Serum Tears and PROSE

[bookwoman]

I was fitted with PROSE lenses in August at Johns Hopkins and am so grateful for the relief they have given me for ATD, MGD, ocular rosacea and corneal neuropathy. What a huge difference in what I am able to do again, read, use a computer and leave my house without sealed dark goggles! I still have a bit of pain left for which I take gabapentin. I have been using serum tears since May 2013 and it was recently suggested to me that I try using serum tears in my device and also as I would use preservative free tears over the top when needed. When I do this I do get more pain relief but my eyes feel itchy by the end of the day. The itchiness only has occurred when I am using them with my PROSE lenses. I use them first thing in the morning before PROSE and after I take my PROSE out at night without any itching. I use 50% which are compounded with preservative free saline by Leiters.

Does anyone have any advice on using serum tears with PROSE and what percentage people are using? One suggestion was to drop the percentage to 20%. Any ideas on what might be causing the itching?

[Amyfloor]

Hi Bookwoman,

I, too ,wear PROSE lens and was fitted at BFS in Boston. In fact, I was just there a couple of weeks ago for a re-fit for my right eye. When I first started using serum tears I asked if they could be used inside the device and the answer was no since there were no studies regarding the "safety" of the tears/ I am glad that philosophy has changed since I would like to try them inside the devices as well. I actually stopped using the serum drops because it is a bit of pain to travel to Philly to have my blood drawn to have them made and I did not see much improvment when using them over the PROSE lenses but perhaps using them inside would make a bigger difference. Please keep us posted.

[bookwoman]

Hi Amyfloor, I see that you are in PA too, I am near Philly as well! Thanks for the feedback, I am really grateful for it. How long ago were you first fitted? Given what you say about the question about the safety of the tears (I know there is a higher risk of infection using them in this way)I think maybe I should accept the itchiness as an indicator that I should not use the tears in the PROSE lens or outside on any sort of regular basis. I have used them on a one off kind of basis when I was really struggling with one eye or the other and found that it helped break the pain cycle. Do you have pain even with your PROSE? Have you found some good solutions for that?

[Fitch]

hello. I successfully used 50 percent blood serum from leiters inside my sclerals that were made for me in dallas by Dr. Greg Gemoules. I would use no more than 3 drops of serum per lens and then fill the rest with unisol 4. I found it seemed to accelerate my healing and has been much more beneficial to me it seems than when i just used the drops as eyedrops 8x or more per day. I hope that you can figure out what is causing the itching because i luckily did not notice any difference in comfort whether it was all unisol or unisol plus 3 drops of blood serum in each lens. I have also used 1-2 drops of 1 percent lacosamide eye drops made by leiters in my scleral lens which greatly helps to reduce the pain from my corneal neuralgia. Good luck and Happy Healing!

[bookwoman]

Good to know Fitch, so glad you have been able to accelerate your healing. Thanks!

[Amyfloor]

Hi Bookwoman,

I was fitted in November of 2012 and have been back to Boston 3 times since for a fit check and then a re-fit. I don't think pain is the right word for what I feel with PROSE-- my eyes still feel dry with every blink and some days I cannot wait to take them out right after work. That being said, I have many more good days than bad and that is a huge improvement. A good day for me, is not having to use artificial tears every hour or so on top of the devices. Some days, I can wear my devices for 12 hours and not even no they are in my eyes! I cannot figure out why either! I think with any chronic condition you just have to learn how to manage it. I do not have any itching at all. Hope that helps.

[bookwoman]

I was wondering if you or any other PROSE wearers have used lacriserts with PROSE? I have really good days and not as good days too, lately seeming due to the drop in humidity here. My punctal plugs have all fallen out and I have scarring so that when I try a new plug it either falls out or I have excessive tearing. I may try a 3 day intracanicular plug to see if I still have excessive tearing. I do wear my PROSE all day for up to 15 hours or so because it reduces my pain from horrific to fairly manageable most days. I am not back to work however...

[Amyfloor]

I wore Lacriserts successfully for about a year prior to PROSE. In fact, the reason I was fitted for PROSE is that the lacriserts stopped working and as you well know, a last resort. I did ask my doc at BFS if I could use the lacriserts with the PROSE as my eyes still feel dry with PROSE and the answer is no. He said it would "gunk' up the lens which may impair vision and perhaps compromise the lens itself. I always wanted to try it myself but haven't as of yet.

[bookwoman]

Wow, I'm glad I asked you about these things, are you cauterized or do you wear any plugs? My favorite drop is Systane Ultra non-preserved over the lens, about every 3 hours. I have tried a drop in the device once or twice and it feels a little weird but can be soothing in the long run. What are your favorite drops? How are you on the computer? Sometimes I still have a hard time with longer sessions on the computer but thankfully I can read books again. Is it hard to get through a day of work for you? I need pain meds in combination with my PROSE

[Amyfloor]

May I PM you? Too many questioins to answer here. (:

[bookwoman]

Absolutely! Thanks so much

[farmgirl]

I have a pair of minisclerals which I don't use every day because after 6 hours of wear my eyes get really bloodshot. When I do wear them they are comfortable and don't give me any grief even though the eyes look sore when bloodshot. I don't like to use pure Unisol as the saline burns my eyes so since I need 5 drops to fill them I use one drop of serum tears, 3 drops of systane ultra non preserved and one drop of saline. That seems to work really well. I tried putting a drop of serum in one eye one day with the lenses in and it just gunked them up and I had to take them out and clean them so that was a failed experiment....F/G

[bookwoman]

Thanks farmgirl, that's a really interesting combo. Did your doctor give you the idea or did your just come by it by trial and error?

[farmgirl]

Nope just cam up with it on my own but it seems to work

[NotADryEye]

I don't like to use pure Unisol as the saline burns my eyes

I think you're probably having sensitivities to the Boric Acid and/or Sodium Borate in Unisol, rather than sodium chloride (salt). You might try replacing Unisol with .9% sodium chloride.