Dr. Robert Latkany

[Cecilia]

Hi everyone,

I am gonna take a trip to new york and i am planning to visit Dr.Latkany. Those of you who have seen him before, how much did the appointment cost? (i hope not too much, my insurance does not cover it)

And more importantly, what should I prepare/ bring along with me? I need to make the most out of this appointment since i am only going to stay there for two weeks, so i probably only get to see him once. I have just bought a copy of his book Dry Eye Remedy online, I hope it gets here before I leave to new york.

I am trying not to get my hopes up too much. I have seen so many eye doctors and got disappointed too many times. I have suffered this eye problem for a year and its been a very long year of torture.

Any comments would be nice!
Have a good eye day!

[Tanner]

The appointment is about $400 the first visit with no insurance. He will want you to get allergy tested with a doctor named bassett. He does immunology. I don't have the number.

[Rebecca Petris]

Check out Step 5 of this article for some suggestions about preparing for the appointment. Also just above it in the FAQ section, the point about traveling to a specialist - some cautions helpful for expectation-setting.

Dry eye specialists are not cheap. A quick call to the office should tell you exactly what to expect and it's good to not get surprises after arriving.

[dryeyes4ever]

Cecilia - I've seen him twice now & I really like him. I've had dry eyes my whole life but they've gotten really bad the past 2 years. I was seeing an optomotrist who specialized in dry eyes who had put me on Azasite & Lotemax in the beginning for several months & then I'd be off a while, have a flare up & go back on etc. etc. I decided to see Dr. Latkany since in live in NJ near NYC.

He diagnosed me w/Ocular Rosacia & prescribed Bepreve & told me to not use Azasite or Lotemax & to stop Restasis in 2 weeks after the app't, to use cold compresses & a lid scrub. I had already been using the lid scrub but was using warm compresses which he said will just make my eyes redder.

I emailed him 2 weeks after seeing him b/c I was having a REALLY bad week & asked him to prescribe antibiotics. He told me to stop ALL prescription drops & just use Refresh Plus tears & cold compresses. I already had an app't. scheduled for 2 weeks after emailing him so I didn't feel the need to get there sooner. My eyes feel SO much better not using ANY prescription drops. They're still quite dry but not as red & don't burn as much.

I saw him last Friday & he did prescribe an antibiotic (doxycycline) 100 mg 2 x a day for at least a month. He said he still has hundreds of things he can try w/me which gave me a lot of hope.

Luckily I have insurance so I only have to pay my co-pay. Good luck!

[Cecilia]

Dryeyes4ever,
Thanks for sharing your experience. it gives me more hope.
I suspect I have Ocular Rosecia as well, even though my face are not obviously red. It gets red and flushed sometimes for no reasons, and I noticed it happens more on the left side of my face (including my ear). And my left eye has always been the worst eye. So I am guessing it might have something to do with rosecia. I agree with what you say about prescription drops. Most drops make my eyes worst, even artificial tears.
You are so lucky you live so close to NYC, so do the antibiotics work?
I know he very often tell people to use cold compress, which I been doing right now for about a month, but so far not much difference yet.
Did he tell you what are the hundreds of things he can try with you? Did he mention scleral lens at any point?

Cecilia

[dryeyes4ever]

Dr. Latkany

Dryeyes4ever,
Thanks for sharing your experience. it gives me more hope.
I suspect I have Ocular Rosecia as well, even though my face are not obviously red. It gets red and flushed sometimes for no reasons, and I noticed it happens more on the left side of my face (including my ear). And my left eye has always been the worst eye. So I am guessing it might have something to do with rosecia. I agree with what you say about prescription drops. Most drops make my eyes worst, even artificial tears.
You are so lucky you live so close to NYC, so do the antibiotics work?
I know he very often tell people to use cold compress, which I been doing right now for about a month, but so far not much difference yet.
Did he tell you what are the hundreds of things he can try with you? Did he mention scleral lens at any point?

Cecilia

I've been on the antibiotics for a week now & I don't notice a difference yet but my eyes are much less red since I stopped using the prescription eye drops. He didn't say what the 100s of things were... I can't imagine using scleral lenses; just the thought of something like that in my eye... I don't understand how people w/severe dry eyes wear contacts. I highly doubt he would want me to try scleral lenses.

I don't have regular rosacea either so I was surpised with the diagnosis. I don't use the cold compresses every day. I did in the beginning when I was still using prescription drops b/c my eyes were so red & sore, but now I only use a cold compress for a minute if my eyes are burning. My left eye is my worse eye too. If it was like my right one, I'd be very happy. I am lucky that I live so close to NYC. Good luck!

[Rebecca Petris]

I can't imagine using scleral lenses; just the thought of something like that in my eye... I don't understand how people w/severe dry eyes wear contacts.

A common point of confusion on this is thinking of sclerals like other contacts. The reason contacts are a problem for people with dry eyes is that they rest on the cornea. Sclerals don't. Sclerals can be designed specifically to hold fluid over the entire cornea all day as well as keeping it insulated from all the things that can irritate sensitive nerves. That's why they're used for extreme dry eye treatment in some cases. Not saying they are a slam dunk (there can be other issues on a dry eye like excess mucous or eyelid sensation) but that they are quite different from contacts worn solely for vision purposes.

[LisaLis]

cecilia

Hi Cecilia,

I saw him too actually the same day as dryeyes. He is a very nice person. He takes my insurance so all I have to do is give him a copay. Someone on here said he is $400 for a visit. I am still in a lot of pain. My eyes are driving me nuts. I have occular rosacea. I had 2 eye dr.'s tell me that is what I have.

I saw him 2 times allready. The first visit he told me my problems are from allergies. He prescribed patanol. The patanol isn't doing much either. From there I saw an allergist near where I live and got tested for type I type of allergies which are dogs,cats,guinea pigs,mold spores, dust dust mites,feathers, etc. I was allergic to all of these. The allergist prescribed cromolyn and veramyst nasal spray. Sometimes I'm using patanol and sometimes and using the cromolyn. Dr. Latknay did not like the fact that the allergist gave my cromolyn. The allergist did not agree with the patanol. All I know is I wish this problem would let up. I'm willing to take anything to get rid of this. I'm going back to the allergist on friday telling him that its not working.

Now I know there are other types of allergy testing. I talked a girl named Mary who told me to get the TRUE testing done. That shows if you are allergic to chemicals too. For some reason I think that may also be the problem because this whole episode got started from me using a different mascara and eyeshadow. Dr. Latkany must be right about allergies being my problem. I saw him in Feb then in march again because I was in so much pain. I really don't think there is a lot he can do for allergies. He brought up a contact lens that would create a barrier for my next visit if this doesn't improve. I'm seeing him the end of April. I don't think he was talking about the sceleras either. My eyesight is really good 20/25. My lids are so inflamed that my eyes turn dry and gritty, and burn just like right now. My eyes sometimes get a little better and I'm talking a little better once and while but it doesn't last.

I'm curious to know what he'll say about you.

[dryeyes4ever]

Scleral lenses

A common point of confusion on this is thinking of sclerals like other contacts. The reason contacts are a problem for people with dry eyes is that they rest on the cornea. Sclerals don't. Sclerals can be designed specifically to hold fluid over the entire cornea all day as well as keeping it insulated from all the things that can irritate sensitive nerves. That's why they're used for extreme dry eye treatment in some cases. Not saying they are a slam dunk (there can be other issues on a dry eye like excess mucous or eyelid sensation) but that they are quite different from contacts worn solely for vision purposes.

Thanks for clearing that up. I had no idea how they worked but they sounded like they would feel awful. Maybe it would be an option for me down the road. I'm just amazed how much better my eyes feel being off Restasis. I've been using it since it first came out & never really noticed any improvement in tear production and my eyes burned for a while after using them.

[Cecilia]

hi,
I just visited him last week, I'm still in new york. I would say I really like him and would recommend him to others. he is quite different from other eye specialists i've seen before, who all told me I have dry eyes and theres not much I can do about it.
Dr. Latkany told me I have meibomien glands dysfunction. My eyes are not dry I have enough tears, its just theres not enough oil. he says my glands are bumpy, clogged and allergic looking, and that my tbut is very short. he also says my eyes dont close completely when i blink. he prescribed 3 weeks of doxy and warm compress+lid massage. I am 10 days into it, cant say I feel much improvement yet. he says it will take a month for me to feel better, its so hard to be patient with treatments. but now that i got a proper diagnosis and know exactly what my problem is, I am more confident I can beat this thing.

[redandunhappy]

Hi Ceclia,

Do you mind me asking, what did Dr Latkany suggest to combat the problem of your eyes not closing completely when you blink?

I'm pretty sure I have that too as I have problems with closing my eyes properly and keeping them shut (feels like my upper and lower eyelids don't fit together properly and I'm using all the wrong muscles to make them close)

[Cecilia]

he just told me to try to break the habit, so i am trying to be aware of this and blink harder!

[spmcc]

Blinking exercises

You can try these blinking exercises.

[Cecilia]

oh and he said i could try the one day acuvue, that'd act as a bandage for the eye. but i havent done that yet..cos i already know i couldnt tolerate them, that was the reason i had lasik.

[redandunhappy]

thanks very much for your responses

spmcc - presumably the exercises are referring to the outer corner of the eyes? (not inner). If so, now I know I am not using the right muscles to close my eyes. Don't suppose you have any idea how to get yourself to use the blinking muscles above the eyes, as opposed to the other muscles. When I' try doing the exercises, I think I'm just using the wrong muscles...