Question for Dwelle/Dakrina users

[momaxwell]

I just started Dwelle/Dakrina and found them to be completely intolerable, though my eye does seem more "wet". They don't just sting; they make my whole eye hurt and redder - however when I woke up this morning my eyes looked better than ever. Very confusing. Anyway, I am not asking for any medical advice here, I was just curious what side effects others have had and if you use Dwelle/Dakrina alone or with other artificial tears. I have heard they are really the last eye drop stop for people with severe dry eyes, so I was just curious as to what others have experienced. Also, has anyone else tried castor oil, I have heard that can really help. Thanks for your input.

[Rebecca Petris]

Momaxwell,

"Completely intolerable", pain and redness - depending how long they lasted - are not normal side effects of any over the counter eyedrop. If I had that reaction I would suspect allergy or at least a sensitivity to an ingredient and discontinue use.

I would be curious to know if you had the same reaction equally with both drops. Dakrina has Vitamin A and for whatever reason some people do not tolerate Dakrina as well as Dwelle. I use mostly Dwelle personally.

Like all drops some people do well on these and others don't, and tolerance for the feel varies a great deal depending on your cornea & tear state and other factors.

The likelihood of initial irritation from the high concentration of polymer is much increased if the cornea is very dry or you have spk. If I end up very dry in the morning for whatever reason (goggle coming off, etc) I usually put some saline in my eyes and then put drops in about 15 minutes later.

[Eli]

I have used Freshkote, which is like either Dwelle or Dakrina (I can't remember which) with an additional lipid additive. I think one of the more common complaints with these drops is that they feel "grabby," or as though your eye is being "squeezed" slightly. I felt this to some degree with Freshkote, although it didn't keep me from using it-it just felt a little weird at first. I remember one day I took a two hour nap after putting in a drop of Freshkote, and woke up with my eyes feeling better than they had for a long time. The reason why I tend not to use it any more is because it leaves strings between my upper and lower eyelashes between blinks sometimes. If you have time to wipe your eyelids off with something clean then it isn't a big deal. I found that I didn't though, so I stopped using it for the most part. I may experiment with it at night however, as Systane isn't really getting the job done. With ocular rosacea, I also tend to stay away from preservatives when possible.

[momaxwell]

Okay, here is a Dwelle/Dakrina update or maybe a "what not to do." Friday was my first day; I used Dakrina 4 times and Dwelle 2 times. The Dakrina stung and made my eye red and then, towards the end of the day, made my eye hurt. I should have stopped after the first time when Dakrina made my eye red, so, yes, I overdid it.

Yesterday (Saturday) I used Dwelle 2 times. It stung and one of my eyes was uncomfortable most of the day (it only hurt around my plug, which I suspect still had some Dakrina on it from the previous day - maybe ). I also had that grabby sensation. At the end of the day I washed my eye out with eyewash - everything felt much better.

This morning I used Dwelle, no pain, no redness, just a slight sting. I am pretty sure I just overdid it the first day. The good news, my eyes are looking and feeling good. We'll see what happens.

[alaron]

I have had the same reaction. Dakrina makes my eyes itch and sting a little bit. Dwelle makes me want to rip my eyelashes out. I've used Dakrina 4x/day and Dwelle every night for the past 4 days, and last night I could not sleep because of the pain. I'm going back to normal eyedrops.

[Rebecca Petris]

If you check The Dry Eye Shop's refund policy, it says "3) We will refund eyedrops if you are dissatisfied with them for any reason." Please go to The Dry Eye Shop and click on the Return Policy link and follow the directions.

Eyelash residue, and initial discomfort, are well known issues with Dwelle and Dakrina and we try to be very upfront about this in the descriptions on the site and in the literature that accompanies the drops. Usually blotting with a damp cloth or tissue will reduce or eliminate the residue. Using a little saline in the eyes a little while before applying the drops can help with discomfort in the early period of use.

I am sorry you are unhappy with them. As we all know, there is unfortunately no one drop that will make everyone equally happy. Our eyes and our eye disease is too individual for that.

[alaron]

How long does this last? I'd be willing to try a few more days.

[Rebecca Petris]

I wish that there were any hard & fast answers. I was just reading your other posts to see if I could get any clues that might help. Personally I've used these drops for years and I am familiar/comfortable with the ups & down and how my eyes react to them under different circumstances - BUT I know it's very, very different when you're just getting started. Artificial tears are "supposed" to give immediate relief and with Dwelle/Dakrina that's often just not the case esp. for new users. They definitely take a bigger time/effort investment. -

I really wouldn't advise anyone to use something that makes their eyes hurt so much they can't sleep. If it's at that stage, then go back to using what's comfortable for you - and also maybe check out additional treatments (not drops). Couple of questions out of curiosity though - with Dwelle, is it just the eyelash crud that bothered you about the Dwelle, or did it irritate your eye surface at all? Also, have you tried the NutraTear (which is quite different from those two)?

Also, in your profile and one post you mention Blepharitis... is this being addressed? I have MGD and mild blepharitis, and there are times when it's not fully controlled and at those times I have a much harder time with drops. Good lid hygiene (maybe exploring alternatives to baby shampoo), heat treatment etc, maybe doxy - all worth investigating/trying.

Hope I'm not overdoing it with the questions, just trying to help troubleshoot a bit!

[alaron]

Couple of questions out of curiosity though - with Dwelle, is it just the eyelash crud that bothered you about the Dwelle, or did it irritate your eye surface at all?

Neither. It irritated the flesh of my eyelids, particularly near the inner corner. I was prepared for the eyelash crud (I did read the precautions), and that didn't bother me at all.

Also, have you tried the NutraTear (which is quite different from those two)?

Yes, with good results.

Also, in your profile and one post you mention Blepharitis... is this being addressed? I have MGD and mild blepharitis, and there are times when it's not fully controlled and at those times I have a much harder time with drops. Good lid hygiene (maybe exploring alternatives to baby shampoo), heat treatment etc, maybe doxy - all worth investigating/trying.

I am seeing an ophthalmologist... so in theory, yes.

Hope I'm not overdoing it with the questions, just trying to help troubleshoot a bit!

Thank you!

[Rebecca Petris]

Neither. It irritated the flesh of my eyelids, particularly near the inner corner.

Interesting. Somebody else reported this recently (Liz56 if I remember right) - specifically, during a period when she was off Restasis. Personally, the only thing I've had like that is an area in the middle of my left upper lid margin which occasionally gets very tender (from blocked MGs I believe) - when it does, my drops will really burn on that spot of my eyelid until I 'fix' the tender spot with some warm compresses.

[calli66]

I usually keep Dakrina around so that I can try it every once in a while. I have a weird reaction to it--it really burns when I put it in, but I could deal with that. Then, within a minute, my eyelids (especially my right) sort of "slow up"--they're hard to open, like they're sticking to the liquid drop layer on my eye--not "sticking" really, but that it is taking lots of extra eyelid muscle to move the lid. It's very uncomfortable. Then it feels like there's something--particles--in my eye. I have learned not to add saline to my eyes at this point...that makes it worse. If I add some NutraTear it helps, but is still uncomfortable.

Does anybody else have that sensation? Is that what you call the "grabbing" or not?

I do use NutraTear in the evenings when my eyes get the most dry and irritated. It always burns a lot at first, but I blot the excess and bear with it, because I have found that NutraTear lasts 4-5 times as long as a regular drop, and it's worth it, for the extended time/ comfort. Other drops last about 10 minutes at most, whereas I can usually get through watching a whole movie with only 2 applications of NutraTear.

Calli

[texaseyes]

Nutritear/Freshkote Question

Rebecca, or anyone else that knows the answer...

I read in a 1990 Dr. Holly article that Nutritear was renamed Freshkote. Is the prescription Freshkote of today the same as the Nutritear drop sold on this website? I'm just wondering if it is worth it for me to try the Nutritear, since I don't like the Freshkote.

Thanks,

Texaseyes

[Rebecca Petris]

Name confusion...

NutraTear (the pink one with Vitamin B12) has been sold under the names NutraTear and RedKote.

FreshKote (now sold by Focus Labs) was originally APL-105.

The two drops are not really related. FreshKote is closest to Dwelle and Dakrina as it has the same concentrations of the two PVAs and povidone, while NutraTear has only the PVAs (and a much lower concentration of each) and no povidone. Freshkote has a patented lipid component called Amisol Clear.

Incidentally... Dr. Holly, who is away travelling for awhile, intends to start a Q&A on DEZ some time after he returns. That should be a great help as obviously he can answer many of these questions much better than I can.

[liz56]

Interesting. Somebody else reported this recently (Liz56 if I remember right) - specifically, during a period when she was off Restasis. Personally, the only thing I've had like that is an area in the middle of my left upper lid margin which occasionally gets very tender (from blocked MGs I believe) - when it does, my drops will really burn on that spot of my eyelid until I 'fix' the tender spot with some warm compresses.

Exactly, you represented my experience perfectly. I don't get it, but I'm back on Restasis and enjoying NutraTear again!

[Rojzen]

FreshKote nicely grabby for me, too

The longer I'm on FreshKote, the more intrigued I am by its effects. So far, it has not eliminated some of the worst, most raw-feeling days for my MGD eyes, the way Restasis seems to have done, for me (I'm experimenting with replacing Restasis with FreshKote), but FreshKote may yet do so. And it definitely produces that grabby feeling, which I LOVE (:^), because that is the sensation that makes me feel like I have an intact tear layer actually covering my eye. . .I am hoping that the patented lipid in FreshKote helps my corneal health, over time, even though I don't think it is yet producing subjective benefits that exceed those of Dwelle, which lacks the lipid. Anyway, I'm on week 3 of FreshKote, and trying to hang in, because I have a wonderful feeling about Dr. Holly's theory regarding penetration of each relevant tear layer by a carefully-calculated-density of substance. . .I think that sensation of our eyes being "wetter" reflects the penetration of the respective layers by Dr. Holly's 3 components. . .