Dakrina Question

[kakinda]

Hi Monamour,
just a quick warning is indeed you are using the same tobradex as we have here in Europe that is a combination of a steroid plus an antibiotic... please check if it includes tobramycine but it should...
steroid use is potentially dangerous (see my numerous posts on the matter) but using regularly an antibiotic.... or worse using it then stopping it and resuming the process over and over again is very, very dangerous for several reasons. For instance you develop resistent bacteria and I don't want to elaborate on that now but you may risk your eyes...
Please check this with your doc and follow the prescription

Tobradex is eye drops also contains benzalkonium but that may not be the immediate concern in this case... Monamour it sounds to me that you are playing a dangerous game if it not done under an ophthalmologist's supervision.
take care!
K

[monamour]

Hi Kakinda: My opthomologist said it was okay for me to use the tobradex about once a week. I didn't do it everyday, but now, it seems with the Dakrina and Dwelle, that I will not need to use it anymore. Hope this improvement lasts. Thanks for your concern. I knew about the dangers of the steroid. but when nothing helps, you become desperate. Regards

[monamour]

I am sorry to report that today was disappointment day with Dwelle and Dakrina. My eyes were very irritated again all day no matter how often I used the drops. I thought I had found the answer. What a bummer. Disappointed.

[Rebecca Petris]

Sorry to hear things aren't going well for you right now. The day to day ups and downs of dry eye are difficult for all of us to deal with.

Monamour, what's your diagnosed condition? Do you have MGD or anything like that? Allergies an issue? other?

[monamour]

Rebecca: I think my biggest problem is sleeping with my eyes partly open. The problem is much better since my doctor closed the outer corners of my eyes, but still comes to haunt me at times. I thought I had found the answer in Dr. Holly's drops, but I guess not. Even though I put the eccoeyes foam glasses on during the night, and the ointment, they sometimes water and cry all night under the glasses. It seems they improve after I get up. Warm compresses help. But the problem is still there and gets very depressing. I guess I will go back to Tobradex. That helps me for about five to seven days usually. Then, all of a sudden, the problem recurs. I am scared of Tobradex, but don't know what else to do.I suppose one drop once or twice a week is not so bad. My doctor does not seem alarmed at that. I also take the thera tears capsules some flax seed oil capsules, but what can I say. Problem still exists.Can we get the Vismed drops here in the States now. Do they help? Thanks for your concern

[calli66]

For Monamour: I did not get relief from Dwelle or Dakrina either, because they sort of "curdle" in my eye environment, for some reason. The "curds" are plasticky white strings, and I find these strings extremely irritating.

In fact, my eyes produce mucous strings and crud pretty regularly on their own--and I have found these particles to be a major cause of discomfort. Once I get them out (by picking very carefully in front of the mirror) my eyes feel much better.

Also, some drops, gels, medications, etc. cause my eyes to do reactive tearing--and these tears, I believe, are not compatible with whatever it is I put in my eye. So it's hard for me to tell if the problem was the drop, or the tearing reaction to the drop.

I don't think you need to worry about using the Tobradex only once a week and in emergencies to calm things down.

Hope you feel better soon.

C66

[kakinda]

Please consider a second opinion regarding the recurrent use (stop resume process) of tobradex... so I really can't agree with cali66 or your doctor's comment on it.

As a patient using slcerals we frequently receive briefings on this kind of things (not just tobradex but sterdex too on the lids) + 15 years of individual experience in ocular surface disease... forces me to insist...
if your problem is MGD related then most docs would probably consider prescribing doxycycline per os instead...
if it's inflammation cyclo or a mild steroid would probably serve you better

sorry to insist one last time, thus far is believe it was duty to warn you about possible risks...

Take care...
K

[monamour]

Kakinda: What would be the name of a mild steroid rather than Tobradex? Thanks for your input.Regards

[Rebecca Petris]

For Monamour: I did not get relief from Dwelle or Dakrina either, because they sort of "curdle" in my eye environment, for some reason. The "curds" are plasticky white strings, and I find these strings extremely irritating...

Also, some drops, gels, medications, etc. cause my eyes to do reactive tearing--and these tears, I believe, are not compatible with whatever it is I put in my eye. So it's hard for me to tell if the problem was the drop, or the tearing reaction to the drop.

Calli66,

I would be really grateful if you could give me any more information about this effect (private message or email or phone may be most practical) - for example how many applications were involved, under what circumstances and if the reaction was the same each and every time. And if it was just Dakrina or Dwelle too. I would like to encourage anyone else reading this who has experienced it to send me details - please don't imagine it'll 'make me feel bad' or I'll think you're complaining or whatever. It's important information.

Excluding yours I've had 3 separate reports similar to this in the last year. All three were with Dakrina and two of the three were people who applied it over contact lenses. I've discussed this at length with Dr. Holly, and we had the manufacturer do some testing on all our batches (the latter drew a blank as all the results were normal). From what I understood from Dr. Holly it is possible under certain circumstances for some polyvinyl alchohols to 'gel'. (In fact there is a patent on the process.) This would not in any way be harmful, but if it happened right on your eye it would be uncomfortable. In the two contact lens cases, the working theory was that the mixture of Dakrina and a lot of buffered saline from the contact lens had something to do with what happened. That is not an explanation on its own, because obviously far more people have had the drop mix with saline without any such effect (including, on a regular basis, me) and we've not yet been able to actually reproduce it. However, he also mentioned that it's certainly conceivable that somebody with a certain type of tear might on occasion experience this.

Proving yet again how unique we all are. My hope is that the research dollars flow more freely so as to come up with good solutions for all of us, and that the best solutions currently available all eventually get into the hands of the people for whom they are best suited.

[kakinda]

Kakinda: What would be the name of a mild steroid rather than Tobradex? Thanks for your input.Regards

sorry but I won't give you names of brands or sort- of-prescribe you anything as I am not ophthalmologist ... despite the fact that I more experience in DE than many of them
it's just a matter of principle you can possibly even get that info on the net and discuss that with some other ophthal....
so I stopped seeing "small" ophthal for quite some time, stopped losing my time and theirs, I concentrate on DE professors in the country I live in
but this is something any ophthal. should know. ... but it sounds to me that yours is not considering long term use consequences and did he tell what type of DE you have?
Did he try lid compresses, doxy, cyclosporine? before telling you to go-head use a combination of steroid and antibiotic...
First do no harm, then determine what may help by reducing the risks...
maybe it's the steroid that's helping you (but the cyclo or restasis could help with less risks) or maybe it's the antibiotic (but then doxy would be the first thing to try).
I'm just curious to know did he or did he not try any of these options first?
Take care
K