Doxycycline Question

[villfan22]

Hi,

Somehow I convinced my GP to prescribe doxycycline 50mg a day to try and rid me of my MGD pain, along with doing a daily warm compress and twice daily lid cleaning. Just wondering how long people have been on doxycycline before noticing an improvement. I am kind off pinning my hopes on this one as i dont think there are any significant other options in the UK for MGD? I am also still waiting to see a specialist (6 months now!!) so i'm only going off what my last optician said re: MGD!

Any advice much appreciated.

[dave25]

I've been on it for a while now and it has helped, but it is not a cure. I have rosacea so it helped clear my skin more than it affected my eyes. It may help with your mgd, but everyone is different. 50mg a day is a good dose to start with because it is on the lower end. Since I had/have rosacea I noticed improvement in my skin in about a weeks time after starting it. I was taking a higher dose than 50mg so it may take a little longer for you. I hope this helps.

[unicorn]

I've been on 40mg doxycycline (it's a slow-release version called Efracea which is known as Oracea in the US) for just over 3 months now. I have not really noticed an obvious improvement in my eyes during this time although when I first started taking it I would see slightly clogged-looking glands (yellowish) when doing lid massage - I now see clear oil in my left eye but the right eye seems stubbornly blocked with nothing much at all coming out. So I suppose it is doing something to help my MGD. I can't seem to do warm compresses though, because my eyes get really inflamed with heat.

I also have rosacea and the only thing I have noticed in the last few months is that I don't seem to be flushing as much - although the doxycycline's not supposed to help against flushing, only really papules and pustules (which I don't really have). I flush a lot less during the summer months anyway, so it could just be that.

You might also want to read up on the use of azithromycin to help with MGD - this is available in the UK as an ointment called Azyter.

Sorry you're having such a long wait to see a specialist. I waited just under 3 months to see an ophthalmologist who then turned out to be slightly worse than useless. But I'm sure you'll have better luck!

[villfan22]

Thanks for the advice, I'll look up Azyter. I appreciate doxycycline is not likely to be a magic potion, but i guess i'm looking for a bit of encouragement that it has helped some in the past. As for the wait on the NHS, i should have just gone private! Would do now but apprently i am due an appointment in the next few weeks so will stick it out. Trying to taper my expectations of the consultation as well, but will try and be prepared with some questions that will provide useful info for managing the condition.

thanks again.

I've been on 40mg doxycycline (it's a slow-release version called Efracea which is known as Oracea in the US) for just over 3 months now. I have not really noticed an obvious improvement in my eyes during this time although when I first started taking it I would see slightly clogged-looking glands (yellowish) when doing lid massage - I now see clear oil in my left eye but the right eye seems stubbornly blocked with nothing much at all coming out. So I suppose it is doing something to help my MGD. I can't seem to do warm compresses though, because my eyes get really inflamed with heat.

I also have rosacea and the only thing I have noticed in the last few months is that I don't seem to be flushing as much - although the doxycycline's not supposed to help against flushing, only really papules and pustules (which I don't really have). I flush a lot less during the summer months anyway, so it could just be that.

You might also want to read up on the use of azithromycin to help with MGD - this is available in the UK as an ointment called Azyter.

Sorry you're having such a long wait to see a specialist. I waited just under 3 months to see an ophthalmologist who then turned out to be slightly worse than useless. But I'm sure you'll have better luck!

[unicorn]

If you do end up going private, try and do some research to find out the best person to see in your area. You want someone who's clued up on external eye disease/ anterior segment, if possible someone who has been recommended to you as having a specialism or interest in treating dry eye. It seems that a lot of them really aren't that interested in the subject! I have found a local optometrist who has recommended a couple of people if I decide to go private in future - having looked them up there is one in particular who does a lot of research on dry eye disease so I think he would be a good person to see. I am currently still waiting for an NHS referral for a 'second opinion'... goodness knows how long that will take!

[Faith1989]

I have been on 100 mg of doxycycline for a month now, and notice a difference in the redness of my lids for sure. I have googled many user reviews and if you have ocular roscea/MGD problems, it says on MANY health sites that doxy is the best option. My eyes were actually white when I woke up this morning which is a new experience for me. For the past week, I have been using Alrex though (which is a mild steriod) so I'm pretty sure that is helping to. I never noticed ANY difference until week 5 with the doxy, and from what i've heard its a SLOW process that things get better. I used to use Restasis for a while, but my eyes kept getting wildly inflammed on it and super red (which is what I'm trying to get rid of) My doctor gave me this new test (I don't know what it's called, sorry) but it basically can tell how dry your eyes actually are using this new machine and my left eye was normal, and my right eye was only mild. So..keep up with the doxy, i think it will eventually help you. Some ppl on the sites I was looking at said it rid them of ocular roscea by month two. Keep your head up, i know i've lost a lot of sleep over this.

[villfan22]

Hi Faith,

Thanks for the encouragement, so far i have been taking the doxycycline for a week and i dont have any nasty side effects so happy to keep popping the pills. Happy to be in this for the long haul if indeed it is going to help. Popping a pill is easy peasy compared to the faffing of warm compresses! My only other concern i guess is am i selling myself a bit short by only having 50mg? I could ask my GP for more, but i have a feeling that will go down like a lead baloon.

I have been on 100 mg of doxycycline for a month now, and notice a difference in the redness of my lids for sure. I have googled many user reviews and if you have ocular roscea/MGD problems, it says on MANY health sites that doxy is the best option. My eyes were actually white when I woke up this morning which is a new experience for me. For the past week, I have been using Alrex though (which is a mild steriod) so I'm pretty sure that is helping to. I never noticed ANY difference until week 5 with the doxy, and from what i've heard its a SLOW process that things get better. I used to use Restasis for a while, but my eyes kept getting wildly inflammed on it and super red (which is what I'm trying to get rid of) My doctor gave me this new test (I don't know what it's called, sorry) but it basically can tell how dry your eyes actually are using this new machine and my left eye was normal, and my right eye was only mild. So..keep up with the doxy, i think it will eventually help you. Some ppl on the sites I was looking at said it rid them of ocular roscea by month two. Keep your head up, i know i've lost a lot of sleep over this.

[Splat]

Hi,

I'm new to this board so hello, just thought I'd let you know that I was on Doxy 100mg (50mg BD) over the summer of this year for 3 months, it was only really in the last month or less I saw significant improvement.

I too am an NHS patient, although I live in Cornwall I am seen at Moorfield's in London and have been prescribed the doxy, plus steroid drops for a couple of weeks, but was instructed that I must do the warm compresses/lid hygiene twice a day aswell. Obviously each patient is different, but I've not heard of doxy being an 'instead of' to the lid care before. It is a bit of a faff, but you get used to it...

Unfortunately I hit 2 weeks off of the doxy before having a big relapse, so back on it now again!

Good luck with your appt

[rm14dp]

Hello I live in Essex and see a Moorfields consultant on the NHS locally. She is much better than the private consultant I saw - luck of the draw. I have had MGD Blepharitis and Dry eye since eye surgery 10 months ago, and having gone through a number of different drops and an eye mask I am now on my second week of Doxy 100mg with fingers crossed. She also said to try Blephasteam goggles ( gasp £200..!!!) so I am also on my second week of them. I will try anything to lessen the pain. My right eye is my worst, painful all the time, I am just hoping that a few more weeks/months down the line I will get some relief. I have the odd day here and there where my eyes are just a little uncomfortable rather than awful as usual, and that is bliss. I know the condition is chronic but is there any long term hope out there? I am also alergic to preservatives ( may as well go for all or nothing) so am on Systane Unit Dose preservative free drops. Does anyone have success with preservative free drops out there, as I tried Systane Balance which is supposed to be better, but not preservative free, and my eyes burned. Good luck everyone

[Lacrima]

Hi Villfan,

I started doxycycline 100mg last Spring. I noticed within 2-3 weeks, that my morning symptoms were almost completely relieved. I used to wake up with very red eyes and it would take a couple of hours to calm down.
This is the only 'visible' change I got from the doxy, but over time my docs have noticed improvement in my general eye health and tear quality. I am confident that in combination with warm compresses (blephasteam) and restasis, doxycycline has really done a lot of good for me .

Good luck with your new treatment plan

[littlemermaid]

rm14dp

I am also alergic to preservatives

So good you've got a doc you like. Just wondering, did you manage to get allergy testing for this? Do you think there's any chance of formulating eyedrops through Moorfields for sensitive eyes?

Villfan, I'm just wondering which ophthalmology specialists you've got around the local university hospital, including optometry department. Are you near Swansea or Cardiff? Worth a look. Hope you get good advice at the appointment

[villfan22]

rm14dp So good you've got a doc you like. Just wondering, did you manage to get allergy testing for this? Do you think there's any chance of formulating eyedrops through Moorfields for sensitive eyes?

Villfan, I'm just wondering which ophthalmology specialists you've got around the local university hospital, including optometry department. Are you near Swansea or Cardiff? Worth a look. Hope you get good advice at the appointment

So I have been on doxycycline for coming up to four weeks now. I haven't had any monitoring from a optometrist so I can't say how my tear film is, but subjectively, I would say my eyelids are marginally less red and I am using less eyedrops through the day, maybe every three / four hours. It is a little subjective though, and as a previous poster mentioned it's by no means a magic cure.

Also, my initial post said I was going to have 50 mg which is what my GP prescribed for three months. However, having read around this seemed to be on the low side, and the NHS CKS website said to go for 100 mg for four weeks, with 8 weeks at 50 mg. So, sod it, I have taken 100 mg a day and will do until the end of the week ... then I will go onto the 50 mg. it means i'll have to go back to the GP to get some more, I might fess up, or lie though my teeth that its working and I want to continue a little longer!

My previous post also mentioned that I must keep up the warm compresses, which i'm doing. Although, I subscribe to the school of thought that every day is counterproductive, and currently go for three times a week. my 15x mirror shows that most of my glands are producing oil, but the quality of it is a bit suspect, as when i wipe my lids with a cotton bud (Q tip to our American friends) the residue is slightly yellow, which aint great.

Littlemermaid... my NHS appointment is immenent, I think i might be breaching the waiting list so may kick up a bit of a stink (i happen to work at the same hosptial though!), but a appointment is due in the next couple of weeks. The guy I am due to see is not an anterior segment specialist, but does list dry eye as an interest. We shall see, there are a number of consultants there and the next step would be to go down the private route. I dont think i should have to though, and if not happy may voice my concerns!

Oh, and thanks for all the advice from all posters.

[villfan22]

So, I have a NHS appointment in two weeks time horrah!

I have gone down to 50mg doxy a day but too early to say if going from 100mg to 50mg is significantly different.

On a slightly unrelated note, I am getting more and more convinced that there is a allergic componant to my dry eyes. Can allergies caused red eyelids? Basically, each morning when i wake up a have a sneezing fit that goes on for some time, my eyes go red, but that could be the sneezing strain as much as anything. In any case, i imagine that is some sort of allergic reaction to dust etc. And a previous optician said i had 'papillary conjunctivitis' which i believe is a sign of allergy.

Is it worth trying an OTC allergy eye drop? I could try oral loratadine or something, but TBH the sneezing doesn't bother me as much as the eye symptoms, and i doubt an oral anti-histamine is going to concentrate enough in the eyes.

Thoughts / experiences appreciated.

[unicorn]

Have you ever been tested for dust mite allergy? You can have a blood test or a skin prick test, you can get this done NHS easily enough. Allergies could certainly be causing eye problems, and the papillary response your optician mentioned can be a sign of allergy. Remember though that even if you test negative to the dust mites, or feathers, or pollen or whatever, there may be other things you are sensitive to or allergic to (eg fragrances, etc) that can be harder to test for.

As for the OTC allergy eye drop, it would probably be more effective than the oral tablets but please remember that it will have preservatives in which could in the long run cause more problems for you. As far as I know there is a preservative free anti-allergy eye drop available in the UK (it is called Catacrom - it is a sodium cromoglycate drop) but you would need to get that on prescription. Maybe you could ask about allergies, testing, and possible treatments at your hospital appointment?

[villfan22]

Have you ever been tested for dust mite allergy? You can have a blood test or a skin prick test, you can get this done NHS easily enough. Allergies could certainly be causing eye problems, and the papillary response your optician mentioned can be a sign of allergy. Remember though that even if you test negative to the dust mites, or feathers, or pollen or whatever, there may be other things you are sensitive to or allergic to (eg fragrances, etc) that can be harder to test for.

As for the OTC allergy eye drop, it would probably be more effective than the oral tablets but please remember that it will have preservatives in which could in the long run cause more problems for you. As far as I know there is a preservative free anti-allergy eye drop available in the UK (it is called Catacrom - it is a sodium cromoglycate drop) but you would need to get that on prescription. Maybe you could ask about allergies, testing, and possible treatments at your hospital appointment?

I am on Opatanol and dexamethasone (for a couple of weeks). I asked again about allergy testing but always get a dismissive answer that for eye allergies it is not particularily useful because, lets say it is dust, your never going to be able to completely eliminate them. May ask my GP instead if they will test for me.