Patanol, Alrex, Allergies, Help?

[shoebox]

Hi everyone!!!!
Actually realized the title here may be misleading. My eyes are doing pretty well. I saw the eye dr today for a vision check and to order new glasses. My vision has changed since resolving 90% of the dry eye issue with punctal plugs, I am thrilled to say! Even though the fitting process was difficult for me, it was totally worth it!
I'm hoping someone can give me some advice about allergies, though. I called my regular dr to see if I can increase my Zyrtec because my eyes are itching so badly lately (same thing happened after taking Claritan for a year -- it stopped working for the main symptom (itchy eyes) and we switched me to Zyrtec). He said no, but that he'd call in an eye drop for me. He called in Patanol, which has BAK. So when I saw the eye dr today, I said I don't like the preservative in Patanol, and he prescribed Alrex instead. Checked into it before having it filled -- it has BAK, too!! I think Patanol works best if used every 12 hours like clockwork, and the eye doc wrote "prn" on my script (I think it says 4x per day prn) for Alrex -- so does this mean it won't be as bad because I only need to use it when my eyes itch, instead of 2x a day, for it to work?
I think knowing it has BAK will prevent me from using it if I get it filled, which brings me back to square 1 with itchy eyes and unused Patanol, and if I rub them they itch MORE and hurt. Anyone got any ideas? I am back to using Dwelle at night just to soothe my eyes before bed. Also, since I have all 4 ducts plugged does anyone think the icky allergens are hanging out on my eyes longer, and maybe using drops to sort of "rinse" my eyes a bit will help or harm?
Anyway -- just looking for ideas. I hope everyone is doing as well as possible and having a fun summer. Hang in there!

[kitty]

I am no expert, but it is my understanding that it is repeated exposure to BAK over a long period of time that can cause problems, and that with short term exposure, any harm done will reverse itself once the BAK is stopped. I use Patanol every allergy season. Since getting plugs, the allergens stay in my eyes and the itching drives me insane. It is ordered every 12 hours, I use it less if I can. For me, it is only 3-4 months out of the year that I need to use it. I have experienced no ill effects from it. It's a matter of risk vs. benefit, and that is a decision only you can make. FYI, I find OTC Zaditor works nearly as well, costs a heck of a lot less.

[shoebox]

Sweet! Thanks, Kitty!
I read some info on the web about BAK from "Review of Opthamology" that also said that any damage to the tear film basically goes away after BAK is stopped. So far since getting the Patanol I've only used it twice for serious itching, instead of every 12 hours. If I don't, I end up unconsciously rubbing and then the inner corners of my eyes swell and get sore.

Kitty how are YOU doing?

[William53]

Just a redflag. Zyrtec, a systemic antihistamine, has been associated with ocular drying in a couple of studies. It took me a while to figure this issue out last fall. My allergist had me on Zyrtec for a couple of months before the dryness got so bad that I couldn't work a full day. So, thinking it was about my eyes, I go to my opthamologist who predictably throws the mega-eye meds - prednisol drops, etc. - at me to solve the "eye problem." Then, on a business trip, I'm reading some of the smart people here on the forum saying to watch out for systemic antihistamines, reading study results on the web, and decided to stop taking Zyrtec for a few days. Within 24 hours, my eye moisture level improved significantly, I transitioned off the mega eye meds, etc. There are trade-offs of course. Like you, I've got allergies and dry eye issues (and asthma) so solving this stuff is never clear cut. Best,

[kitty]

Everyone is different. I find Zyrtec to the be the least drying of any systemic antihistamine.

[kitty]

Sweet! Thanks, Kitty!
I read some info on the web about BAK from "Review of Opthamology" that also said that any damage to the tear film basically goes away after BAK is stopped. So far since getting the Patanol I've only used it twice for serious itching, instead of every 12 hours. If I don't, I end up unconsciously rubbing and then the inner corners of my eyes swell and get sore.

Kitty how are YOU doing?

You are welcome! I am hanging in there, having some significant flaring right now with the hot, dry weather and AC at work. Thanks for asking!

[clairvoyant]

They have used BAC to induce dry eye in rats/mice. So.... I would hope it's only temporary but if that is the case then it must be permanent? Still treatable though.

[Blueyes]

I am also no expert, but I know that Patanol is safer to use than Alrex that is, in fact, a steroid. However, Patanol does not do much for my allergy.

[skygoddess]

You said your eyes were itchy, and I was wondering, have you ever been tested for CONTACT allergies?
They are different than hay fever etc. Testing is different also. Basically it is any thing that comes in contact with your skin.
Not necessarily just the skin around your eyes either.
I have Occular Rosacea, Mgd and Blepharitis. I just was not getting better, no mater all my best efforts I kept having flare ups.
So I went for contact testing. 4 items popped up. All together they are in over 2,000 known items.
One of them is in , get this, BABY SHAMPOO. So you might consider getting tested.
They tested my drops too.
Genteal- I was allergic. Go figure.