Breakthrough pain on Lotemax

[kitty]

Has anyone else experienced breakthrough pain while using Lotemax?

When I last used Lotemax a year or two ago, I had nearly 100% relief of my pain with twice daily dosing and the relief happened within a couple of days. This time, with four times a day dosing, it took nearly two weeks to get relief. I have also had side effects from the Lotemax (burning and blurred vision) that I did not experience previously.

I have had several days where I nearly forgot I had DES, then other days where my symptoms are about 50% of what they were. Has anyone else had a similar experience with Lotemax, with it working well one time but not so well the next? If so, what did your doctor say was the reason? Has the formulation of Lotemax changed or has my DES worsened?

[Teri]

I don't know why this happens

Kitty,

I have had similar experiences with other drops, not necessarily Lotemax. A couple of times that I used Azasite, there was no stinging and my dry eye symptoms were greatly reduced. There are other times when I've tried to use Azasite that the burning has been so intense that I had to flush it out of my eye, which had turned completely bright red.

It's happened with Restasis and a couple of other prescription drops: sometimes they sting and burn and sometimes they don't; sometimes they seem to "work" and my symptoms are reduced and sometimes they seem to make things worse.

I have no idea why this happens. I wonder if the quality control is not what it should be when they are making these drops (I hope this is not the case!), and I think it could also be that our eyes are changing and our condition is not static. There are other factors at work, like what other drops or medications you are using, allergy season, etc.

I wonder what would happen if you waited a month or two and got a fresh bottle of Lotemax. Would it be the non-stinging, instant relief or the burning, partial-relief?

This was probably not a helpful response. Sorry! It is just so frustrating that there are so many factors in play that something that worked a year ago will not work today, or vice versa.

Teri

[Teri]

Well, now I see that there has been another discussion this week about this very topic.

See the thread "Success with various drops" posted by "calcan"

They are discussing why drops work, then stop working, then they work again. I guess it's more common than I realized.

[kitty]

Saw my doc today. He said the delayed response to the Lotemax was due to the Lotemax reducing inflammation enough to get my meibomium glands functional again. It's not the Lotemax, but the return of meibomium gland function and the resultant increase in lipids on my ocular surface that is making me feel better now. He did not explain the burning episodes this last week, I forgot to question further. I started on Doxy today for its anti inflammatory effects.