How much NAC to take & Systane question

[NCRedhead]

Very quick questions...I want to start taking NAC supplements to help with my MGD. What dosage has worked best for those of you where this has been helpful?

Second, my doctor tells me not to worry about how many drops of Systane or Refresh that I use, but I sometimes wonder if I am "dependent" on them and that this compounds the problems. I do have to use them frequently due to my MGD. Should I try scaling it back on a long weekend to wean myself to lower dosage or does this really matter?

So far, doxy pills have not helped me...and warm compresses have very limited benefit. But supplements are helping some.

Planning to try a new doctor in the Charlotte area soon.

[Gretchen]

NCRR-

There was a study that showed efficacy with NAC at 100mg 3x daily. I just recently started this protocol but have nothing to report, ie I haven't noticed anything.

As far as the eyedrops, it is my understanding that keeping our eyes moist is the single most important thing that we can do to begin to regain balance in our ocular environment. The current understanding is that dryness starts an inflammatory cascade that can wreak havoc on all of our wetting structures - lacrimal glands, MGs, epithelium, goblet cells, eyelids. Wetting your eyes with drops are a good thing and pretty much all research shows that eyedrops DO NOT cause dependence. In my opinion, and I know that Dr Holly has written about it here as well, the one issue is frequent dropping of anything directly onto the eye may aggravate it. I would use the method of eyedrop application where you pull out the lower lid, put the drops into that "pocket" and then blink a couple times. You need to do this in front of a mirror. For me, that is the least irritating and also I save a lot of artificial tears (and makeup!) because it is easier for me to gauge a proper amount vs dousing my eyeballs cause I can't see what I am doing.

Also, be patient with the doxy. It took me about 2 months to see a difference. Oral doxy has been the most beneficial therapy that I have done so far.

So keep those eyeballs wet and good luck.
Gretchen

[msienkiewicz]

Gretchen,

I think I have wreaked havoc on my eyes this summer. I simplified my routine too much, and my eyes are paying the price. I have returned to wearing the lacriserts and using the restasis three times a day.

I have yet to try the oral doxy; I am seeing a new doctor August 12th. I will speak to him about the doxy. Are you on it indefinitely?

melissa

[Gretchen]

Hi Melissa -

Yes. I am on Oracea indefinitely.

I hope that you are feeling better.
Gretchen

[NCRedhead]

Thanks Gretchen...

You are always so full of great information. I will try the doxy for a longer period then and keep up my Systane. How is Oracea different from doxy?

[Gretchen]

NCR -

Oracea IS doxy. It has 30 mg doxy, 10 mg slow release for a total of 40mg. Because of its low dosage amount and slow release component, it is better tolerated (less gastric issues) and remains sub anti-microbial. The latter means that you will not build up resistance over time to macrolide antibiotics as well as have a reduced chance of getting yeast infections, etc.

Thanks,
Gretchen

[msienkiewicz]

Gretchen,

I am anxious to see this new doctor. Like I said, I have laxed with my summer routine, and I think my eyes are paying the price. This is my first summer with dry eye, and I thought I would see what I could get away with. The real problem for me is that area of scar tissue. I think I let my eyes get a little to dry and my upper lid rubs on that "scratchy spot" which created a sore or even raw spot on my upper lid. I am praying that in a couple of days of wearing the lacriserts it will improve.

My left eye is the dryer eye, but it has no "scratchy spot." It feels fine even though I had reduced my routine. It is that darn spot that is causing me the pain. It took three months after the cyst aspiration for it to even remotely feel OK. Something is not right, but I don't know how it could be removed.

I know you mentioned membrane transplant, but this sounds so drastic to me. Perhaps a scleral lense would cover this area, but I doubt it. It is just above my lower lid half way between the iris and the inner corner of my eye. I have even considered having this eye partially sown shut if it would avoid the rubbing. There has to be something that will help, and I no longer care what I look like.

I have been pretty comfortable today with the lacriserts. I just put in restasis in the morning and then insert the lacriserts right away to prevent the rubbing. I hope it will heal. I know it eventually did after the surgery. I carry surgical tape with me so that I can tape it shut at any time during the day if it becomes painful, but so far I haven't had to do that.

I think what I have would closely resemble lid wiper ep.... I will continue to wear these lacriserts until my appointment August 12th. I willl most definitely discuss oracea with this doctor as well. If you have any suggestions, please let me know. I always appreciate your comments.

Melissa