out of the picture for a moment and look strictly at products intended exclusively for lubrication, there's gels (eg Genteal, or come to think of it there's ONLY Genteal) and then there's ointments (eg Refresh PM etc). I just meant that those are the ones that can be compared apples-to-apples in terms of whether they work, what the side effects are etc. I think in this community it's been abundantly clear that between ointments and Genteal Gel, the latter is a hands-down winner. Not that it's the greatest product in the world but it doesn't take much to beat an ointment.

Bernmee, YES Genteal PM is an ointment like all other ointments - petrolatum and mineral oil. Genteal GEL is not, it's a polymer based product. I think these companies do us a disservice by putting all these products under the same name: too durned confusing.

[dianat]

Genteal PM is an ointment?! I don't use Genteal products, but if I ever resorted to them, I'll be sure and use the gel. Thanks for the further clarification.

[mary kenny badami]

Rebecca wrote, in part: "What I was really trying to say was that if we leave drugs (eg erythro-etc which use a lubricant as a vehicle) out of the picture for a moment and look strictly at products intended exclusively for lubrication, there's gels (eg Genteal, or come to think of it there's ONLY Genteal) and then there's ointments (eg Refresh PM etc). . . "

Rebecca -- not to confuse anybody even more, but isn't "TheraTears Liquid Gel" a gel? and non-preserved? sold in foil pouches of 4 sterile single-use containers? I'm copying from the label -- which I just happen to have handy: "Active Ingredient = Sodium Carboxymethlcellulose 1%, Purpose = eye lubricant."

Now in fact, as any steady reader of this website can easily discover, my most preferred eyedrops for years have been Dr. Holly's Dakrina and NutraTear. However, on occasion when I ran out, I found TheraTears Liquid Gel to be far more soothing to my eyes for overnight use than Genteal Gel. (I initially bought the TheraTears product by mistake, but ended up liking it a lot!)

Knowing how variable the reactions of our members are to these various products, I wouldn't want someone to give up on at least a trial of TheraTears Liquid Gel . . .