Fantastic news for dry eye patients in Norway

[Toril]

No need for prescription. Just a new form of tear substitute. I haven't seen them in any pharmacy here yet, but maybe they're sold at the optician? Not sure.

Most of the tear substitutes I use aren't available in Norway, and I either buy them from Denmark (www.theratears.dk) or from the UK (www.dry-eyes.co.uk). The latter has a big range of tear substitutes!

Toril :-)

[sunshinelover]

I am so exited now that I am going to Olso on Monday! That will be my birhtday present to myself since it is my birthday. However - i got bad news today! A Norwegian doctor can not prescribe a license product like Restasis to me here in Sweden. For a normal prescription it would have been fine, but not license. And according to what Joanna wrote it also seems very hard to get a prescription i France. I can't understand why Europe is so behind in this with DES! When US docs say they treat Dry eye more aggresively, here we are left with lubricating drops which helps nothing! I use gel now Viscotears like 6 times a day, but most days I can do nothing after seven oclock because eyes are completely hurting, and I am sure it is due to inflammation.
Well, that said, it is still good to go and see an interested eye doc, may be to get a better diagnosis.

[Toril]

Keep us updated on how it goes in Oslo! Good luck!

About getting Restasis in France: I can only talk for myself and I have autoimmune related dry eyes, and I got a prescription of Restasis by Prof. Baudouin without any problems. I wouldn't have got it if he didn't think I could have benefit of it though. I don't know if there are any specific rules for getting Restasis related to diagnosis, or if it depends on if your eyes are very inflamed or not. Maybe his secretary can give an answer to that?

[sunshinelover]

Hi! Here is an update on the Olso visit! I am cufused at a higher level!
I can really recommend this guy, he spend 1,5 hour with me, doing all sorts of tests (may be extra time since he had another doctor "trainee" in the room as well. The results is somewhat confusing though, so happy for comments on that:
Left eye (worse eye), Shirmer 15, TBUT 8, but BAD osmolarity. Right eye (better eye): Shirmer 5, TBUT 4 (better osmolarity!!)
Symptoms are at par with the osmolarity test, but I can unerstand how the othermeasurements fit into that! The left eye feels bone dry compared to the right!
Also: some dry spots on the corneas (level 2), nerve sensitivity normal (so no LASIK induced thing??), the meibum was clear but I had gland drop outs that didn't deliver anything.
So diagnose: BOTH lacrimal and meibomian dysfunction! I don't like that... He wanted to put me on Restasis but it is not possible unless I can get a Swedish doc to do it, it is not approved in Sweden - does anyone know of anyone in Sweden who prescribe it? And also wanted me to make tests to rule out Sjögrens since I had lacrimal dysfunction also. Could also be seborroic dermatisis so I also got Doxy and Azyter. Anyone tried that for MGD?

Well ,osmolarity test is said to be the best Dry Eye test and that must be true, since it correlate with the symptoms.

[Toril]

Hi again, Sunshinelover!

Thanks for the update! Was very interesting reading! I will go there and get all the tests too in a while. As far as I know I've never done an osmolarity test, and I'm pretty sure my score will be very low (which is also the case with the Schirmer's test and the TBUT test). I've been on low dose Doxycycline for many years now for MGD (first I started out with 100 mg. per day, but now I use 100 mg. three times a week). When not using Doxycycline for a couple of weeks my eyes tend to get worse (they get more sensitive to wind, etc. and I get an "icy" feeling). I've also tried to manage without Restasis, which made my eyes feel worse again (and getting more inflamed). I also use Zaditen allegy drops on a daily basis, and these seem to have an anti inflammatory effect as well.

I don't know any doctors in Sweden prescribing Restasis, but maybe the secretary of Prof. Baudouin knows someone? Like I mentioned before, Prof. Baudouin mentioned there were a couple of "good guys" in Sweden when it came to dry eye doctors. Otherwise you could stick with your appointment in Paris, hope to get Restasis there and bring the boxes with you back home. A complicated way to go though (and expensive....).

I'm amazed that all these treatments are available in Norway all of a sudden. It's like a miracle. Would never ever have thought that would happen in a long long time yet.

[spmcc]

Well ,osmolarity test is said to be the best Dry Eye test and that must be true, since it correlate with the symptoms.

Hi sunshinelover,

Did the doctor give you a treatment to improve osmolarity? Here in North America, the locations that are performing the Tearlab Osmolarity Test are recommending Blink Moisturizing Lubricant Drops.

Hope you feel better soon.

[sunshinelover]

Hi,
Is Blink Contacts Lubricants the same as Blink Moinsturizing Lubricants? I only find the Blink Contacts here, and I can't find if there is a difference. Are they suoposed to be better for osmoloarity then other drops? I use Viscotears gel now frequently throughout the day, as I do not get any relief from ordinary drops.
N, he didn't say anything about any special treatment regarding drops other than Viscotears. What I can't understand is why osmolarity is so much worse in the eye that have better Shrimers and TBUT...

[joanna]

Thanks for the update sunshinelover!
I think it should be my next step. What's the name of the doctor?

[spmcc]

Hi again sunshinelover,

Yes, I think Blink Contacts and Blink Moisturizing Lubricant are different products. The packages are different. Online info shows:

Blink Contacts® Lubricating Eye Drops is a sterile, buffered, isotonic, preserved solution.
This aqueous formulation includes purified water, sodium hyaluronate, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, boric acid and is preserved with OcuPure® preservative (stabilized oxychloro complex 0.005%). This preparation contains no chlorhexidine, no thimerosal and no other mercury containing ingredients.

Blink Tears: Active Ingredient - Polyethylene Glycol 400 0.25%
Inactive Ingredients- Boric Acid; Calcium Chloride; Magnesium Chloride: Potassium Chloride; Purified Water; Sodium Borate; Sodium Chloride; Sodium Chlorite (OcuPure® brand) as a preservative; Sodium Hyaluronate.

Here is a published article (Apr 2010) on TearLab's Osmolarity Test and OTC drops: http://www.ncbi.nlm.nih.gov/pubmed/20153684. It looks like the TearLab people like polyethylene glycol or sodium hyaluronate (Blink Intensive Tears) to improve osmolarity. Perhaps discuss this with your doctor?

All the best.

[sunshinelover]

Thanks spmcc! Good info!
Joanna, I recommend them. The docs name is Sten Raeder.

[Toril]

The best drop containing hyaluronic acid I've tried so far is Hylo-Comod. Been using it for years, and it's an important part of my dry eye regimen.

[ugly-eyes]

Hello . So i was on this clinic yesterday. iam shocked og confused. The doctor said that my meibomian gland produce normal clear meibum. That mye problem is the lacrimal gland dont produce enoguh tears. Iam now more confused if my meibomian glands rally work why the hell is my lid margins red all the time? The lower eyelid is always dry. I lose eyelashes often and sometimes they itch. He gave me thera tears eyedrops and put plugs in my tear ducts just the lower ones. How do you treat inflamation in you eyelids?

[Toril]

Didn't the doctor say anything about your eyelids then? Did you mention for him that they itch and that you loose eyelashes? I'm not sure how you treat inflamed eyelids, but maybe they will get less red and less irritated if your eyes are less dry (hopefully a result after putting in the plugs)?

I think I'll be going to this clinic myself in not too long. I'm really curious about the testing possibilites they offer (which would give me a more accurate diagnose).

By the way; do you follow them on Facebook or Twitter? They post really interesting and informative stuff.

[spmcc]

Hello . So i was on this clinic yesterday. iam shocked og confused. The doctor said that my meibomian gland produce normal clear meibum. That mye problem is the lacrimal gland dont produce enoguh tears. Iam now more confused if my meibomian glands rally work why the hell is my lid margins red all the time? The lower eyelid is always dry. I lose eyelashes often and sometimes they itch. He gave me thera tears eyedrops and put plugs in my tear ducts just the lower ones. How do you treat inflamation in you eyelids?

Hello ugly-eyes,

Well, part of that is very good news - your glands are not dead as you thought. But I can understand why you are confused.

In the past, my doctor said that itch means allergy. Did your doctor look *under* the lids? Did he mention anything about antihistamine drops or pills?

But, before you rush to do more things, you should wait to see if the plugs and drops he gave you help with your tear layer. I hope you feel better soon.

All the best.

[HNautumn]

Hello sunshinelover, how are your eyes now? does it get better? Im new here, have severe dry eyes after PRK surgery 6 months ago, TBUT only 2 sec and 4 sec. Since there is very few or none eye doctor here (netherlands) who heve acknowledge about dry eyes. Im thinking i maybe go to Norway too. I would love to hear from you.