Sodium Hyaluronate (Blink / Aquify)

[SusieD]

I have used a HA drop at 0.2% (preservative free - made in Italy) I cant honestly say it was any different to any other drop for me. It didnt feel as though it lasted any longer.

Will be interested to hear how you get on though Neil - particularly with the castor oil drops.

[SusieD]

Neil - how are you getting on with the drops you are using at the moment? are you finding you can apply them less?

[neil0502]

Susie-

Thanks for asking. I've been using both the HA drops and the castor oil drops since April 3rd. They both require refrigeration (no preservatives), so I can't just take them with me, but I've managed to use both about four or five times each day--always first thing in the morning and last thing at night.

Before the drops, every time I rode my bike (PanOptx glasses), I was having pretty severe problems ("gotta stay out of the contacts for a few days" type stuff). In the last week, I've ridden six times--granted, for shorter distances than I'd like--and had no major issues.

Ordinarily, my worst times are first thing in the morning and later in the evening. I've noticed that--since starting this regimen--a few minutes after I wake up, but before using the drops, I have some tears ... some actual tears ... that I can see (tear meniscus) pooling slightly above my lower eyelid.

I also found myself sort of strolling through the grocery store the other day, and--as most of you know--that's not a place to take your time.

I'm really being very careful not to either get overly optimistic, or to attribute with any certainty any improvement to the new set of drops (it's usually more complicated than that), but ... I actually think it's beginning to help

[neil0502]

Oy! Be Careful!!

I really have to dramatically limit my computer time (and no "paper reading"), but ... you can't stop looking into this stuff.

Here's what I found yesterday:

http://tinyurl.com/klbff

I'm not a chemist, though--right now--I wish I were, but ... the BLINK appears NOT to use a "phosphate buffer," but rather a "standard buffer." I'm interpreting this to mean that BLINK DOES NOT cause the calcification, though I will contact their manufacturer to verify this.

http://apps3.fao.org/jecfa/additive_...e/T0368e14.htm

Meanwhile, MY 0.5% Hyaluronic Acid drops DO, INDEED, use a "sodium phosphate buffer," so my doc has told me to cut way back rather than take any chances.

You can never relax with this dry eye (or, for that matter, any other chronic condition) issue....

I'll keep all posted.

Neil

[Flick]

Neil - you wear contacts while bike riding? Do you have a pair of prescription sunglasses you could use instead?

By the way, I was in California last week. Have you ever been to Yosemite? Pretty amazing.

Flick

[neil0502]

Neil - you wear contacts while bike riding? Do you have a pair of prescription sunglasses you could use instead?

I've got a strong prescription--much too strong to get any sort of wraparound eyeglasses. Also, on a road bike, I actually have to look over the lenses in most positions (rendering me fairly well blind!).

I used "Cocoons" over the glasses sunglasses once but they don't block wind at all. The contacts with the PanOptx glasses should be good. I've thought about swim goggles, but the optics aren't good, and there's some concern--especially with my relatively thick contacts--about corneal edema from lack of oxygen.

Whaddyagonnado?

By the way, I was in California last week. Have you ever been to Yosemite? Pretty amazing.

Yup. Spectactular. Old friend of mine has a brother who was a horseback mounted ranger. He took us riding through the backcountry, up Half Dome, and to a few other pretty incredible hikes.

Glad you enjoyed it!

[Toril]

Hylo-Comod

I want to recommend one eydrop called Hylo-Comod (Ursapharm, Germany).

It contains sodium hyalutonate, has no preservatives and still is in a bottle! The bottle has a special closing mecanism, and the drops can be used 12 weeks afer opening. Google it, and you'll find the company's homepage. I've been using these drops for a while now, and until now I think it's the best drops I've tried. My eyes are terrible in the morning, in the evening, with drops, without drops...well,...all the time..no matter what I do...but these drops give some comfort at least. The negative with them is that they are really expensive (but then again you are supposed to need less drops during the day with these drops because their comfort last longer). In a pharmasy I have to pay 250 (!!!) Norwegian kroner for one bottle,..if I go to the optician next door to the farmacy it costs 200 kr (stilll expensive though).

Today I bought an other drop containing hyalutonate called Oxyal. They were released not long ago and I wanted to try them out. It's too early to say if they are working well or not (just used them 2 times), but they way they felt in the eye was about the same as with Hylo-Comod. They contain preservative called oxyd, which turns into oxygen, water and natrium cloride when in contact with the eye.

Other drops I use are

- Tears Naurale (Alcon):Good ones...but not the effect is not long lasting,..best for people that with less dry eyes I guess)

-Thera Tears, preservative free: Same comment as for Tears Nautrale. These drops are not available in Norway, but I've gotten in contact with a Danish optician that is working with the product and that is willing to send them to me.

- Celluvisc preservative free(Allergan): Good for night-time use. Too sticky for daytime I think.

Thera Tears for night, preservative free: Very similar to Celluvisc, but each pipette (is that the right word??) contains more drops compared to Celluvisc.

In the night I also use an oinment called Simplex in combination with Celluvisc or Thera Tears for night. It's very greasy and sticky,...and I can't imagine it's that healty for the eye,..but I feel the watery effect of the drops last longer in combination with this. My eyedoctor recommended me to use it during the night, but I've read here in this forum that it's not good for the eye after all (I think you can compare the product with lacrilube)?

I tried Systane (with preservatives ,..the ones without preservatives are (of course) not available over here), but I felt my eyes got irritated by them after a while.

Toril

[neil0502]

I want to recommend one eydrop called Hylo-Comod ](Ursapharm, Germany).

Toril,

I would recommend being very careful with this drop .... perhaps not even using without prior consultation and ongoing monitoring by your eye doctor.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Corneal calcification following intensified treatment with sodium hyaluronate artificial tears.

Bernauer W, Thiel MA, Kurrer M, Heiligenhaus A, Rentsch KM, Schmitt A, Heinz C, Yanar A.

Department of Ophthalmology, University of Zurich, Theaterstrasse 2, CH-8001 Zurich, Switzerland. wolfgang.bernauer@hin.ch

AIM: To report a potential adverse effect of intensified treatment with sodium hyaluronate artificial tears. METHODS: Five cases of deep calcium deposition in the cornea associated with ocular surface disease and frequent use of hyaluronic acid artificial tears are described. All patients used one formulation of phosphate buffered hyaluronate eye drops when rapid calcification developed. All eyes required corneal graft surgery for visual rehabilitation. Specimens at keratoplasty were available for light microscopy and investigation by dispersive x ray analysis. The phosphate concentration in the medication used for topical treatment was measured and compared to alternative hyaluronate preparations. RESULTS: Light microscopy showed dense mineralisation of the entire stroma. The crystalline deposits consisted of hydroxyapatite, Ca5(PO4)3OH. A 50-fold higher concentration of phosphate was measured in the sodium hyaluronate eye drops used for treatment (50.9 mmol/l) when compared with normal serum. The other hyaluronate formulations showed phosphate concentrations from <0.1 mmol/l to 10.9 mmol/l. CONCLUSIONS: The hyaluronate artificial tear formulation "Hylo-Comod" favours the formation of insoluble crystalline calcium phosphate deposits in presence of epithelial keratopathy. This is because of its high phosphate concentration and typically frequent instillation. Manufacturers and prescribers should be aware that topical preparations may contain considerable amounts of phosphate which may lead to sight threatening corneal complications.

[neil0502]

Found another positive study for the Hyaluronic Acid/Sodium Hyaluronate drops at commercially available concentrations. It's not overwhelming because they did NOT compare it to the scores of other drops available on the market. Nonetheless, in an absolute sense, Sodium Hyaluronate DOES increase Non-Invasive Tear BreakUp Time--a good thing, especially for evaporative dry eye folks....

----
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

Performance profile of sodium hyaluronate in patients with lipid tear deficiency.Prabhasawat P, Tesavibul N, Kasetsuwan N.
Siriraj Hospital, Mahidol University, Thailand.

AIM: To assess the short term efficacy of hypotonic 0.18% sodium hyaluronate (SH) in patients with evaporative tear sufficient dry eye due to lipid tear deficiency (LTD). METHODS: This was a randomised, double-blind, controlled, exploratory study. A total of 10 patients with dry eye due to LTD were treated as follows: 1 drop of hypotonic 0.18% SH in one eye and one drop of isotonic 0.3% hydroxypropyl-methylcellulose (HPMC) / 0.1% Dextran in the other eye. Non-invasive tear film BUT (NIBUT) evaluated by using tear scope with grid pattern and subjective ocular symptoms of dry eye were assessed at 15, 30, 60 and 90 min following instillation. RESULTS: Both, SH and HPMC/Dextran caused a significant (p < 0.05) improvement in NIBUT and symptoms. Mean NIBUT in SH were 3.2+1.0, 6.4+2.8, 5.5+1.9, 5.3+1.3, 3.9+1.7 sec at 0, 15, 30, 60, 90 min respectively compare to 3.6+1.9, 5.5+3.2, 5.0+1.5, 4.4+2.2 , 3.5+1.2 sec of HPMC/Dextran group. However, increase in NIBUT was significantly (p < 0.05) greater and longer in the SH group than in the HPMC/Dextran group. CONCLUSION: Treatment with SH and HPMC/Dextran eye drops are useful for treating patients with dry eye due to LTD. However, SH caused a significantly (p < 0.05) greater increase of NIBUT values compared to HPMC/Dextran in such patients.

[Vicki In Oregon]

Is this a good product to use?
http://www.herbalremedies.com/anti-aging-oral.html

It is HA in droplet form. I only have tablets at home.

One of the articles posted by Neil stated the following:

Conclusion: Hyaluronate eye drops are useful for treating severe dry eye in Sjögren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.

Is hyaluronate the same as hylauralic? I have asked my doctor many tiems for HA eye drop RX and he wont give me one. But there is a compunding pharmacy that can do it. So all I would need to do is ensure the drops did not contain sodium phosphate buffer? What preservative would be in them or can we get these in individual vials? I dont get what is meant by hypoconicity showing better effects than isotonic solution. Is this hypoconcity a solution too? How do you get all that accross to ones doctor? Thanks Neil.

[neil0502]

Is this a good product to use?
http://www.herbalremedies.com/anti-aging-oral.html

It is HA in droplet form. I only have tablets at home.

I don't see any reason to believe that the "taken by mouth" versions (the link you provided OR the tablets you reference) will have a significant benefit on dry eye syndrome/ocular surface disorder.

I have asked my doctor many tiems for HA eye drop RX and he wont give me one.

I'm reluctant to come between you and your doctor, Vicki. My only advice would be to do a little independent research--perhaps presenting copies of a few of the studies to your doctor and discussing the matter with him in greater detail.

Good luck!

[Vicki In Oregon]

I am frustrated the doctors wont prescribe me something new to try as i have given everything a minumum of 2 weeks by itself to see if it works. Most things much longer. The refresh and theratears PF drops have all been tried along with others. I even ordered Viva online (before i saw it could be bought at the store) and this one homeopathic drop that suppose to get to the root of the problem (yeah right) I would like to try compounded drops or at least Freshkote or soemthing. One doc did not say why he would not prescrive them the other said they can do more harm. I dont know why. They just keep telling me to stay on Restasis and the artificial tears, theratears and soothe. Both of them dont do much for me at all. Always miserable, eye lids and under the eye lids too along with the eye balls. The Systane Free I used too much but helped at least a little. Of all the things to be recalled. Ugh. i feel that getting worse after 6 months should mean something to the doctors. Worse both with the eyes as well as other dry areas but that is for a different board i know. But since it is all treated symptomatically, with or without other disease, I dont get why they wont give me more to try. I dont want to have to fly to see Dr. Tseng or Dr. Rosenthal or any other doctor if they have access to soemthing that can give me relief here. I will give the Restasis full 6 months (that means 2 more months) and then that's it for me. I will be forced to go elswhere despite my poor health and limited resources. Honestly, if I had even small steady improvmenent that would be enough to keep me going and not look further. I should also mention that I have been using the nighttime tranquileyes and not sure if I am doing something wrong but they seem to actually agggravate my eyes for some reason. The more dry my eye, the more it cant handle the pressure of the goggle. But any less pressure and my tears will evaporate and that defeats the purpose, they dont feel tight overall. But my eyes, espeically the right is just so sensitive. Sorry I went off on several topics. If it gets moved that is okay. I just too tired to post a bunch of posts and trying to not post all over the place either. This is just where I am at with this whole thing.

[Rebecca Petris]

I should also mention that I have been using the nighttime tranquileyes and not sure if I am doing something wrong but they seem to actually agggravate my eyes for some reason. The more dry my eye, the more it cant handle the pressure of the goggle. But any less pressure and my tears will evaporate and that defeats the purpose, they dont feel tight overall. But my eyes, espeically the right is just so sensitive.

Vicki, just a stray thought on this: you might want to try it without the moisture pad, just a good strong lubricant in your eye. That way there would be no pressure on the eye, and even without the moisture pad, the foam around the perimeter plus the rubber front piece is better than nothing in terms of controlling air movement and helping with some moisture retention.

[sissy]

non-preserved sodium hyaluronate

There is an unpreserved sodium hyaluronate. New product called Oasis Tears. I found them at my recent visit to my optometrist - in fact he called me when he got them in stock. From what he says, this is a very high molecular weight (?) sodium hyaluronate which means it stays on the eye somehow, and without being blurry. They are great! I used to have to put various drops in throughout the day, but with these I am down to twice a day - once in the AM and once in the evening when I get home from work. Apparently they are only available from eye guys, not WalMart and the like so call your doc and see if they have them. Oh, there is a website too where you might be able to order them - I haven't checked that - oasistears.com

[calli66]

I wish the website had more info about the active ingredients. I couldn't find much more than glycerin listed ---I'm sure there's more to them than that.

Calli