Thick ointments such as lacrilube - useful?

[brd888]

Anyone using ointments such as Lacrilube?
I've just read that there is a strong possibility that ointments interfere with the wettability of the ocular surface and lid lubrication.
I've been using lacrilube at nights due to recent problems with dry eye but maybe this is perpetuating the current problem. I've only been given lacrilube by one of my GPs and the opthalmologist I saw almost a year ago, neither of which were very concerned about dry eye. Maybe it is time to bin the stuff.
Regards,
Bruce.

[Rebecca Petris]

I've just read that there is a strong possibility that ointments interfere with the wettability of the ocular surface and lid lubrication.

In addition to that the residue may clog up the meibomian glands.

Ointment can be useful in some situations but IMHO daily use can pose some problems.

[Eli]

If you're going to use Lacrilube, why not use Refresh PM instead? It's preservative free. However, I have also seen the speculation about ocular surface wettability and meibomian clogging, and it certainly seems possible. It's a shame, because the stuff really does work.

[stella]

lacrilube

I have never dared use this directly in the eyes -despite being told to by an optician. I did use it on the lids for a while as i felt they were soo dry(being careful not to get it on the lashes - so as not to block the already blocked glands)
Interestingly my daughter works in ITU as a nurse and tells me they routinely apply lacrilube into the eyes of all unconcious patients in her hospital as protectionI spent a life time in ITU as a nurse and our protocol for protecting the eyes of unconcious patients was to apply folded gauze swabs dipped in normal saline - then directive come from the eye- dept that we were to use sterile water insead [B]There was also an interesting substance called " jellyperm" It come in protected sheets and was cut slightly larger than the eye and we wet it with sterile H2O]and placed it over the patients eyes To me at that time it seemed a great protective solution- Then it was withdrawn due to costs (it was see- through, and resembled thick plastc)also was permiable
I wish I had some now - I would try it at night
After all, the unconcious patient often has the eyes only half closed and never blinks - if unconciousness is drug- induced for their condition and in most cases it is
I thought that info might add to the discussion
I just stick to celluvisc (carmellose sodium) both day and night - I must find out what carmellose sodium is ?
You dont seem to have it in the USA?
Anyone throw any light on that one?
Stella

[Rebecca Petris]

I'm chemistry challenged but just from having seen these over and over, I believe...

Carmellose = carboxymethylcellulose

(similarly, hypromellose = hydroxypropylmethylcellulose)

These polymers are both used in various artificial tear products available in most western countries. Check our lubricant listings and look for CMC and HPMC.

CMC is in most of the Allergan products and in Theratears.

[stella]

Thanks for that info Rebecca !
Stella

[tiggy]

Hi- Interesting conversation!

I have MGD and find that applying a mineral oil based ointment like Refresh PM once a week actually helps. I also have found that washing my face with castor oil and steaming it helps unclog my pores. Maybe occasional use of an oil based product my have the same effect on the eyes?

I think it would interfer with moisture content of the cornea with daily use.
My .02-
tigs

[Kevin]

Cleaning eyes in the morning!

Hi everyone...i have recenltly moved to london, england from the USA and have been using oitnments at night..the problem is im having a hard time finding sterlid and occusoft etc here. Does anyone know where i can get these here...rebecca can i order from the dry eye store for international shipping? Also, I have long eye lashes and when i put my glasses on in the morning (even after cleaning) i have left over mineral oil residu build on my glass lenses.....its sooo annoying...does anyone know of a good way to clean the gunk out of our lashes in the morning? I appreciate anyones input! thanks

[irish eyes]

Hi Kevin

Welcome to the cold UK.

I am surprised you are having difficulty getting hold of Sterilid and Ocusoft. I got mine from my local optometrist here in the North of England. Some good chemists might stock it. I imagine several internet companies would supply it. This company (below) is OK to do business with. They have a range of products called Blephaclean / Blephasol which do the same job. I find most of these products rather harsh on the poor lids. I used to have the same problem as you have - long lashes causing my glasses to get smeared!

www.dry-eyes.co.uk/

[thistledown]

If you're going to use Lacrilube, why not use Refresh PM instead? It's preservative free. However, I have also seen the speculation about ocular surface wettability and meibomian clogging, and it certainly seems possible. It's a shame, because the stuff really does work.

for the first time last night i used Lacri-lube, because i'd been having to get up two and three times in the night to re-apply my Refresh Plus drops.

Here in the UK Lacri-Lube comes without preservatives. (i wonder if there are other differences, too, in the ingredients?)

i haven't tried Refresh PM but might in the future. anyway, although i had to reapply the Lacri-Lube once more in the night, today my eyes are more comfortable than they've been for quite a while, and i'm going to use it again tonight. a good night's sleep seems to help more than anything else - i'd like to get to the point where i can put the Lacri-Lube drops in and sleep right through!

i take on board what's been said about blocking the glands, and will keep an open mind on that. but just the relief of not having a very sore eye on waking (and the accompanying depression) seems worth a bit of gland-unblocking afterwards!

and this morning, before putting in the Refresh Plus drops, i carefully cleaned the remaining gunk out of my eyes with a cotton wool pad soaked in hot water. hopefully this might stop build-up?

so far, anyway, i'd recommend the goo.

[thistledown]

aaaarrrrgggghhhhhh!!! help, please!

for the first time last night i used Lacri-lube, because i'd been having to get up two and three times in the night to re-apply my Refresh Plus drops. ... so far, anyway, i'd recommend the goo.

oh boy. why don't these things work consistently? last night i put in the Lacri-Lube goo (and what a business that is! stuff keeps spooling out of the tube even when i'm not squeezing it, and by the time i've managed to get some in one eye without poking my eye out, it's too blurred to see what i'm doing to the other eye. consequently i end up with about a teaspoonful of the stuff all over my face. there doesn't seem an easy way to use this stuff... ) - anyway, i then woke up at about 3 am, eyes dry and sore, struggled to put more of the thankless gunk in them (by torchlight) - cleaning up my eyes, face, etc woke me up thoroughly, so i didn't go back to sleep for about an hour and a half. when i woke up at about 7, my eyes felt like a gremlin had been in there, rubbing them down with sand paper.

so it was back to Refresh Plus, which works ok, but not for long enough. and i just don't know what to do tonight! do i give the beastly goo another chance? or drink lots of water and wake up every two hours to put in the Refresh Plus? which at least is easy to apply, but it means i get another interrupted night...

i do want to try Celluvisc - which i'm hoping to get my doctor to prescribe - but i don't see him till tuesday. perhaps also Refresh PM - though i have a feeling this is just more oily goo, isn't it? the same as Lacri-Lube?

please could someone tell me whether i can use all this stuff together, and if so in what order, and if not - which one to ditch? i'm having a really down day today, and i was feeling so good yesterday, thinking i'd got it sussed!

rats rats rats!!!

[calli66]

Bear with me and read this little narrative:

A close friend of mine with Sjogren's ---with severe dry eye---was literally "hooked" on the ointment for over a year. With 0 Schirmer's score and corneal
'points' (I don't know the name for it---caused by the dry eye), she HAD to use something strong at night. The "lube" helped heal the "points," gave relief, and she even noticed that the greasy lubrication lasted into the next morning, giving her relief until almost noon.

But after noon, and for the rest of the day, her dry eye was awful, making her desperate. I tried to encourage her to use the gel at night instead, but she couldn't get used to the sticky lashes and the need to wake up and re-apply several times----difficult for her because she took sleep medication. Eventually, she had to use the CPAP machine at night and couldn't use petroleum jelly products with that, so was more or less forced into trying several nights with gel only.

I had been suggesting Genteal Gel (available in US), and this product was too harsh---really burned---but she finally found a different gel--I think it was Refresh Liqui-Gel, and was finally able to quit using ointment. After that, her eyes improved rapidly---they didn't get more tears, but they felt much better.

Each person has to find what works best for them, but it's my opinion and my experience that the ointments interfere with the wetability of the eye surface, and while they help in the moment, they are not good to use long term.

I've read articles about people with "chapstick addition"---it's kind of a joke, really, but I think the effect is similar. The more you use, the more you have to use. If you don't apply if, your lips seem to be drier than ever. I don't think petroleum jelly is an evil substance----I use it in my nose at night and am pretty dependent on it---but for the eyes? Doesn't seem right to me.

With the eye, we're not talking about lubricating ball bearings, we're talking about a delicately balanced lubricating system of tears/lipids/mucous that's spread by blinking. Petroleum ointments can function to prevent gross damage to the cornea (like erosions). But as a barrier to air exposure, there are better ways. Some type of gel and TranquilEyes goggles at night works for me---not perfect---but I've learned to live with it, and generally get pretty decent sleep.

Calli

[thistledown]

Bear with me and read this little narrative:..... Petroleum ointments can function to prevent gross damage to the cornea (like erosions). But as a barrier to air exposure, there are better ways. Some type of gel and TranquilEyes goggles at night works for me---not perfect---but I've learned to live with it, and generally get pretty decent sleep. Calli

thank you, Calli. that's useful information.

i'd like to stop using the Lacri-Lube as soon as i can get hold of an alternative, perhaps Celluvisc.

last night was slightly better, maybe because this time i didn't overload my eyes with the goo. i still had to put it in again in the middle of the night. i've given up trying to apply it with the tube nozzle - i put a little bit on a well-washed fingertip, and smooth it onto my lower eyelid. some gets inside! maybe, like facial moisturizer, the less you use the better it works?

[calli66]

Do you have to get a prescription for Celluvisc in the UK?

Sounds like you're doing better since you're minimizing the quantity of ointment. I do much the same thing when I have to use medicated ointment---just put a tiny amount on my finger and apply it to my lower lids. That way, it doesn't overwhelm the eyes.

C

[Lucy]

i put a little bit on a well-washed fingertip, and smooth it onto my lower eyelid. some gets inside! maybe, like facial moisturizer, the less you use the better it works?

That's exactly how I use either gel or ointment to apply before bed. I even Pull out my upper lid and scrape the finger with the gel on it so some gets up under the upper lid too. Lucy