Restasis after a few months of misdiagnosis

[rooneyandfergie]

Hey guys,

I have previously mentioned in a separate thread that i was diagnosed with glaucoma. I also mentioned that I have discomfort in the eyes especially when looking at computers and driving. My doctor gave me Zaditen and told me my eye surface was not dry. He said Zaditen had the same anti inflammatory qualities as Restasis which should help make the eye more comfortable.

I went back to him about a month ago and he was still like my eyes are free from any ocular disease. I said yes but they are still not comfortable. All he offered was a lame solution to switch glaucoma eye drops that cause less drying. But i already had dry eye problems before using glaucoma eye drops.

I finally got fed up and went to a dry eye doctor yesterday. I had a reading of 13 and 2 for my right and left eye respectively for my schrimer test. i was told my left eye dont produce enough tears.

My TBUT was like in the region of 3 seconds for both eyes. Can someone pls explain to me in simpler terms what all these numbers imply? Is it very bad?
Anyway i was given restasis and told to use it 2 times a day for 3 months. Hence what i am doing now is that i use a vial put in one drop into each eye in the morning. i then seal back the vial and put it in the fridge and use it one in each eye in the night. I would like to know if this is okay and if it is okay to refrigerate restasis. would it cause restasis to lose its effectiveness. the dry eye doc actually wanted to give me a mild steroid for a few weeks to tide me over till the restasis kicks in but i rejected it due to the possibility of it aggravating my glaucoma. Can anyone who has used restasis share with me his or her experience with it? How best to use it?

I was also given theratears eye nutrition. Has anyone had any experience of using it.? I was also given sodium hyaluronate which is to prevent further drying and damage to the cornea.

[painless]

I use Restasis the same way you do -- placing the cap back on and keeping it in the refrigerator for the day. Some people on this site continue using the same vial until it is empty; I discard mine at the end of the day.

TBUT = Tear Break-Up Time. Under 10 seconds is supposed to indicated dry eye. However, from what I've read here, any given TBUT score can feel better/worse to one person than it does to another.

All I know about the Schirmer (sp?) test is that it is apparently unreliable.

Many people take omega-3 supplements (which is what I think your Theratears thing is) for their dry eyes. I don't know how effective it is for most people, but it's supposed to be good for one's health anyway.

[Guest]

I put the cap back on Restasis after using it also... I use the vial until it's empty. I store the open vial capped inside an empty prescription pill bottle.

When I first started using it, I kept the open vial in the fridge... cold Restasis stung less... now that I've been on it for months, I no longer need to do that as it no longer stings very much.

[ryanross]

My eye doctor told me that you CAN put the caps back on the restasis and refrigerate them for 2-3 days of use. Bacteria grows at a much slower rate in colder temperatures, so it should be safe to use this long as long as you dont touch the cap to anything.

Also, I too have been using theratears nutrition for about 6 weeks now. Its not a miracle supplement, but it has helped me. My eyes generally feel comfortable during the daytime, although they still get dry while I sleep. It does take about a month to start working, and it is hard to tell when it starts to work because its effects come gradually. My eye doctor told me that it has surprised many physicians.

[rooneyandfergie]

My eye doctor told me that you CAN put the caps back on the restasis and refrigerate them for 2-3 days of use. Bacteria grows at a much slower rate in colder temperatures, so it should be safe to use this long as long as you dont touch the cap to anything.

Also, I too have been using theratears nutrition for about 6 weeks now. Its not a miracle supplement, but it has helped me. My eyes generally feel comfortable during the daytime, although they still get dry while I sleep. It does take about a month to start working, and it is hard to tell when it starts to work because its effects come gradually. My eye doctor told me that it has surprised many physicians.

Wow 2-3 days ! I didn't know you could use it for that long. But anyway I totally understand what you mean about theratears needing time to work as it has a gradual onset. However, I can't really tell if either Restasis or Thertears is working. I've been on both for close to 9 weeks now.

If anything, it seems that my dry eyes has been getting worse. I have also developed twitching over the last few days in my upper left eyelid In addition, my eyes seem to be pretty itchy recently. I don't know if it could be due to allergies.

[rooneyandfergie]

Went back for review recently after 3 months on Restasis

Recently, I went back to the doctor after 3 months on Restasis. Frankly, i don't know if my dry eye has improved in terms of the Schirmer score and TBUT but it still doesn't feel comfortable. It's still burning all the time especially when I am in an air conditioned environment using the computer. The doctor told me there was no need to do the Schirmer and TBUT again as what i felt was more important than the results of the test. I also noticed the inside of my lower eyelids are like always red. In addition i still have those aching sensations in my brow areas and sometimes twitching of the eyelids. The doctor believed that the twitching and aches were most likely due to dry eyes although the pain in the brow areas could also be due to sinus. Needless to say, my eyes also tend to be red most of the time. People have been coming up to me and asking me why are my eyes so red which has been pretty depressing. The doctor also told me pretty much nothing could be done about the prominent veins in the eyes which has been very discouraging. All she can do is to decrease the inflammation to make it less red and more comfortable

I was given 0.5% cyclosporine to be used 4 times a day without the castor oil. One of the side effects i had with Restasis was that my face will feel extremely hot and my ears will turn very red as if i was having a hot flash. Does anyone have similar experiences with Restasis. The doctor believed it could be due to the castor oil. Hopefully the increased concentration can help make my eyes more comfortable. However the cyclosporine sting real bad when i put it in. Its like putting needles in your eyes. Another drawback is that it has to be kept refrigerated which can be quite troublesome especially when you are on the go. It also makes my eyes red when i put it in although its just temporary. I've seen a few posts where people had have success with higher concentrations of cyclosporine. Hopefully, that works.

I was also given doxycycline for my MGD. Has doxycycline got the effect of making the eyes whiter? I understand its main mechanism of action is to kill the bacteria that may be causing the MGD. I have felt a bit of nausea and loss of appetite since taking it though i am not sure if it's due to doxy or some other unrelated reasons. Can anyone share their experiences of doxy? Has it been effective in treating MGD and improving the redness and lipid layer? Are there any effective means to reduce the redness of the eyes?

I also asked to the doctor to give me Naphcon A (allergy and decongestant eye drops) to use when needed. I seem to have hives sometimes below the eyelid area and i believe those are due to allergies. I skipped the punctal plugs as i was told by my doctor that new research showed that tear production actually decreased in some people after punctal plugs were put in. She said its part of the eyes natural reflex action to the insertion of plugs. This kinda surprised me as i have never come across such medical literature.

[Jan Baker]

Dear double name,

Regarding the doxycycline, two things: my investigation yielded the idea that not only should they not be taken with vitamins, they should never be taken with dairy, which interferes with the uptake completely, and it is better not to take them with any food at all, which interferes to some degree. I take mine about an hour before I go to bed, and the second when I wake up to use the bathroom, which is usually not eight hours later but more like six or six and a half. It should be twelve, I suppose, if taken twice a day. But my regular doc said she thought that should still be fine. I began to take the doxy at night because I take other pills during the day some of which might either mess with, or get messed with by, the doxyclycine.

The other thing is, you should be checked for vitamin D deficiency and then take the supplement if you are. And you should be deficient because you should be using a heavy sun block when you use the doxyclycline, or you can get skin discoloration from the sun. My doc said to tell the eye doc I should be on the doxycycline from fall to spring, and 'off' for the summer, so I can get some sun, and the doc (at U of Illinois Dry Eye Clinic) said that worked for him. Best of luck. I'm not out of the woods myself, and am waiting for my nine months of doxy prescription to arrive even as I type. It doesn't mess with my stomach so other than the pain of taking yet another pill I can't complain. And it's cheap.

[Guest]

... the second when I wake up to use the bathroom, which is usually not eight hours later but more like six or six and a half.

If you wake up, take your doxy, then lie down and go back to sleep right away, that would not be ideal... you should remain upright for 1/2 an hour after taking it because it can cause damage to your esophagus if it were to sit there too long due to your not remaining upright long enough after taking it. If I misunderstood and you get up to go to the bathroom then stay up after that, then don't mind me!

[Súil Eile]

I skipped the punctal plugs as i was told by my doctor that new research showed that tear production actually decreased in some people after punctal plugs were put in. She said its part of the eyes natural reflex action to the insertion of plugs. This kinda surprised me as i have never come across such medical literature.

I'd be really interested in this as I'm getting plugs on Friday. Do you know where that research is published?


My eye doc gave my Vividrin drops for 3 months to change the pH balance of my eyes to make them inhospitable to bacteria. I was a little sceptical at first but my blepharitis is now gone Vividrin is an over the counter drop for ocular allergies.

[Guest]

I skipped the punctal plugs as i was told by my doctor that new research showed that tear production actually decreased in some people after punctal plugs were put in. She said its part of the eyes natural reflex action to the insertion of plugs. This kinda surprised me as i have never come across such medical literature.

I've seen some abstracts about that also... I don't have the links handy though.... hmmm... I have a feeling the DEWS report might have touched on that potential issue... don't have time to confirm right now though

My thoughts are that you could always just remove the plugs if they didn't help or made things worse though (assuming they are not the intracanicular type)

[Súil Eile]

I must read through the DEWS report again so. I think it's worth the risk; as SAAG said they can always be removed. Although I guess it depends on the individual and it might not be suited to everyone.

[rooneyandfergie]

I must read through the DEWS report again so. I think it's worth the risk; as SAAG said they can always be removed. Although I guess it depends on the individual and it might not be suited to everyone.

Hi Eile,

I just saw your post and it's Fri today, so i supposed u may have gotten your plugs. When i asked my doctor if I put in the plugs and removed them later, would my tear production go back to normal, she said supposedly it should be.

But i guess the thing is that plugs are a very subjective thing. It works for some and others absolutely hate it. You do need to get the inflammation in your eye in control as i read somewhere that if you don't, the inflammation could get worse with the plugs.

Hopefully the plugs work wonder for u.

Hi Baker,

You're lucky that doxy doesn't cause problems for me. As far as i am concerned, doxy causes nausea and stomach upset for me. Perhaps it's because my doctor gave me the 100mg ones. I still have to endure 2 more weeks of doxy. SAAG is right. You shouldn't lie down or bend forward in the first hour of taking doxy as it may damage your esophagus. I bent forward once after taking doxy and it caused acid reflux. I could feel the doxy in my throat and it burned !!!! Even after taking tons of water, i couldnt stop coughing for the next 1 hour.