DHEA drops and aqueous deficiency?

[Julie1]

I have been reading about the DHEA drops on this website over the past few days, and it seems that the DHEA drops seem to help MGD problems due to androgen deficiency. I really wasn't able to find any information about DHEA and aqueous deficiency. Does anyone know if the drops help that component of dry eye?

I have a severe aqueous deficiency with some MGD. I'm also 26, so I don't believe that I have a hormonal deficiency. I was just curious if anyone knew if androgen levels are related to the quantity of tears not just quality.

Thanks!
Julie

[Eileen]

Hi Julie,

I believe that researchers have determined that the lacrimal glands have androgen receptors so one would assume that DHEA or testosterone would help aqueous deficiency IF hormonal deficiency is the cause of one's aqueous deficiency.

I think the key question is "Do these androgen eye drops consistantly create enough of an improvement for the patient to feel subjectively better"? Some people will improve and others will not notice a difference. It's worth a try to find out.

Eileen

[Pinky]

DHEA drop and aqueous deficiency

Hi Julie,
I read a brief summary about Dr. Sullivan's work that stated that his research demonstrated the role anndrogens play in regulating the lacrimal and meibomian glands. Also, a study I found by Connor CG, Fendes J "Comparison of Androgenic Supplemented Articial Tears", showed that TBUT and shirmer test results improved with DHEA - supplemented tears. The study concluded that dry eye patients may benefit from the addition of androgenic hormones to artifical tears. It didn't say that it was only beneficial to those with MGD. In fact, I don't think it mentioned MGD at all. If you want to check out the info go to Review of Optometry and search DHEA.

Eileen: Thanks fo the info, probably no hairloss, one less thing to worry about!

[kaypeeoh]

I tried DHEA eyedrops a couple years ago. I had a 1-2 second tear breakup time. Restasis brought it up to 5 seconds, not enough to allow wearing RPG contacts. I didn't use the drops for long. The drops are a cloudy white color. If I used the drops at bedtime, I woke up the next morning with thick, white crusts pasted to my eyelids. At that point I was giving up on contacts so didn't continue using the DHEA eyedrops. They might have worked if I had used them longer. The white crusts adhered to my eyelids enough that it was difficult to rinse them off.

[Pinky]

DHEA drops and crusts

Do you think the DHEA drops would leave crusts if they are used during the day? I would like to avoid crusting at all costs as my eyelids are easily irritated and difficult to keep clean.

[Julie1]

Thanks Eileen, Pinky, and Kaypeeoh for answering my question.

I was thinking about the hormone deficiency issue this weekend, and I really wonder if I even do have an androgen deficiency as I am 26 years old and still have moderate acne (which is controlled by minocycline at this time). I would think that if I had an androgen deficiency that I would have clear skin or at least mild to no acne. However, my dry eye problems started at the same time that I was on spironolactone and ortho tricyclen lo (both of which I think reduce androgen levels). There seems to be a correlation between the medications and the onset of my dry eye, and the doctors cannot figure out what caused my dry eye other than "some underlying condition." I guess maybe it is possible to have low levels of androgen in the eyes and higher levels throughout the body. I guess trying the DHEA drops are worth a try as long as the risks are low.

Julie

[Pinky]

DHEA and crusting

Thanks Eileen for your private email reply, you are a Godsend!

I talked to Charles Leiter at Leiter's Pharmacy for his feedbback on side effects from DHEA drops. He said most people experience transient stinging. Also, because the drops are a suspension they are grainy and can leave a residue which is easily wiped off. He did say that they have recently improved on the formula so that more people can tolerate them (not sure when they did this though). He said there has been no reported hair loss or eyelash loss. He said that many people have really benefited from the drops. He recommended that I try the 1% four times a day. I notice that there is also a .5% concentration. Just wondering what most people are using?

Julie: Re: androgen deficiency: Like you I had mild acne as a result of rosacea and was on minocycline until I recently switched to doxy when I got severe DES. I can tell that androgen is a factor with my acne becase it acts up about a week before my period when the lower side of my face suddenly becomes more sensitive. I read once that this can be a sign of androgen induced acne. However, I don't think that this would mean that I am not a good candidate for DHEA drops. I plan on giving them a try. I will report my results to the group.

[Julie1]

I hope the DHEA drops work for you, Pinky! I just read your question to Dr. Latkany. Maybe you should ask him if he has noticed what types of people (i.e. age-related, type of dry eye, etc.) do better with the DHEA drops. I wonder if he can identify who would benefit from the drops. Just a thought.

[Dry-eyed-suzy]

Hi,
I've been on C-DHEA 0.5 % P.F. CMPD OPH. eye drops for a week. They sting & I'm not sure if they work yet. Might be a bad batch. They are compounded by a firm called Leiter's in San Jose, California. Tried Progesterone drops last month. I'm 45. Noticed my DES about 6 months ago but it may have existed prior. Can't say the prog. drops worked well since I am also on progesterone only birth control (for hot flashes etc). I'M NOT MENOPAUSAL. I've explained this to many doctors. low hormone levels & perimenopausal. Never had lasik, never done contacts, have no idea why I have MGD. I have atrophied glands in one eye. no tears at ALL. trying everything since there are crazy pollen levels here. basically burning my face with this eye mask to get oil out. I do have crazy allergies which are under control by various drugs. or I thought they were. This is frustrating to mein that some of these "cures" have been around since 2004, but 2 ophthalmologists I saw have no idea about the DES/MGD field & did not care. they just want to cut on cataracts. * Why isn't more research being done to make our lives better? Is it because it's not sexy or lethal like breast cancer???!! I can barely drive my kids to soccer practice due to blurry vision. Maybe we should get car insurance companies to pay for our cures?! ok rant over. I was hoping to find more info on effectiveness of these hormone eye drops, but nobody seems to know much. At least I found an ophthalmologist that attacks this on multiple fronts. (since she has DES!) I am scheduled for lipiflow later. It will cost me $1700. insurance does't pay for it. why? again, there is no $$ behind research or advocacy for DES or MGD. very frustrated with rich, lazy ophthalmologists these days. and the FDA. new to this arena, but geeky enough to read as much as possible & not go down without a fight. - s

[Max]

No eye doctor has reccommended anything other than restasis

Restasis does not work for me at all. I am currently using bandage contact lenses that are mostly water and are disposable every night. I have to change the lenses after four hours so I wear two sets a day. They often feel irritating and sometimes just pop out.

I am post menopausal. I've had dry eye since my youth, was being treated with punctal plugs and vials of hypoallergenic artificial tears. I was told I needed cataract surgery and the surgeon suggested Lasik as well - that caused serious dry eye; virtually no malbomian gland activity and painful dry eye syndrome. My vision is nolonger correctable with glasses. The dry eye is not improving over the years.

I despise the the artificial tears that leave my eyes gritty and glued together. My eye doctor has not recommended any new treatments at all.

Does anybody think an oral DHEA might help? Would love to get opinions before I try it.

Thanks, Max

[Amanda]

Hi,
I've been on C-DHEA 0.5 % P.F. CMPD OPH. eye drops for a week. They sting & I'm not sure if they work yet. Might be a bad batch. They are compounded by a firm called Leiter's in San Jose, California. Tried Progesterone drops last month. I'm 45. Noticed my DES about 6 months ago but it may have existed prior. Can't say the prog. drops worked well since I am also on progesterone only birth control (for hot flashes etc). I'M NOT MENOPAUSAL. I've explained this to many doctors. low hormone levels & perimenopausal. Never had lasik, never done contacts, have no idea why I have MGD. I have atrophied glands in one eye. no tears at ALL. trying everything since there are crazy pollen levels here. basically burning my face with this eye mask to get oil out. I do have crazy allergies which are under control by various drugs. or I thought they were. This is frustrating to mein that some of these "cures" have been around since 2004, but 2 ophthalmologists I saw have no idea about the DES/MGD field & did not care. they just want to cut on cataracts. * Why isn't more research being done to make our lives better? Is it because it's not sexy or lethal like breast cancer???!! I can barely drive my kids to soccer practice due to blurry vision. Maybe we should get car insurance companies to pay for our cures?! ok rant over. I was hoping to find more info on effectiveness of these hormone eye drops, but nobody seems to know much. At least I found an ophthalmologist that attacks this on multiple fronts. (since she has DES!) I am scheduled for lipiflow later. It will cost me $1700. insurance does't pay for it. why? again, there is no $$ behind research or advocacy for DES or MGD. very frustrated with rich, lazy ophthalmologists these days. and the FDA. new to this arena, but geeky enough to read as much as possible & not go down without a fight. - s

They stung for me as well! I told my dr. and she recommended I put them in the refrigerator. I did that yesterday and used them this morning with no sting!

[Amanda]

I am aqueous deficient with a slight MGD. I like to clarify that first b/c I think it makes a HUGE difference in what treatment might work for each person.

For example, I tried doxy and I don't think it really works for me. I am using azasite at night just on the lids and I do notice a difference from that so I continue using it.

I just started using 1% DHEA a few weeks ago 2x/day and I am not sure if they are helping, but my dr. wants me to stay on them for at least 3 months to see. She said the longest she has had a patient on these was 2 years. I think I notice some relief from these already in symptoms (burning and discomfort, mainly).

What has helped most is closing all 4 ducts (plugs in the bottom, cautery in upper).

I will try to remember to update my progress with these drops in a few months!

[Amanda]

the DHEA drops have been stinging more and more. I put them in the refrigerator and they still burn/sting when I put them in. For awhile I was not concerned about this, but lately the left eye has been stinging ALOT...more than what I am comfortable with in an eye that already has so many problems. Has anyone else had this experience. I intend to email my dr. today as well as call Leiters. When I first asked my dr. if any of her other patients had stinging/burning with this she said no...hmmmm.