refresh pm inside the eye? how many of you use it? safe?

[jenny2008]

my left eye has been so ext dry i went ahead and got some refresh pm. it seems to help for a bit but then wears off.. i know it says preservative free but is made of petroleum and mineral oil.

is it safe to put inside the eye? does it make MGD worse or the tear film worse??? thanks everyone..i am allergic to BAK. i know its not in there but my eyes can be sensitive

[Hopeful2]

Hi jenny,

I would suggest using a very small amount to start, maybe a strip of 1/4 inch long. Because the Refresh pm is so dry, I would add a lubricating eye drop to it (something like Bion tears, Tears Naturelle, Refresh Endura tears. I think with some moisture in there you won't have the same issue of your eyelid rubbing against the ointment.

Rebecca does have a link somewhere to an article where Dr. Latakany suggests that ointments may interfere with MGD. Someone please correct me on this if I am mistaken.

Another option would be to use Genteal gel. There is a preservative in it, but I don't believe it is BAK. Genteal gel is not as thick as Refresh pm and might be a better option for people with MGD.

Personally, I use the technique recommended above (with Refresh pm) before going to bed, as I find my eyes get very dry through the night.

Hope this helps Jenny : )

[jenny2008]

i will look for that link..thanks... i have heard dif things from dif docs.. ughhh... so refresh pm is dry?? maybe that is why when i put it in my eye it becomes drier 20 min later? weird.. why is it dry?

[Hopeful2]

Hi Jenny,

I think it is dry so that it will stay in the eye for a long time and not get washed away down the tear duct. If it feels dry 20 min later, consider adding a 'watery' artificial tear like Bion tears, or serum tears if you are using them.
Here is the link to the article I was referring to,
http://www.eyeworld.org/article.php?sid=4449

Wishing you well Jenny : )

Hopeful2

[jenny2008]

thanks.. my doc who retired-dr. foulks wrote in that article too... i am so confused.. after getting my glands expressed one of my new docs told me to use ointment.. ughhh...thanks

[PotatoCakes]

My former corneal specialist told me to use it every night, although honestly, I had a better experience with Genteal (not Genteal PM, just regular Genteal in the tube). I've developed an allergy to the mineral oil or petroleum or maybe both and when I used it, would wake up with really inflamed lids and red eyes. I can't use commercial Restasis for the same reason.

Refresh PM also softens the cornea, although not permanently, from what I understand. I don't know if that's cause for concern or not.

Unless I'm having a very bad night, I put my serum drops in right before bed, apply Saran or other plastic wrap and that's it. Sometimes I'll wake in the night and add Refresh Plus drops or Celluvisc if necessary. If I'm having a bad night, I prefer the Genteal Gel. I try to use it only when necessary since it does have a disappearing preservative (not BAK).

[MaryVa61]

It's so funny that my eyes, which are ridiculously sensitive, do extremely well with Refresh PM at bedtime. I don't think it would do as well during the day because blinking would squeeze it out onto the lid and not keep it in the eye. But that's what makes it great at bedtime, it sits in the eye and doesn't go anywhere as opposed to wetter liquids that will drain out unplugged ducts or evaporate if your eyes aren't completely closed during sleep. A fresh tube is "wetter" than an old open tube. And be sure to check expiration date.

I don't have MGD as far as I know (non-communicative ophgthalmologist) but have hx of years of Blepharitis and have some chemical allergies, but not to ingredients of Refresh PM. I do have a bit of trouble any time I try the Systane nightime ointment though.

At bedtime, it does work best for me to use as the instructions say (don't skimp on amount) and do it as the very last thing before going to bed so I don't blink it out. I do usually use regular lubricating drops (OASIS Plus) around 30 minutes before bedtime, but not closer to bedtime than that because I don't want to dilute the ointment.

I'm not sure that Petrolatum is a petroleum product. Tried to determine that but only found vague info, which inlcuded that it's FDA approved as a food additive, can be from plants, etc. This (I mean THIS) website's eye lubricant list includes many eye products that contain it or mineral oil. http://www.dryeyezone.com/encyclopedia/lubricants.html

That page on the website doesn't recommend ointments at night and I can understand that. It's possible it helps me not because of DES per se, but because it coats and protects my eyes from chemicals I'm allergic to in fabrics (pillowcase), kind of like petrolatum ointments the dermatologist recommended for my dry, itchy skin (same formaldehyde allergy that affects my eyes).

That's what works for me, but sorry that doesn't really help you with using it in waking hours.

Mary

[alisonW]

I will just say "ditto to all of what Mary said" - same experience for me with Refresh PM. My eyes stay moist until mid-morning the next day. Gels and gel drops only get me a few hours of sleep before I wake up and have to apply more.

[NeedMyEyes]

Ointments

I'm another one who does really poorly with Refresh PM. When I wake up, my eyes are soooo irritated and red, I wish I had never hear of Refresh. Refresh doesn't have a preservative which is why my doc told me to use it.

However, I have done a bit of research on this and GenTeal PM does NOT have a preservative. It is 85% petrolatum and 15% mineral oil.

GenAqua is the preservative in the other GenTeal products, but it is NOT in the PM ointment, according to the box and the GenTeal website.

MGD is supposed to be exacerbated by petroleum based ointments, just like acne gets worse when you put Vaseline on your skin.

Oh, and petrolatum is definitely a petroleum byproduct.

One other thing about it is that supposedly, it hurts the formation of the tear film. So it may help you sleep at night but during the day your eyes do worse. This is from something I read by Dr. Holly and Rebecca. It is true from my experience.

Personally, I think the only time you should use an ointment is if you have a foreign body rubbing on the eye. Like a suture that will come out in a couple weeks but is really hurting you while it is in there. I have heard of other uses - like for Floppy Eyelid Syndrome, Lid Wiper Epitheliopathy, etc. I have FES and LWE and I haven't used any ointments in several months, but I think maybe I should.

[jenny2008]

hopeful2 i tried to reply to your PM but it said your inbox is full so it wont go through!!!!

[MaryVa61]

I actually would like to go off of it just because I don't trust that petrolatum and mineral oil are as safe for allergic-types as is usually claimed. Experimenting cautiously. But if I go back to waking with crusty, swollen painful lids and bloodshot eyes I'll definitely just stick to the Refresh PM. For whatever reason, I have far more difficulty with drops (with the exception of OASIS Plus). And I've tried many different drops.

Maybe my custom eye drop ingredient allergy tests will reveal some helpful info, if they ever get the tests ready to try.

Mary

[Hopeful2]

Hi Mary,

That's interesting . . . I want to go off refresh lacrilube (I think it is the same as Refresh pm) because I wonder if it is contributing the mild crustiness that I get in the morning. I tried genteal gel and didn't like the way it felt in my eye. I really don't like the idea of petroleum in my eye so I'm wondering if there are more 'natural' alternatives. If anyone is using something more natural, I'd really like to hear of your experience.

Thanks,
Hopeful2