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should I use the lotemax gel that my doctor prescribed for my blepharitis

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  • should I use the lotemax gel that my doctor prescribed for my blepharitis

    I've had this eye problem where I can't look at screens for too long or else my eyes start to hurt. Having had this issue for around 9 months now, I went to the doctor and he said I had severe dry eyes and blepharitis. As a solution, he said to do 4 things: use 4 eye drops a day, get a humidifier, take omega 3 supplements, and use Lotemax (loteprednol etabonate) ophthalmic gel 0.5%

    From doing some research online on blepharitis, I can not find any sources that say you should use lotemax gel when you have blepharitis. So should I listen to my doctor and use this gel, even when it seems that this gel is usually not associated with helping blepharitis?

    Also, this gel is considered a Corticosteroid, which from my knowledge, simply acts as a pain reliever and not something that actually cures or get rids of the problem.

    Any thoughts? Also, I've read success stories where people use "wet ones" and that got rid of their blepharitis. Is there any dangers involved with doing that? It seems rather dangerous - who knows what chemicals are used in those and whether it'll hurt your eyes.

  • #2
    Hi Crammerstyle. Did the doctor by any chance press on your meibomian glands to see if you also have MGD?

    First and foremost, definitely DO NOT use Wet Ones to clean your lids. You are right that there are harsh chemicals in there not meant for the eye. Instead there are several wipes and foam lid scrubs available. I have MGD and blepharitis, and have found Ocusoft Lid Scrub Plus Foam works best for me. It was recommended to me by one of my eye doctors after minimal success with various eye lid wipes, because he said it has an antibiotic to help address the blepharitis, and that the foam version seems to work better than the wipes version, which it did indeed for me:

    There are several other lid scrubs and wipes available, including the one above in this forum's Dry Eye Shop below, (as well as on Amazon and elsewhere). Rebecca has some helpful descriptions listed for each that may help you decide which may be most applicable for you, and you can also ask your eye doctor for recommendations.

    Second, regarding Lotemax, it is fairly common for eye doctors to prescribe a steroid to reduce inflammation related to blepharitis and dry eyes. And Lotemax supposedly is one of the few steroids that does not immediately raise eye pressure, so more doctors seem to prescribe this steroid. HOWEVER...

    -Lotemax contains the dreaded preservative BAK, which can damage your ocular surface and cornea, and further compromise your existing condition. In fact, while on Lotemax, I had developed involuntary shutting of the eyes (blephospasms), which did not go away until a month after I stopped using it, so am fairly certain the BAK was adding to my eye problem.

    -Steroids like Lotemax also can promote cataracts. I recently was diagnosed with early stage cataracts for my age, and I suspect it was because I used Lotemax and other steroid eye drops.

    So if you must use a steroid longer term, perhaps ask to get a preservative-free steroid, but it will likely cost more. If you must take any drop with BAK, steroids, (or any other drop that also has potential negative side effects) longer term, my eye doctor agreed rinsing with preservative free saline 20-30 minutes afterwards may limit the negative side effects, while still getting the benefit of the drop. I use Purilens PF saline, but there are various brands and sizes:
    Last edited by Hokucat; 01-Oct-2017, 12:08.


    • #3
      Thanks for your response. From what you said, I am more hesitant than ever on using this lotemax gel to ease the pain, as I think it is bearable right now and not worth the risk. I also will probably look to use alternative cleaning method to using Wet Ones.

      I am still not sure however, so any more suggestions on lotemax or anything else is greatly appreciated.