Advisory: TheraTears Dispenser change

[Bill Sonoma County]

Once again, Advanced Vision Research (an Akorn Co.) has changed its preservative-free TheraTears dispenser without notifying users. About one tenth of the way into my latest online order of TheraTears, I was trying to open a new vial in the middle of the night. First thing I noted was the absence of a spot to rip open the foil pack, so I fished a knife from the nightstand and sliced it open. Next I found that the container was altered from the standard design, and I had trouble lining up the tip with my eye. Finally, with fluid all over my cheek and pillow I tried to recap the vial and found it was no longer reclosable. Even though we all know that reclosing a preserv-free vial and using it much later risks contamination, most serious DED sufferers have figured out how to effectively use the recap feature to get the few sequential floods of fluid that provide us with relief. Those sequential floods were even part of the TheraTears product instructions at one time.

When I contacted AVR they could not tell me whether the new style was taking over or whether the old style was still available. The picture of the dispenser on the package does not match the dispenser that is inside the box. They said they would report this fact to their marketing department. If any of the original style dispensers were still available, they could not locate them. They did not know what had been packaged inside boxes with different lot numbers. They said that I could order more, but it would be up to chance as to what product I would actually find when I opened the boxes.

Akorn’s dispenser variations have been problematic in the past:

http://www.dryeyezone.com/talk/showt...ighlight=akorn
http://www.dryeyezone.com/talk/showt...ighlight=akorn

The late Dr. Gilbard developed a good DED treatment. It is sad to see AVR/Akorn making his contribution less useful to serious DED sufferers.

Best of luck to all.

Bill

[Guest]

So they did it to you guys too? That really sucks.

They changed the packaging in Canada ages ago - same thing: difficult to open foil packs, the vials are no longer straight up and down, but bend at the end, and you can't reseal the vials.

Even better, often when you twist off the cap to open the vial, it doesn't actually leave a hole for you to get the drops out - so you end up THROWING OUT the un-useable drops!!!

Or, to make things more fun, you might twist off the cap to find that while it left a hole for drops to come out, when you squeeze the vial, rather than have the drops drip straight out the bottom, they squirt at unpredictable angles off to the side - so you end up with drops on your nose, in your hair, in your ear, on the nightstand beside your bed... pretty much everywhere except IN YOUR EYE!!! (Dear Theratears Manufacturer - nope, it's not my aim - I get ALL other brands of drops into my eye on the first try... why? because they drip straight down like they are supposed to. Unlike your product.)

I've written to them about it, to no avail. However, in the U.S., you guys have a waaaaay bigger population than we do in Canada, so maybe there will be enough of you to complain and make a difference!!!

And in case anyone from the company that manufactures TheraTears ever reads this, I have stopped buying your product because this packaging and dropper tip change rendered the product useless to me. I'm sure I'm not alone in this. I work in a pharmacy and we rarely sell TheraTears PF drops. As far as sales go, they might as well not exist - it's been so long that I don't even remember the last time we sold any.

[Bill Sonoma County]

SAAG,

Thanks for the insight from the pharmacy perspective. The long tip dispensers did show up periodically in retail pharmacies here in California--caused me to stop buying the product, but the online lady said she would only ship standard tip to US customers (what do they have against Canadians?). Alas, the shipment two months ago consisted of 12 boxes of the Squirt Gun model. They expressed surprise and told me they thought they had removed those from the warehouse.

Thanks also for the info on the new glycerin/hyaluronate product. Going to try and obtain some. I hope time heading into the future becomes your time machine to unwind the Lasik mess.

Bill

[Amyfloor]

Hi all,
I too, am done buying this product because of the new packaging design and the inability to re-cap the vials. I am using the twist off caps from my restasis vials to close the Thera tears until I can use them all up ! Hope this helps

[LaDiva]

I complained to Akorn last year, and they told me to order online and they would ship only the pointy tips. It was my understanding that those hook nosed atrocities were discontinued, but I guess that is not the case. Unfortunately, this is the only eye drop I can use. Thanks for the heads-up Bill, and thanks Amy for a good idea. I don't use Restasis anymore, but still have some old unused vials!

[Cindy]

This used to be a problem a long time ago. You can use a prescription pill container to stand the open vials up in. ~That's a really grammatically incorrect sentence ~

[Bill Sonoma County]

I like Amyfloor's and Cindy's ideas. But I worry about contamination. A little pseudomonas and you have a hole in your cornea. Any thoughts?

Bill

[Amyfloor]

Hi Bill,

Thanks for bringing this to my attention.

When I first started using artificial tears I thought I had to use the whole vial at once as directed on the box of Thera tears. I asked my corneal doc about this and she said if was okay to use the vial over a period of time without fear of contamination. Thus I was able to re-cap and use a vial over the course of the day. So as long as I am careful and do not touch the cap or caps, I think it is safe to use the tops of my restasis vials on my Thera tears vials. If you have any other thoughts it suggestions, please let us know

[soaps]

I like Amyfloor's and Cindy's ideas. But I worry about contamination. A little pseudomonas and you have a hole in your cornea. Any thoughts?

Bill

oh my goodness i had pseudomonas it ain't nice and really hurts and thank God the weak preserving free antibiotic worked. Usually doesn't .
in Australia the gel drops are still capable and it's only thing i use .

[Bill Sonoma County]

Amy and Soaps, thanks for the input. A friend of mine (with no Dry Eye Disease) had a pseudomonas corneal ulcer from a contaminated contact lens and he was miserable. Fortunately it healed without major scarring. And Amy, good to hear what your doctor said--I've been very attentive about handling re-capped vials. Do you sterilize the old restasis caps before popping them onto the thera tears? Or are you using a fresh restasis cap each day? Seems to me that the underside of a freshly removed cap is sterile, just as are the contents of the vial prior to being opened. And if we don't touch the vial tip during dispensing, re-cap it cleanly, and keep it in a relatively clean environment, we should be OK for a while. Is that your feeling also? Clearly we would not leave the re-capped vials out in an unclean environment. There have been times when I just threw away the vial after using it in a dirty work setting, or dropped it onto the bench at the gym or whatever. And I also would not want to place it in a location where it was going to be brushing up against a surface that had repeated environmental or finger contact.

A few of us have also reported severe DED flares following viral conjunctivitis. Not well explained by ophthalmologists, but huge in terms of suffering.

These comments help. In the presence of manufacturer's vagaries, patient experience and consensus are valuable.

Bill

[alisonW]

Have they changed the caps on the Thera Teras Liquid GEL drops too? The last box I bought still has the caps that you can re-close. I'm wondering if they've changed the caps on both drops or only the regular non-gel Thera Tears.

[Amyfloor]

Hi Bill,
No, I do not sterilize the restasis tops and quite frankly, never thought of it. I actually use 1 restasis vial for my two doses a day (approved by corneal doc) and then use that cap on the TT. However, with all this talk about contamination I am going to try another drop that can be re-capped. It is not worth taking chances.... Thanks for all the great advice!

[Bill Sonoma County]

I don't know about the gel, Alison. Yes, Amy please let everyone know what drops you find that work and allow safe recapping. Pls see related discussion at:

http://www.dryeyezone.com/talk/showt...rs-Cheating-Us

Bill

[buntbean]

Well, that whole pseudomonas corneal ulcer thing is quite disturbing. I've been using thera tears for 9 years now (every 5-15 min) for severe dry eye, bleph., ocular rosacea, and I'm also lucky enough to have corneal neuralgia as well. Hated the crook necked variety and complained about it but I still see them in our Massachusetts stores. I get 9 boxes every 1 1/2 months. Newest batch has changed once again to the ones that you cannot replace the tip. They are also harder to pull apart, and the foil packet has no notch for opening. I'll be honest, when I started using the eye drops I was super careful about contamination. But now I regularly leave them all over my house, in my car, etc. and use them without hesitation. My right pocket has the one I'm using (with or without a cap) and my left pocket has new ones. I've even used some that are days old. Maybe because I use them so often the saline washes any bacteria away or certainly God watches over the stupid.

[soaps]

Yes i used to b like u and carried heaps in pockets but ever since infection im so careful. it resulted in a lot of pain very extreme and very red. i can't describe pain. it was in my duct and felt like nose was going to push through eye lol.
I can't have a lower plug anymore and my eye is dryer than other.

I wash my hands constantly and if drop get a bit warm or touches anything even finger then i throw it. not worth risk considering how far iv come . but i do get drops heavily discounted by medicare which gives me freedom to b so careful.

I never got an ulcer just pain so yes God truly is merciful