Azithromycin eye drops OK long term? & Blephasteam goggles success ( UK)

[rm14dp]

Hello, I am from Essex England.
Its a year since laser & cataract surgery has left me with DES MGD Blepharitis. I also have facial pain from nerve damage. Having been through a number of drops, hot compresses and Doxy which did not help, 9 weeks ago on my consultants advice I started using Blephasteam goggles once a day. 3 weeks ago I started a course of Azithromycin ( Azyter 15mg) eye drops (16 day course). I keep a simple diary with a tick for a good day and a cross for a bad day, and over the last 3 weeks there are far more ticks than crosses and the pain is not as intense. Went back to the consultant today, and there is for the first time vast improvement in the Bleph.
The drops are rather strong and sting like mad but its worth it. Has anyone out there been using Azithromycin long term or on a cycle which has given prolonged relief? I have just been told that when the Bleph flares up again to get another prescription. - I am lucky my consultant is Moorfields trained and has been persistant with treatments to try to help. Thanks for taking the time to read this.

[littlemermaid]

Hello RM14dp, I'd like to know this too. How to use Azyter long term. I was reading about a US doc using AzaSite for 1wk in 4wks (lost the ref as usual) on a cycle for chronic bleph. We've just used Azyter for a short 5 day course to clear the MGs after clogging and infection, and yes, it stung although that improved.

We are also using Blephasteam or hot flannel every day to keep things good. Also cleaning with sterile warm water and cotton wool.

Also trying very dilute organic tea tree shampoo as a gentle eyelid wash, using it right to the eyelash base in case there's demodex, and that's going well.

Hope you get a reply from US on AzaSite.

[rm14dp]

Hello. Thanks for your reply. I have seen an article as well where its 3 weeks off one week on with Azyter. Its been a week now since I stopped using the drops, and my right eye which is my worst has been bad again. I went to my GP and she has given me another prescription which takes a week to order the drops. I'm going to give it a week, and if things dont improve, I'm going to use them again and see if it improves again but Im going to get in touch with the hospital clinic as well. At the moment its Blephasteam goggles, Blephaclean wipes and Systane drops. (Blephaclean wipes are available on prescription & preservative free have you given them a try?)

Im going to keep looking and asking. Let me know how things go with you. There has got to be a way to get this pain well under control.

[littlemermaid]

Im going to get in touch with the hospital clinic as well

Yes, please do. Your ophthalmologist should be tailoring a regime based on observations, looking for improvement. Is it blepharitis from mgd that's flared up again, do you think?

Do you know how to check the meibomian glands? Press gently upwards with 2 fingers under the lower lashline and you may see a row of tiny dots that looks like baby oil along the eyelid margin, if things are well. Otherwise, the glands may be clogged and nothing happens, or a whitish substance may be exuded, or more likely with us, we see it clogging the tiny glands. I'm finding there isn't always meibom to be seen in a healthy eye, for example after a warm compress we won't be seeing any because it's expressed, but it's reassuring to see it when it's there, so it's worth a try. Good daylight standing right up to a mirror is the best place, or with a magnifying mirror.

And the kind ophth will like to tell you what s/he sees if you ask questions that show you're educated on this. Now they've got over the fact we're all on the internet, the good ones do like talking more technical and relax into a nice useful working-together type chat.

The standard dose for Azyter to clear an infection is 2/day for only 3 days and it's supposed to be closely monitored by regulators. http://www.medicines.org.uk/emc/medi...43/SPC/azyter/ We didn't use it more than 5 days and I thought that was more than enough. It's supposed to penetrate tissues and stay there at least 5 days.

It may not be doing your eye surface any good. I'm still not seeing why we can't just wipe it along the eyelid margins, as Marguerite MacDonald (2 video talks)-
http://www.dryeyezone.com/talk/showt...ght=marguerite
http://www.dryeyezone.com/talk/showt...ght=marguerite

Or it may be needed in short courses in pulse therapy to keep the glands clear, who knows; this is the skill we're all looking for. I'll feedback if I get any views out of our various ophth.

I'd do a bit more research on what Azyter is actually supposed to be doing and have the chat with your ophth. The Moorfields way is rather to have a crack at fixing blepharitis and then we self-manage in long-term follow-up, they are telling me, so it's great you've got the opportunity to nurture this good relationship. Who knows whether Azyter's doing you more harm than good with the guesswork though (GP won't know). Sorry, but I had to say it. I do know what it's like <hug>

http://www.healio.com/ophthalmology/...conjunctivitis Topical antibiotic rapidly effective easy to use in children with bacterial conjunctivitis, Ocular Surgery News, Healio
http://eyeworld.org/article.php?sid=5792 Study finds azithromycin potential LASIK prophylaxis, Eyeworld Mar 2011
http://www.healio.com/ophthalmology/...iatric-rosacea Topical antibiotic effectively treats paediatric rosacea, OSN, Healio - this study by Serge Doan has a repeat interval at 10 days, then 15 days, similar to you

Thanks for the Blephaclean tip ~ I had no idea they can be prescription. I confess with Azyter we insisted on separate bottles for each eye to avoid cross-infection, and then carefully used one bottle on both eyes, never letting the nozzle touch the eye. Thus, 2 courses obtained NHS.

Is the nerve damage from the surgery or is it a separate issue? So sorry.