Dwelle

[rp123]

I would like to try Dwelle when it available again but am surprised that it contains preservative. My opthalmologist has warned me against anything with preservative in. What is your opinion.
Also I live in England so will it be difficult to get. I have heard thar Clinitas Ultra 3 is the same. Is this so? Thanks

[irish eyes]

Hi lilahselman

No, they are not the same.

I've been using Dwelle over the last few weeks and I think it's helping. It hasn't irritated my eyes - and they are usually extremely sensitive. My eyes certainly seem to feel a bit `easier' - any improvement however slight can make a huge difference to my day!

I've also tried Clinitas Ultra and Clinitas Soothe but both seemed to irritate the lids. It's worth giving Clinitas a go first - I got mine online from:

http://www.dry-eyes.co.uk/

The company are based in Oxfordshire.

I have a few vials of Clinitias Soothe left - would you like me to send you them? Send me a pm if so.

[Rojzen]

preservative in Dwelle

http://www.dryeyezone.com/talk/showp...52&postcount=2

The link above will get you to Dr. Holly's discussion of the preservative used in Dwelle, and why it is not only non-irritating, but potentially even therapeutic. I believe that Clinitas Ultra 3 contains not only Dwelle's polixetonium (the preservative), but also disodium edetate dihydrate. I am not sure whether that latter preservative has been addressed by Dr. Holly, but I believe that we have had some posts here that would support that disodium edetate is certainly not harmful in the way that BAK is.

I would also consider that many eye doctors who are at a loss regarding how to help dry eye patients will emphasize one or another strategies, not always in a really balanced and scientific way. For example, some doctors will prescribe rather long courses of unpreserved steroids, careful to exclude the preservatives, but not so focused on the dangers of the medication itself. In other words, if you look at the potential healing benefits of Dwelle or Clinitas Ultra 3, both of which are preserved in very benign ways, and compare them to the absence of proven healing benefits in a product like completely unpreserved Refresh artificial tears, the benefits of the preserved products may hugely outweigh any benefits from the unpreserved product.

There are bona fide cases of hypersensitivity to preservatives, but in my experience, these not-so-common cases do not warrant a blanket warning against any and all preservatives in products used for dry eye.

Also relevant is the fact that Dwelle, in particular, has a serious track record of facilitating the healing of corneal erosions, in which a patient's corneal tissue is very delicate and very stressed. I sense that if polixetonium were risky to the corneas in any way, such excellent results would not be possible.

[stella]

Hi folks
I have just about decided to stop the clinitas ultra 3
As you know i was going to give it a 6 month trial - i have been on it for nearly 3 months
I am becoming more and more convinced that while it is good for the eye surface, it is irritating to the inside lids and the lid margins - My eyes are not as good as they were and i think it is maybe a vicious cycle --- My already inflammed lids due to chronic bleph always sting when i put in clinitas , this means they are irritated by the clinitas ; this in turn causes my meibomian glands to be more dysfunctional and so i do not produce oil and my tears evaporate causing further dryness of my eyes - that is my analysis
The clinitas eases the dryness temporarily but because of the flare up of the blepharitis they dry out more quickly
Tonight i tried my old pf free celluvisc and it was a relief to feel it soothing to the lids. I also put a v light smear of vasaline on outer lids (not on margins - 'though i continue to use antibiotic ointment to lid margins at night)and that helps definately

I really would like to give Dwelle a go - are they available yet from Rebecca's shop ?

[Rojzen]

possible interference by petrolatum?

Wondering, Stella, whether you have ever used Clinitas Ultra 3 at a time when you were not on a regular antiobiotic ointment for the lid margins. . .

I used to apply nonprescription petrolatum-based dry eye ointment to my eyes daily, for an extended period, and during that period, I could never benefit from any kind of eye drop, because the petrolatum blocked the drop's access to my corneal epithelium, and the drop just dissipated or drained off. More importantly, I found that the ointment would eventually coat the lid margins, and then slide down below the eye, and that lid hygiene was futile, with all the glop filling up the gland orifices.

In other words, I wonder if it might be possible to see whether the Clinitas Ultra 3 still irritates your eyelids when your lids and margins are not dealing with the very long-lasting residue that the ointment in a topical medication may leave.

[dianat]

Rojzen,

If Rebecca ever needs a spokesperson to represent the Dr. Holly line of products, I think you should be elected! The only person who understands them better is Dr. Holly himself...

Good to see you and happy new year!

Diana

[stella]

That's an interesting thought Rojzen-
I may try a lay off of the ointments - after we return from Tenerife (we are going to the sun for a week and i would'nt like to rock the boat whilst in foreign parts )
Actually my eyes are the most comfortable following lid hygiene ,then application of ointment, and that is applied last thing at night and lasts well into the morning then i start to feel dry itchy scratchy and sore and the i would start drops - so it is hard to stop something you feel helps
I dont put ointment into my eyes - just on lid margins and outside lids (of couse it must seep through )but i can always see enough to read in bed,and i find that i can open my eyes MUCH easier in the am

O help - lets face it - I dont know, and like everyone else - I muddle through trying this and that and just pray for strength to get through a day at a time
Well at least i can be thankful i have still got my sight !!
I always look as if i have been crying though, small red puffy eyes

[Rojzen]

thanks! the ticklish issue of noncompliance and antibiotics

Thanks, Diana! Always great to see your sunny countenance! I also appreciate your not feeling saturated by all my posts about Dr. Holly's drops. I owe so much to Dr. Holly that it comes very naturally to spout off about this whenever possible (:^)...

I want to say to Stella, along the way, that by suggesting a trial of Clinitas Ultra 3 during a period when ointment isn't also in use I am not saying that the medication carried by the ointment should be set aside, especially if it is helping and continues to be prescribed. In a more perfect world, we could get the meds we need delivered in a variety of forms. . .I know that doxycycline can now be made in liquid form, and that a whole array of other ocular antibiotics also come in liquid form, but sometimes the precise one we need may not be available in the form we need it. Then we are presented with a dilemma...

That said, I have to confess that even though I accept that some antibiotics can alter the consistency and content of meibum, and also may fight subacute deep tissue infections in the lids, I have concerns about the permanent chronic use of antibiotics in any form. Hence, while I once had a doctor who wanted to keep me on oral tetracycline indefinitely, for what he felt was ocular rosacea, I ultimately went my own way, and discontinued the drug, after learning about a study that closely associated prolonged oral antibiotic use with breast cancer.

Again, I would not advocate this kind of noncompliance as a general matter, but there usually comes a point in medical care where the patient is more alert to treatment response than is the doctor. At this point, a certain empowerment can kick in, and new directions then present themselves (:^)). . .Again, in a more perfect world, our doctors would be omniscient; but until they are, it is a blessing that we retain our own good judgment, and our ability to dig deeper...