R E S T A S I S

[clairvoyant]

Ok, I have gone to some extremely good eye doctors. 4 in particular I feel are among the best in the country as far as dry eye is concerned. Although I think Dr. Latkany, who I haven't seen is probably leaps and bounds ahead of them.

Each one of them, even ones suffering from and having complete control of their condition reccomend restasis. From what I have seen it seems like Dr. Latkany prescribes it too.

Now there seems to be alot of controversy over the product. Some saying it disrupts the mucin layer(or something there about), some saying it increases inflammation and even more saying it decreases it. Of course that is all in relation to the castor oil. I'm sure most will agree the cyclosporin is therapuetic.

So the tipping point for me seems to be the discrepancy between all of these negative claims and the fact that alot of well respected doctors prescribe this.

I have a guess on why this would be and would like some input from people who have been wondering this same thing.

I think that castor oil can add inflammation and may even be toxic but I think what most doctors think is that it serves as a 2 fold medicine. Where in if the patient uses it as directed then over time it will (the castor oil) actually decrease inflammation. I think it might even be theraputic for blepharitis. It seems it is just not talked about because of the initial inflammation it causes, the controversy and the phenomenon of it showing toxicity but at the same time curing (and I use that losely) people of this disease.

So I think it is one of those unexplained things(they don't understand the exact mechanism of how it works but it does) that seems to keep some people symptom free if they are on restasis and doing evertying else. I.E. hygeine, exercise, compresses, some what conscience of diet, artificial tears, keep skin disease at bay, ect.

Now I have learned that you really have to be on your toes when it comes to this stuff because medicine that seems like something perfectly safe, intended to help your condition can in fact worsen it. Doxycycline is a perfect example of this.

So my advice is listen to your doctor but sometimes you have to pay attention to detail and be very apprenhsive when it comes to your health.

The other conclusion I have come to is they're pharamceutical drones (I mean that with the upmost respect) and they have financial interest in prescribing restasis. BTW I could be completely off here but figured I would post the idea and see what others thought.

Thoughts and comments plz

[curlygrl31]

Great post. I think what I am learning is that I need to be in charge of my own health. Like you, I have been to multiple docs who recommended drops, drops and more drops. Well, went off all drops (including Restasis which I had been on for two months) and I have been better the past few days (less redness/inflammation). Too early to say, but I don't think Restasis was helping... for me, it seems to have been making things worse. Interestingly enough, when I was telling the eye docs that the lubricants & Restasis were increasing my redness, they just kept telling me to "press on."

After 9 months of redness, soreness, frustration and depression, I think it is most important to make some of my own decisions as to what works for me. I believe Restasis had a negative effect for me.

I also love these boards to get an idea of what patients are really saying. Most importantly, what is WORKING!!! I know for me, if I find what works... I will share it and share it! Pay it forward!

Curlygrl

[indrep]

I think if you read the Restasis insert that comes with the med you will find that it only helped 15% of the people that it was "Intended to Treat". 17% were more irritated.

Restasis is an antiinflammatory ONLY. Restasis needed five trys to get approved by the FDA. It was approved on the last try by including patients WITH Punctum Plugs.

Restasis works on patients whose lacrimal or meibmian glands are constircted due to inflammation. It does not induce the glands to produce more aqueous or more lipids.

Restasis can be great for those people who can intenditfy that they are going to have Dry Eye issues soon (Refractive Surgery Patients) or those who by some incredible luck are prescribed Restasis before they have any symptoms of Dry Eye Disease. Unfortunately if nthing is done to stop the proinflammatory environment that hyperosmolarity of the tear film creates then you will be on Restasis forever and then the negative aspects of the medicine itself will come into play.

Restasis has its place unfortunately it is not for most Dry Eye Disease sufferers. The reason docs prescribe it so much is they want to help and based on their limited knowledge of the disease and the treatments as propogated by drug companies they think this the best they can do for patients.

[Rebecca Petris]

Each one of them, even ones suffering from and having complete control of their condition reccomend restasis.
...
The other conclusion I have come to is they're pharamceutical drones (I mean that with the upmost respect) and they have financial interest in prescribing restasis.

There is more than one way of being a pharmaceutical drone.

Truth be told, I have met doctors who actually boasted about where they stand on the list of Allergan's most frequent Restasis prescribers (and you'd better believe they get wined & dined a lot for it).

However in the vast majority of cases I don't think the issue is any direct or indirect financial interest in prescribing Restasis.

I think it's just that, by and large, this is what doctors know and do (prescribe drugs). Restasis is "there". It's ophthalmology's counterpart to Prozac, Ritalin, Lipitor and so on.

I remember a few years ago, I was exhibiting at a relatively small conference attended mostly by corneal specialists. I heard from several frustrated doctors who were saying things like "I prescribe Restasis all day long and I don't even know if the darned stuff works!". These were doctors who really wanted to do well for their patients and were frustrated that there were not more choices available to them.

[NYer]

... who I haven't seen is probably leaps and bounds ahead of them.

MGD, Dr. L prescribed Restasis to me last week...clearly because it was simply worth a shot - for no particular specific reason that I'm aware of. Nothing else has helped, although I haven't exactly been given all that many other options yet. But I guess it was the easiest next thing to try. I mean who cares if MY eyes get irritated - they're not HIS eyes.
I'm not going to use it. I don't know about "leaps and bounds". And I'll just leave that point where it is.

[Redbirdi]

This discussion is helpful…

This discussion is helpful…

Thanks for this thread and the comments here. I am still most unsure about this product. I’ve been using it for a few years and I still dislike it. Not sure that it has made any difference for good and find it most annoying and irritating to use. My doctor has insisted I continue to use it, so what can I do?

I’m looking forward to trying the Dwelle, but unsure if I should discontinue the Restasis for a few weeks and see if there is a difference? I am willing to do this if it is known to be helpful.

[HOSADOS]

MGD, nice call. I feel the same way, and I would take a wild guess that every patient eventually-sooner or later reach to that conclusion.

As for Restasis. My personal expereince suggest that there is a problem with this drug. After 15 minutes or so after I instill it, I start to feel drying sensation, and I also feel that my glands get blocked ! I think the blame is on the castor oil !!! I also feel that some that it (castor oil) become solidified and stick to the glands the internal lid, and I have no doubt it cause demage to my eyes. Hence, I started cleaning my eyes with baby shampoo 20 min or so after Restasis and then clean my eyes with water and that help. On this note, I baby shampoo also cause demage but this is a different story ( I would say that when it get into my eys it inflame it even if it's a very little amount).

To examine this issue once and for all, and also to improve my health I've decided to find an Ophthalmologist that would be willing to prescribe me with Cyclosporine without the castor oil vehicle and recently I found one !
he prescribed me with cyclosporine 0.05% just like in Restasis but with a vehicle in a form of gel that doesn't burn or sting the eye or irritate it- at least so he say. I will test it as soon as I recieve it and report my experience.

Not only that but it's actually way CHEAPER !!! it's 30% of the price of Restasis...and I guess this would my much better for my conditino.
On this note, I must say that I suffer from DES, MGD and Blepharitis among other things, so my experience is probably also subject to my specific diseases.

Finally, if I'm not mistaken, Dr. Holly of whom I 'm a big fan ! argue that all type of oil are bad for our eyes and I think he was referring to castor oil as well in particular he one has MGD. The best would be to ask Dr. Holly on this one. Here is a quote from Dr. Holly's Q&A forum

timewise apart it is probably a good idea for you to use NutraTear because it would repair the damage the restasis and its vehicle does to the ocular surface. Afterall, it is an emulsion of Castor oil, a mucous membrane

http://http://www.dryeyezone.com/tal...light=restasis

[clairvoyant]

I had a doctor recently tell me castor oil and petrolatum are toxic. Then I said well what about restasis and refresh pm. She then assured me that it was ph balanced and perfectly safe.

She reccomended genteal gel rather than refresh pm, though.

Now that I have put more thought into this and read or remember reading something about oitments being detrimental to the glands, I have come to the conclusion that this is what one should be worried about. I do not think the castor oil in restasis is toxic. Might it be detremental to the glands? That is another story.

Maybe stuff like refresh pm will clog those glands and maybe the castor oil in restasis will do the same? I am pretty sure about the oitments, not so sure about the castor oil. Anyone have a link to those study's off hand?

My expierence has alot to do with my routine for the day. If I shower then use restasis and eat a very light breakfast 30 to an hour after the restasis I get superb results. Compress > shower > restasis > hour > eat, also yields great results (probably better than the previous). Eating prior to my routine seems to hinder it a bit but is still effective granted I get a good compress in and am not fooling around on the computer.

[GinaJ]

Imteresting. I was told by one of my eye doctors that the reason more people don't see benefit is cause they don't stick it out long enough since it takes at least 6 weeks to see any difference. Also because many people for the start have what I did and why I quit but am going to try again that gritty/burning. I am confused though I thought restasis was to produce more tears but does it also help with infection like blepheritis?