Pilocarpine for Dry Eye?

[Aaron77]

Pilocarpine for Dry Eye and HOA's

Salagen/Pilocarpine - Drops vs Tablets

I heard this stuff can help with dry eye as it can stimulate the lacrimal gland, then I also heard it increases the actual movement of tears through the tear duct (when using the eye drops) - that may be a bad thing. Its also suppose to constrict the pupil size if administered by eye drop, good for HOA reduction. Figured tablets might be better for just the dry eye as I just want to stim the lacrimal glands for tear production.

Any thoughts on this stuff?

Also heard about Evoxac but I don't think its available in Canada?

[irish eyes]

Unsure about this one.

Pilocarpine in tablet form (Salagen) - One consultant suggested I might try them to stimulate tears but admitted it was a `long shot' in my case. I had tried everything else, none of the drops were helping and Restasis was not a realistic option. (This is the UK)

I read up on the side effects and decided I didn't want my stomach and general system upset any more than it is already. My GP tended to agree.

I think the drops might be for people with glaucoma - they work by increasing the rate that fluid exits the eye. (Would that make them more dry??)

All I know about Evoxac is that like Salagen, it decreases dry mouth and other symptoms of Sjogren's Syndrome.

[jenny2008]

Hi
I have been on 30mg Evoxac the past year and it helps quite a bit with dry mouth--it does not however, do anything for my eyes. I haven't noticed any improvement in my tear production since taking it.

[Aaron77]

Azasite, pilocarpine, restasis, minocycline, doxycycline coctail

I had lasik surgery 4 1/2 months ago and I have not yet been properly diagnosed for my current eye problems. I'm hoping to get some type of diiagnoses in the next few weeks. I can't function as of roght now so I hope I don't get the same old line that everything looks fine.

If I've got dry eye I'd assume it would have at least to some extent something to do with MGD (not sure with the lasik dry eye) I expect that they should give me Azasite, pilocarpine, restasis, minocycline or doxycycline or maybe even some type of coctail.

I seem to have a bit of redness and swelling on the bottom eyelids, I figure this might mean some type of inflammation of the eye lid and something like Azasite, minocycline or doxycycline could be prescribed.

If the tear production is down I figure restatsis would be a good thing to prescribe but it only work in some patients, if pilocarpine also works to stimulate tear production i figure maybe i could be prescribed both.

Even if my tears get back to normal I still figure the optics are now messed up from lasik and are going to give me problems with headaches and dizzyness. So I'll have to find out a solution for that to.

DHEA - a mild androgen is available in Canada by prescription, Androgens regulate meiboman gland function - i might possibly be able to supplemt with DHEA to imporve the function. Symptoms of DHEA deficiency may include persisting fatigue, depression, anxiety, hypersensitivity to noise, loss of libido, dry eyes, skin, and hair, and loss of head hair.

[Eric Brewer]

Evoxac

I have been on Evoxac for 11 months for dry eye. It is approved for treatment of sjogrens syndrome dry mouth, but I have studies from the manufacturer demonstrating it's moderate effectiveness for dry eye. I don't remember if the studies were in pt's with normal or dry eyes, though. For me, I don't think it is helping with chronic, severe dry eye caused by lasik 2.5 years ago.
Eric

[bernmee]

Aaron,

Who is telling you "everything looks fine". If it's your Lasik surgeon then you are well past the date when you need to move on.

I found a great Dr.3 months post surgery who told me I had ocular rosacea, MGD, corneal erosions and dry spots, and treated me accordingly. I scheduled my apointmts with my Stanford educated surgeon the following day who told me "everything looks fine" and even suggested I had a low pain threshold. At this stage I was in agony so i don't know how he couldn't see things were wrong!

I have read that 70% of DE is caused by MGD issues, I think I read this one of the "intro to dry eye" pages on this site. lasik causes inflammation in the eye, that can cause MGD. DE taht results from Lasik does not have to be a lack of tears only.

You need to find someone who will take this seriously. If some one is giving you the run around then move on. I know you may have signed up for post op. care with your surgeon, but if you are not getting it then it's time to start paying extra to go see another Dr. who will help you. For me when I got my serious eye issues under control then my eye seemed to wsettle down in terms of vision issues and headaches. Though having said that I now see double vision in my Lasik eye and can't read close up. Thankfully I only had one eye done so the other eye is picking up the slack.


Good luck,

Bernadette

[autumnn]

I have heard much of the same thing- and like Bernadette I was even suggested that I have a low pain tolerance- I know for a fact this is not true- I was a marathon runner and know what pushing through intense pain is like- I was also an extreme snowboarder and took vicious falls that did not shake me.

We have to be our own advocates- look for another doctor and dont stop until you find one you trust and whose ideas/explanations make sense to you.