Treat with drops aggressively or not?

[rubyslippers]

I am new to this whole thing and posted below. I have a specific question.

Should I use all the stuff I have been given aggressively, even when I have periods where I feel kind of better? I have been given Soothe, Gen Teal gel, Gen Teal ointment, Refresh, and Refresh Endura. Are you supposed to use these things when you start to get uncomfortable or use them on a schedule no matter what? At this point the gel works at night and the Soothe seems to be the best during the day, but the doctor said no more than 4 times a day. When I use it, and then 30 minutes later add Refresh, am I just washing it away?

[Rojzen]

greetings! frequency of drops; properties of drops

These are great questions. . . and within them are yet other implied questions, I think. . .

Did you get all these different eye drops as samples to try, with the goal of your choosing what will eventually help most? or did the practitioner, rather, wish you to include all these different products in your regimen? I am going to guess that the situation is the former...

Assuming that you have some flexibility, are you choosing the drops based on their properties, such as the presence of a lipid (Soothe and Endura), or based on consistency (gel/ointment)? or is comfort your priority? I ask this because long-term benefits may not necessarily flow from the drop that is most comfortable on a daily basis; and because the properties of the drops you've been offered so far may not, moreover, include some additional properties that some of us here are finding important. . .

The warning against using drops more than 4x/day is one traditionally given for any drop that contains preservatives. But while overuse of any preservative is never advisable, preservatives vary GREATLY, one from another, in the degree to which they can do harm. None of the drops you have mentioned contain BAK, which is affirmatively and seriously harmful (according to published studies), but the drops you have do not run the gamut of all available preservatives. . .In any case, if you end up committed to one or more of the products you have, preservative-free equivalents may be available for them. . .The Refresh products come unpreserved, for example. Alternatively, you may end up with a drop that contains a preservative not present in the commercial products you're trying.

Regarding the long-term objective: Everyone here knows what I'm about to say . . .I vote for your exploring the section here at DEZ dedicated to the work of Dr. Frank Holly. He is a very serious scientist who, quite some time ago, developed an absolutely unique approach to the treatment of tear film and corneal epithelial disorders. Our mentor/moderator here, Rebecca, has sacrificed and struggled, over the years, to keep Dr. Holly's work in the public domain. . .Several of his OTC eyedrops are, accordingly, available through the Dry Eye Shop. . .

If you surf around here, you'll see that several of us have made remarkable advances in healing our corneas and stabilizing our tear films while using Dwelle, in particular. . .In Dr. Holly's section, you will find a long entry by him specifically addressed to the frequency with which it is safe to use Dwelle, which is a preserved product. . .

Elsewhere here, you will find posts showing that some of us do better with only 2 or 3 doses a day, of Dr. Holly's drops, than with many more a day. . .

For discussions of other drops, like the ones you're trying now, please visit the section on drops, gels, and ointments, listed in the Dry Eye Talk directory. . .

[Francesco]

I think that it has been already discussed here....in my opinion even preservative free drops shouldn t be use too much (unless you have severe dry eye) ......first of all because they are not like our tears (they are lubricants), make the eyes more dry/irritated to a lot of people if used in abundance and i read somewhere that might reduce the ability of the the lacrimal glands to make tears (again, if you really use them a lot...something like every 5-10 minutes) ...anyway don t worry they are fine but less is always better bye

p.s. if you use a different drop after 30 minutes you are not washing it away! ...a lot of people use lotemax and after 5 minutes restasis and that surely doesn t wash lotemax away....i guess you should just wait 5 minutes to use another drop!
Also, if the doctor said you should use them 4 times a day (maybe to heal the conjunctival epithelium/mucin layer) ...use them even if you feel ok!

[Rojzen]

physiology of impact of drop on eye: striking a balance

Sometimes, our eyes feel so dry or painful that it is unthinkable that we could allow them to languish without some help for too long. . .Possibly, some moisture is better than none, during those difficult periods. . .At the same time, the action of drops hitting the eyes is not without consequence, and so as one seeks to strike the right balance between pain relief/moisturizing and avoidance of mini-trauma to the eye, it may be good to read Dr. Holly's very specific discussion of the effect of drops hitting the eye, which appears in his Department of Dry Eye Talk. . .

[rubyslippers]

I am finding this site so very helpful. I appreciate it very much. I will take some of the information to my doctor on the products. He wants me to experiement with what I have and he asked that I not "muddy the water" with other things until he gets a better grip on my situation. Yes, he limited the Soothe due to the preservatives. I am doing well enough today that I may be able to get away with only 3x use today. Who knew that dry eye was such a miserable thing? I had heard of it and even had mild bouts before these damaging medications, but I had no idea!!