Question about steroid drops and eye pressure

[DryEyeBrian]

I'm 22 and went to an ophthalmologist for the first time recently to get some help with eye dryness/redness that was caused by Accutane.

The doctor measured my eye pressure and prescribed me to the following regimen:

1. Prednisolone acetate (steroid) 4x a day for two weeks
2. After those two weeks, start using Restasis 2x a day and reduce the steroid to 2x a day for 4 more weeks.
3. See her again after these 6 weeks.

I have been using the prednisolone for 6 days now. It seems to be improving the redness. But I read on the included sheet that you should have your eye pressure checked if using it longer than 10 days. 6 weeks is a LOT longer than 10 days, so it has me concerned. The last thing I want is glaucoma when attempting to treat a lesser issue...

Should I be getting my eye pressure checked or is there some reason she doesn't think this is a concern for me? Also, do I have to see an ophthalmologist to have my eye pressure checked or can an optometrist do it? It seems like her schedule is always booked, so the 10 days would likely be past by the team I can see her.

I'll probably call the doctor's office tomorrow, but I was hoping for some additional insight from those of you here.

[unicorn]

Absolutely get your pressure checked within 10 days. I was on Dexamethasone steroid drops 4x day, and within 2 weeks my eye pressure had risen to 40 in both eyes as I'm what's known as a 'steroid responder' - about 1 - 5 % of the population are. (Btw I used Timoptol drops to reduce the pressure, and touch wood I'm now fine, pressure wise!)

You can go to any optometrist (optician) to get your pressure checked - at least here in the UK, I don't see why it should be different elsewhere.

By the way I didn't experience any symptoms from this drastically raised pressure - all the more reason to get it checked.

Good luck!

[DryEyeBrian]

Thanks for your help! Glad you were able to successfully recover from the pressure increase.

[littlemermaid]

Should I be getting my eye pressure checked or is there some reason she doesn't think this is a concern for me?

Sounds like she is taking a risk with your eyesight by neglecting to advise you to get the eye pressure checked. Lucky we have the medical information ourselves.

In UK they are introducing data tracking which will show up errors like this when there's been harm. As Unicorn says, any Optometrist can check our eye pressures. A non-contact tonometer is best for dry eyes.

Are you using warm compresses every day, Brian? And tear substitute eyedrops to get comfortable?

[libralady]

Hello, As other members have said yes should get your pressures checked when taking steroids. Some people are steroid responders like myself. Usually once the steroids are stopped the pressures return to normal but it is better to have them checked so that pressure reducing drops can be given if necessary. Hope all goes well.

[DryEyeBrian]

Had the pressure checked and it turns out it has elevated to 25 from a measurement in the teens before the drops. I am now switching from prednisolone acetate 4x a day to Lotemax and restasis 2x a day. I'll get another IOP measurement in a couple weeks. I'm really glad I went in and had it checked...

Thanks for your help.

[Jow]

Brian,

I also have dry eyes from accutane. I'm 22 as well. How are you holding up? This hit me in October, it's gotten better but it's still annoying. Not many on this site that have it from accutane.

Josh

[DryEyeBrian]

Brian,

I also have dry eyes from accutane. I'm 22 as well. How are you holding up? This hit me in October, it's gotten better but it's still annoying. Not many on this site that have it from accutane.

Josh

Hi Josh.

It turns out that the optometrist I visited for the IOP test had a "technician" that was helping who caused a corneal abrasion on my right eye when she was doing a pachymetry test (corneal thickness measurement). I didn't notice until after my previous post, when the numbing stuff wore off. It hurt like HELL and I couldn't see in that eye for days. Fortunately, it healed up and my eyesight is back. I think accutane has caused some major problems with my eyes that makes them respond negatively to some of these treatments and tests.

My ophthalmologist contacted some other ophthalmologists and dermatologists for input and unfortunately they told us that my dry eyes from accutane may be permanent (very difficult thing to hear). She gave me a list of some treatments I can try (home, prescription, and surgery) and sent me along my way.

Currently I'm doing flaxseed oil 1000mg/day, using Soothe eye drops, and doing some warm compresses at night. I think the Soothe eye drops are working better than Refresh Optive, but I have good days and bad days.

Overall, I think my eyes are dryer and redder since I started that steroid treatment...

I just wish there to be something out there that is the anti-accutane and could reverse the process. I would take the acne any day over the red eyes. Acne is much more manageable than dry eyes...

How are you managing?

[Jow]

Yeah dude it sucks. I hadn't heard that news explicitly from a doctor but I figured as much. Although, it seems weird... I've been off accutane for 2-3 years and I never really had dry eye symptoms until this past October. And since then I've made decent improvements. I guess maybe my body finally stopped producing so much oil on its own and now I have dry eye symptoms? Who knows. Seems like there has got to be a way to kick our bodies back into teenage levels of oil production, haha!

Anyways, right now the only thing I'm doing is taking Costco fish oil and "biotears" (google it) as recommended by Dr. Carver here in Socal. I went on it for 2 months, felt pretty good, and recently starting slacking on it and this week has been a little rough on my eyes so I'm going back on it. Expensive crap though! I can't do warm compresses (increases inflammation for me) or lots of drops which seem to always be short term relief only - like 15 minutes or so and I'm worse than before.

I'm experimenting with overnight stuff, cause I do like to put in drops before bed, but can't seem to settle on something that I like. I've decided that I hate all ointments, and right now I'm currently trying to find a good preservative free gel drop. I have tranquileyes, but stopped wearing them and haven't really noticed a change. With or without I basically wake up with super dry eyes which feel better after a minute or 2.

Other than that, sleeping well and trying to stay away from situations which make my eyes hurt.

I'm sort of lucky as I don't have it horrendously bad like some dry eye sufferers - I can still work 8-12 hrs days at my job on the computer (advil assisted sometimes), ride my bike on the weekends etc. I just can't stand heat, excessive a/c or fans blowing, etc.

I'm still trying to figure out why I can ride my bike for 6 hrs on the weekend and not think about my eyes but if I go to lunch and we sit outside my eyes are bugging me after 30-40 minutes. Must be cause I'm sweating when I ride? No idea.

Josh