Alphagan P, Anti-inflamatories, Conjunctivitis and Dryeye (Post Lasik)

[Aaron77]

When I take Alphagan P I find that my eyes get really really white after being bloodshot with very visible veins, it also seems as though the burning sensation that I often get seems to change to what I feel as a tight feeling in the eyes. This tight feeling seems to bother me less than the itchy feeling when the eyes are red but its still quite bothersome. I don't like toaking to much of this stuff as I think it may act to make my dry eye worse, same thing with allergy drops like patanol.

Is ones reaction to Alphagan P somewhat indicative of what there eye problem might be?

Are there anti-inflammatories out there that can act to bring down the inflammation and redness in the whites of the eye?

Had punctal plugs put in a couple of weeks ago and they seem to be helping. I did have good tear volume it was just the TBUT that seemed to be the problem. Worried that the punctal plugs may just agitate allergies by keeping contaminates in the eyes for a longer period or that they may even result in less tear production.

I often think that my problem my be with the conjunctiva and the fact that its not very healthy at the moment. The surgeon that did my lasik surgery really jammed the sepculum in hard, I had major bruising in both eyes around the cornea. I remember it hurting the most in my right eye and now this is the eye that seems to be giving me the most problems. I'm thinking that this may be one of the main reasons why my eye hurts so much. 5 1/2 months out of lasik now, I feel that I've improved considerally in the last few months but that I still have a lot of room to go. I still have ups and downs and many days when getting out of bed is extremely hard to do. Hopefully it keeps getting better, much better I hope!

Practically any ocular surgery that uses a sepculum(keeps the lids seperated) causes trauma to the conjunctiva. The conjunctiva is where most goblet cells are replenished. Goblet cells are responsible for mucin, without mucin there is no interface to hold tears to the ocular surface.

As for limbal cells, many pterygium surgeons know that using limbal cells at the wound of the pterygium surgery speeds healing.

[Lucy]

Aaron, I hope you're taking Alphagan under the direction of your eye doc. I'm glad you had plugs put in. You need to give them some time to work and let's hope that's the case.

You sound much better than you did just a few short weeks ago. Are you taking the Alphagan so you can drive at night? For me, I took it just one time to drive after dark and I was so sorry for doing that. I never used it again because it burned my eyes badly and left them more dry.

You are still really just a short time out from Lasik and you'll continue to do better. Lucy

[Aaron77]

The Alphagan P might make a bit of a difference in my night vision but the main thing it does for me is make my eyes really white. So if I only had one little thing to do in the day and it would only take a couple of hrs I might take it to keep the red out of the eyes but I don't think it does much good for me in the long run, may be making my eyes worse.

Do Anti-Inflammatories like Minocycline do a lot for redness and pain?

My biggest concern right now is the eye pain, redness and itchyness witch seems to drive me a bit mad and I think gives me a feeling of being off balance.

just to note, my eye measurements are:
Right Eye: +.25 -.25 007 Shirmers 20 TBUT 3-4 Secs
Left Eye: +.50 -.25 071 Shirmers 15 TBUT 5-6 Secs
Even with the high shirmers values I still had plugs put in after these measurements were taken 2 weeks ago, they seem to give me a bit more comfort but not a whole lot.

[Lucy]

Aaron, you need to give the plugs more time and i think to forget the Alphagan. If the plugs were two steps forward and the Alphagan is one step back, you are not doing yourself any good.

I know you, and everyone wants to have white eyes. You really need to deal with the pain and vision before going for the red. I hope everything goes well for you. Where are you getting the Alphagan? Does your doc approve? Sorry for the inquisition. I think you're hurting yourself with this stuff. Lucy

[Gretchen]

Bromonidine not a good idea.

Hi Aaron,

Unfortunately, Lucy is right. Alphagan is not a good idea. It is a vasoconstrictor, with a mechanism somewhat similar to the dreaded "get the red out" drops. It will cause rebound redness and pupil dilation. Just not good for you right now when your eyes are still healing.

I have ocular rosacea and know that it is difficult to not get OCD about the eye redness thing. But really eye redness is an indicator of inflammation. Get the inflammation under control and a great deal will fall into place - pain, photophobia, redness, etc. From your measurements, it sound that you are having issues with the lipid layer or your tears, not the tear volume itself. So you may want to search the boards for folks dealing with MGD. For inflammation, there are many things to such as doxy, azasite, steroids, restasis, etc.

But Alphagan P, no. Vasoconstrictors can lead to a loss of "tone" in your eye blood vessel walls leading to severe and persistent rebound redness. In the long run, your problem will only get worse.

Keep the faith. From your post progression, it sounds like you are getting better.

Regards,
Gretchen

[gz9gjg]

Hello Aaron,

Any vasoconstrictor, including Alphagen, "Clear Eyes", etc will cause dryness and will have rebound effects. That is, your eyes will appear more red after stopping their use.

Redness is a fact of life post-LASIK. The best way to deal with is improving your tear quality and quantity. That may be with warm compresses, flax seed oil supplements, wearing a sleeping mask, using a humidifier at night, and/ or using Dr Holly's Dwelle or NutraTear drops. Get sunglasses with gaskets to use when outdoors, to keep moisture in and dust out. Having plugs may help short term, but they generally do not improve tear quality, only quantity.

I find that wearing RGPs helps because they hold tears against the cornea.

Good luck,

Lynne
Phoenix, AZ

[Aaron77]

Just found out today that the lower punctal plug in the right eye was missing. Surgeon I saw today cauterized it, he says the cautery should only be temporary and that it should open back up again in a month or so. So that might explain why the right eye has been so much worse then the left.

Been on the computer a good deal as of late, the eyes still bother me a good deal but not to the same extent as a few months ago. The sharper pains have seemed to diminished quit a bit. When I've been staring at the screen for quite a while I feel as though my eyes get swollen with a somewhat thicker tear film and my face muscles seem to just kind of go numb, it feels and looks so un-natural. Lasik really does weird things to you.