Am I using too many eye drops? Please help

[cathy8889]

Hi all,

Any advice would be really appreciated. I cant bare my eyes being so red so I use a lot of drops, worrying now that I am using too many!

I have 2 pinguecula in each eye and dry eye which is caused my reduced tear production My pinguecula are always red and inflamed due to the dryness, when my eyes are lubricated the inflammation reduces considerably.

I am using drops twice an hour and am going through a bottle of vismed multi (10ml) every three days, sooner in some cases.

Am I causing long term damage to my eye or making my condition worse by not letting my eyes rely on the few natural tears I am producing?

Is there any other way I can reduce inflammation without using so many eye drops? Can cold compresses do this? If so what types of cold compresses do people use?

Many thanks

Cath

[DryInDenver]

I've been told it's okay as long as you are using preservative free eye drops. Also, I think twice an hour is not on the extremes of high frequency for people on this site. I think it's likely that the risks of having inflammation caused by excessive dryness long term is worse than the risk of using drops to control the dryness. I read about one use on this site who puts preservative free systane in scleral lenses, which would be like using drops every second of the day. If that's not causing problems, I doubt your rate of usage will.

[Guest]

Hi, I have looked this up recently and found a site that said too many artificial drops (preservative free also) can wash away your natural tear film. It might be just one opinion but I did read that our natural tears have nutrients that cannot be replicated in a bottle. It's very hard to experiment when you depend on drops but I am desperately trying to limit myself as much as possible. Try once every hour and see how you go and see if you can wean yourself off them? I have had lower plugs in recently so find that every now and again I feel my own tear moisten my eyes. Could be an idea if you don't have plugs already? X

[Rebecca Petris]

Personally I'm in the camp of those that feel constant dropping is not good for you... but as with so many other things, at the end of the day we need to do what works and there are always exceptions to every rule. We sure have had a lot of people here over the years who felt they started getting better when they reduced their drops. The thing about dropping is, most people use frequent dropping as a pain management tool rather than a medical necessity. The most effective way to reduce drop frequency (other than plugs... and if lowers aren't enough you might want to consider flow controllers in the uppers to increase tears without too much risk of overflow) is moisture chamber glasses.

A note on preservative free drops: That's a must for anyone with dry eye. But... being preservative free is not a virtue, it's just absence of a vice. I mean PF is not enough. It needs to actually be a decent lubricant with some staying power.

[cathy8889]

Thank you for your help dryindenver, this is a good way of looking at it, I feel like the damage being done to my eyes by the dryness, like neovascularisation and new pinguecula , is worth putting the drops in but will look in to punctual plugs.

Thanks again

I've been told it's okay as long as you are using preservative free eye drops. Also, I think twice an hour is not on the extremes of high frequency for people on this site. I think it's likely that the risks of having inflammation caused by excessive dryness long term is worse than the risk of using drops to control the dryness. I read about one use on this site who puts preservative free systane in scleral lenses, which would be like using drops every second of the day. If that's not causing problems, I doubt your rate of usage will.

[cathy8889]

Hi Claire, thanks for your message, i will try limiting myself to once an hour I think. I really hope the ophalmologist I see next thinks I'm a candidate for punctual plugs, I would to love feel my own tears moisten my eyes again. It's funny at random times when I blink I can feel the coolness of my own tear film and it's like heaven, this probably happens like once a week.

Thanks again

[cathy8889]

Hi Rebecca, thank you for your advice, it's a good point about the pain management, I don't know Whether I'm using drops so frequently because I'm do afraid of going back to the pain I was in a few months ago. I was just wondering about the flow controllers you mentioned, I have not heard of them before, how do they work?

It's also good point about a lubricant with staying power, vismed multi which I am using at moment is quite runny, I don't know whether to look for another but they are the only drops I've used that don't irritate my eyes. This dry eye business is such a mine field.

Thanks again

Personally I'm in the camp of those that feel constant dropping is not good for you... but as with so many other things, at the end of the day we need to do what works and there are always exceptions to every rule. We sure have had a lot of people here over the years who felt they started getting better when they reduced their drops. The thing about dropping is, most people use frequent dropping as a pain management tool rather than a medical necessity. The most effective way to reduce drop frequency (other than plugs... and if lowers aren't enough you might want to consider flow controllers in the uppers to increase tears without too much risk of overflow) is moisture chamber glasses.

A note on preservative free drops: That's a must for anyone with dry eye. But... being preservative free is not a virtue, it's just absence of a vice. I mean PF is not enough. It needs to actually be a decent lubricant with some staying power.

[Guest]

Hi again! My consultant gave me hylo forte (you can get it from the NHS) which you can also buy over the counter at boots under the name hyco San extra, it's a red bottle. It's preservative free and has 2mg of sodium hyaluronate which is long lasting. I have spent hundreds on drops and prefer these. Another thing is vita pos, an ointment found in boots too for a fiver, it works on corneal regeneration with vitamin a. These drops made my eyes v v comfy but I ending up finding them too thick so stopped using them. If pain is an issue they could help but it's not suitable for everyone.

About the plugs I was a bit insistent I got them, I said I do long shifts (lies!) at my job and can't use my drops when I need to because of clients or being away from my desk. He then agreed it would be a good option. They caused a little irritation at first but it calmed down.

[Rebecca Petris]

I was just wondering about the flow controllers you mentioned, I have not heard of them before, how do they work?

They're hollow, so they provide some occlusion but don't block things completely. For some people they help them get a good balance between retaining tears and not having their eyes drip too much at times. Here's an example... http://www.dryeye.org/flow.htm though I think there are now another brand or two of them on the market.

[cathy8889]

Hi Claire,

I think i have tried the hyloforte, but I mgt revisit them thank you. Anther lady on here kindly mentioned the vita pos and I've been meaning ever since to give these a go. I'm a bit worried about using ointment as I used to use lacrilube overnight and I'm sure my eyes were sometimes worse in the morning, maybe this was due to the humidity in my room during the winter though. I will definitely stress how awkward it is for me to put drops in my line of work, I might over egg it a bit too!

Thanks again

Hi again! My consultant gave me hylo forte (you can get it from the NHS) which you can also buy over the counter at boots under the name hyco San extra, it's a red bottle. It's preservative free and has 2mg of sodium hyaluronate which is long lasting. I have spent hundreds on drops and prefer these. Another thing is vita pos, an ointment found in boots too for a fiver, it works on corneal regeneration with vitamin a. These drops made my eyes v v comfy but I ending up finding them too thick so stopped using them. If pain is an issue they could help but it's not suitable for everyone.

About the plugs I was a bit insistent I got them, I said I do long shifts (lies!) at my job and can't use my drops when I need to because of clients or being away from my desk. He then agreed it would be a good option. They caused a little irritation at first but it calmed down.

[Guest]

Hi Cathy, hope you're ok!

I have found this which is worth a read http://www.visionsurgeryrehab.org/pd...esentation.pdf and I paid particular interest to the bit where it states that too many drops may cause more harm than good. They recommend 5 - 8 drops a day at most. I was thinking about this and have recently been panicking because my eyes have got worse over the last week, in a state of panic I poured the drops in, they now look worse. I think drops may be causing more irritation. See what the web page also says about ointments, they don't allow the tear to spread properly (so ignore what I said about vita pos).

I really think where red veins are concerned that too much tampering is disruptive. Especially thick lubricants and ointments. Try plugs, moisture goggles and cold compresses for small relief and apply drops only when needs be. I am going to try and be strict on myself, I see the state of my eyes and first reaction is to drown them in moisture so I am going off how they feel now and not look.

[DryLondoner]

Cathy8889 - my personal experience has been that when I overdo it on the drops, I get 5 minutes of relief followed by a day or two of irritation. One particular day I found myself using hylo forte every hour (they looked so lovely and white when I put a drop in), and woke up the next day with the reddest angriest eyes. Personally, if I blink through it in the long run my eyes seem happier. I have to add that I don't (touch wood) seem to have serious problems in terms of eye damage. My opth. also said that it was better to try and preserve my natural tears for as long as possible rather than put in drops. So I got a plug in my eye which is a little bit worse.

Claire, I completely agree with you about going off how they feel rather than how they look. I'm so impatient and I think that has harmed my eyes more than anything!!

I tried going "cold turkey" with the drops but caved after two days. I think that might have to what I try again next...

[Guest]

Hi drylondoner!

That's exactly what I have been doing, I've been abusing the hyco forte and then waking up the next day with lots of small red veins on my sclera, I panic and repeat the process.

Today I tried my hardest to be strict on eye drops, unfort I had a good cry today and have used some to help them out. Think restricting them is a good idea, let's both try it and see if it helps!

[DryInDenver]

For what it's worth, I've used both Systane Ultra PF and Refresh Plus PF (not Optive, which I didn't like) in pretty high quantities over the past year and have not noticed any redness while using them or the next day. For those that are experiencing redness, I'd recommend experimenting with different drops to try and find one that helps without those side effects (although I feel a bit silly recommending that since, most likely you've already been through that process).

Regarding overusing drops, despite my history of high use, I tend to agree with those in the less-is-better camp. But, for me limiting drop use wasn't really an option (Now, with my Laserfit lens sclerals , I still use drops but at a much more reasonable pace). Within a couple hours using drops once an hour or less, I'd develop intense pain that would radiate throughout my head and could only be calmed down by a closing my eyes with cold compress. Then depending on how bad I let it get, it would then take several days to a week for the pain and inflammation in my eyes to get back to my base level. This process has conditioned me to use drops sooner rather than later.

From what I understand, one of the biggest determents to using drops is that it can wash away the small amount of natural tears that are in the eye. I view natural tears as a magical substance that help sustain the health of the eye on many levels (proteins, growth factors, cytokines, and lots of medical stuff that is a bit over my head). I was particularly concerned about this because I'm "recovering" from LASIK surgery and want as much of that good stuff in my eyes as possible to hopefully facilitate any type of healing. So to try and make up for my over use of drops, I'd periodically do several things to increase the natural tears in my eyes:

*The best of these was a cold compress. I used cold soda (or beer) cans and slowly roll them around my closed lids. When I'd open my eyes after several minutes of this my eyes would drip natural tears. Also, the cold felt great on my sore, painful eyes. Warm compresses made my eyes water a bit but over time I decided cold ones worked best for me.

*The most frequent thing I'd do is gag myself. It sounds horrible, but dry eyes put many other things in perspective so it wasn't THAT bad. A slight gag, which I could initiate without putting anything in my mouth and wouldn't have to be a full out dry heave, would cause my eyes to tear. This would at least get some natural tears in my eyes for a bit and if I could, I'd close my eyes for a minute or two to try and bathe my eyes. One thing I never figured out though, is how/if these tears would differ from normal tears since tear composition can vary quite dramatically. I also would use this technique if my eyes were glazing over and I couldn't use a drop - for instance if I was driving in heavy traffic and couldn't take my eyes off the road).

*I started using serum drops since those contain many of the same magical ingredients that natural tears do.

*I got lower plugs, which didn't hurt but didn't seem to help my condition much either. On a side note, I've heard some people's natural tears can actually be inflammatory (from pro-inflammatory cytokines, for instance http://www.sciencedirect.com/science...43466610006782 ) and in those cases lower plugs actually make things worse. Could it be possible that diluting these tears might be beneficial? I don't know, just thought I had.

*Use as small of a drop as possible so that it would hopefully mix with any minuscule amount of natural tear I had in my eye. If drops/tears came out of my eye after putting in the eye drops then I knew I used too much.

*Working out helped. Hard physical activity, particularly while wearing moisture chambers, helped immensely and I could forgo using so many drops. Sometimes after a long, painful day at work, I'd come home and put in one of those Insanity work out videos which offer a hard, sweaty work out. 20 minutes into the video my eyes would often feel the best they felt all day.

I'm not sure if any of this info helps much but wanted to mention it just incase or provokes some additional thoughts. Also, I'm curious, does anyone know of any other risks related to using drops frequently, or is primarily just related to keeping what little natural tears are there?

[cathy8889]

Thanks Rebecca

They're hollow, so they provide some occlusion but don't block things completely. For some people they help them get a good balance between retaining tears and not having their eyes drip too much at times. Here's an example... http://www.dryeye.org/flow.htm though I think there are now another brand or two of them on the market.