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**kitty** · 22-May-2006, 09:04

Welcome! I am sorry we had to meet this way. You will find much valuable insight from the people here, and the best support that there is.

What kind of drops are you using? Have you tried something thicker than drops for use at night? I personally like GenTeal gel (in the tube). 2 drops give me fairly good protection throughout the night; one is generally not enough. I have heard good things about the drops sold in the dry eye shop (see link above); I believe it is Dwelle that is more popular for night time use. Some people benefit from eye ointments at night. Some, like me, find the ointments make the eyes worse. So much is trial and error to find what works best for you. You could also try the Tranquil Eyes goggles. I have not used them enough to formulate an opinion on them, but make sure that they are not causing pressure on your cornea in any way while you sleep. You might want to discuss all of these options with your eye doctor to make sure that nothing is contraindicated with their use.

**shells** · 22-May-2006, 09:09

Hi Froniga,

I'm so sorry to hear that you have had dry eyes your entire life. I was going to reply with some suggestions for nighttime, but I see a reply from Kitty just popped up and she pretty much covered everything that I was going to mention. I also use the GenTeal gel that Kitty mentioned, and it keeps me comfortable throughout the night. I also use a sleep mask over my eyes to make sure that they stay closed all night. If you sleep with your eyes partially open, this may be adding to your problems. There are others on this site who have particularly bad nighttime dryness, and maybe they can offer you some more suggestions. Welcome and I hope you find some relief soon!

-Shells

**neil0502** · 22-May-2006, 09:16

Welcome, Froniga, and ... sorry.

Can you check to see what preservatives are used in your glaucoma medication? (I sound a bit like Johnny one-note here, but...).

There has been A GREAT DEAL of testing, specifically on anti-glaucoma drops, revealing that drops preserved with Benzalkonium Chloride are brutal on the eyes, ESPECIALLY with dry eye patients.

Here are a couple of links:

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

http://serials.cib.unibo.it/cgi-ser/...&view=articoli
[scroll down a bit. The abstract IS in English

]

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

I could go on and on, but ... if you are using drops with this preservative, I would suggest that you contact your eye doc immediately and discuss alternatives with him or her.

I'm in a similar situation for different reasons, but the BAK has done (I'm quite certain) severe damage to my eyes after almost seven years of daily use....

All the best,
Neil

**froniga** · 22-May-2006, 09:31

thanks

Hi Shells and Kitty.

Thanks so much for answering. I bought GenTeal Gel about 3 weeks ago, it's the best so far, but still need to put it in every few hours. I'll try 2 drops before sleep. Sure blurs up the vision, no more reading in bed....

I've been afraid of sleep masks as I tried once back when this started and shortly after the dry eye accelerated with a vengeance and I feared the vulnerable corneae might be open to infection.

I also notice with all my drops and humidity techniques that my sinuses work overtime and my nose runs once I'm up in the morning, I even have a little congestion in the chest early in the day. A neti pot wash helps to clear out that congestion once I'm up and about.

I know these new early morning phenomena are all related and am seeking a balanced regime. The body is a finely tuned instrument as I see it and compensates as I continue to search for answers. I feel optimistic that my new found dry-eyed friends will give some guidance. I'll try to find posts by others who face the night time ordeal. If anyone knows where to look that would be appreciated. There's a big world of posts here, thank the forces that be for the internet, ey?

best regards

**neil0502** · 22-May-2006, 09:33

Benzalkonium Chloride also has nasty effects on sinuses.

Take a look at this thread:

http://www.dryeyezone.com/talk/showthread.php?t=1411

Yuck.

Neil

**froniga** · 22-May-2006, 09:44

thanks Neil

thanks for your good feedback!

I have told my eye doctor "No more of these meds!"

as they don't help the glaucoma and they're harming my eyes. After going through 4 versions and having screaming pain in the eyes each night I put my foot down. The teensy print and pages of warnings had me hoodwinked at first, thinking my eye doc knows about dry eye etc. but I had to become firm as sleep deprivation was causing me to nod out during the day. A deadly combination with driving on mountain roads! Thus I had the surgical procedure for glaucoma as an alternative, having dryeye, that procedure was pretty tough. He wants to do it again and stronger and I'm thinking hard if this is the right thing to do.

That's when I brought my internist into the treatment loop and actively began researching what I can do to bring things to a better place.

Thanks for all the time to post references too.

**Rebecca Petris** · 22-May-2006, 09:53

Froniga, welcome to Dry Eye Talk!!

I'm sure Neil's on the right track with the BAK problem. I get calls pretty regularly from people with this issue - BAK in glaucoma meds pushing night dry eye symptoms over the edge. Some systemic meds like blood pressure meds are doing the same thing to some people.

Originally posted by froniga

I bought GenTeal Gel about 3 weeks ago... Sure blurs up the vision, no more reading in bed....

Might be worth trying Dwelle. (You can get samples for cheap.)

I've been afraid of sleep masks as I tried once back when this started and shortly after the dry eye accelerated with a vengeance and I feared the vulnerable corneae might be open to infection.

There are alternatives to masks. You can use medical tape to ensure better lid closure. (Hard on the lashes and skin though.) Or you can try what I used to do, cut a piece of saran wrap and pat it down around your eyes. Definitely won't be reading in bed with that on

I think that tranquileyes is safe as long as you follow the instructions about carefully washing and drying the pads after each use. Also worth noting that Eye Eco is coming out with a new self-heating insert for tranquileyes (called "thermoeyes") which should be available next month and which I think may have a good chance of helping nighttime dry eye patients through more of the night without having to re-goop so soon. Suzanne says it maintains very high humidity for something like 75 minutes.

**kitty** · 22-May-2006, 09:57

Froniga, do you have all four puncta plugged or just two? What kind of plugs do you have (surface or inside the puncta)? The nasal symptoms with the drops tells me that you may still be losing too many tears through your puncta. You might want to re-evaluate how well your plugs are working.

**shells** · 22-May-2006, 10:29

Originally posted by froniga

I'll try to find posts by others who face the night time ordeal. If anyone knows where to look that would be appreciated. There's a big world of posts here

Froniga,

You've probably already noticed that there are several different sections that the posts are split into (punctal plugs, side effects, goop, etc.), so that may be helpful in narrowing down your search. Also, there is a search feature right under the little private message box that you can use to search all the threads for any info. you are interested in. Hope this helps!

-Shells

**froniga** · 22-May-2006, 10:33

to my new friends.

Firstly. two lower ducts are plugged with silicon, my eye doc told me that he had to special order the largest plugs available, perhaps that is a clue to this congenital condition. I've never shed a tear in my life, but my nose runs when I cry.

Also I am a veteran of dealing with sinuses, due to the tearlessness in part. If you need this info, a neti pot works to clear the sinuses very well naturally. They are available at healthfood stores and internet. Essentially it is a snub nosed little teapot that you fill with salty water, you tip your head, pour the water in the upper nostril and it comes out the lower nostril. Then do the other side. The neti pot is an ancient yogi tool. Hope this might help someone.

I have not heard of Dwelle. Is that over the counter? Can I get it from my eye doctor?

On to glaucoma drops, thanks for the info there. I won't use them again. The only good

thing about them is this odd side effect, they make the eyelashes grow long and luxurious.

I think mascara is a viable alternative.

Joking aside, I will no longer take anything with BAK.

On to the diuretics. I was taking hydrochlorothiazide (12.5 mg) a very low dosage. Since quitting I am retaining fluid and the BP is elevating a little. I'm hoping I can resume this at some time in future, any feedback on that?

Thanks for all this feedback from all of you, I'm afraid if I go back to list your names, I lose this post. again. I'm finally feeling some optimism.

**indrep** · 22-May-2006, 10:52

froniga:glauc and dry eye

Talk with your glaucoma surgeon about a SPECIAL ORDER valve for glaucoma/Dry Eye that New World Medical made that allows fluid from the inside of the eye to be used on the outside for Dry Eye relief. These valves typically lower pressure to the 8-15 range.

New World Medical is located Rancho Cucamonga, CA. If your Glaucoma surgeon is unfamiliar let me know and I can get you some info.

**Rebecca Petris** · 22-May-2006, 10:56

Originally posted by froniga

I have not heard of Dwelle. Is that over the counter? Can I get it from my eye doctor?

Yes, it's OTC (though not available in drugstores yet). Some doctors carry samples of it, mostly in Florida. More information in our Dry Eye Shop.

On to the diuretics. I was taking hydrochlorothiazide (12.5 mg) a very low dosage. Since quitting I am retaining fluid and the BP is elevating a little. I'm hoping I can resume this at some time in future, any feedback on that?

I wouldn't stop using any prescription medication unless your doctor agrees. I do know people on diuretics who are managing reasonably well during the night with protection and goop.

I'm finally feeling some optimism.

Wonderful. That's the place to be!!

**froniga** · 22-May-2006, 11:06

Great info indrep

Great info indrep. My eyedoc teaches at UCLA and is part of the Jules Stein Eye Group as well. Hopefully he is current on this. I printed out your post to take with me next time I go in to see him. What a great concept:"fluid from the inside of the eye to be used on the outside". Meanwhile I'll read up on it as well.

I'm also going to pass on this website address here to my doctor for his other patients.

To all: Knowledge is power and your generous & informative posts are empowering me. What a resource! I now feel I can cope, despite being a bumbling sleepyhead (with extraordinarily long eyelashes

) during the day. I will also research using the search function once I've digested all of this.

**neil0502** · 22-May-2006, 11:10

Originally posted by froniga

On to glaucoma drops, thanks for the info there. I won't use them again. The only good

thing about them is this odd side effect, they make the eyelashes grow long and luxurious.

I think mascara is a viable alternative.

Joking aside, I will no longer take anything with BAK.

I feel compelled to post a CYA here, agreeing with Rebecca

My official recommendation would be that you discuss these studies with your ophthalmologist before stopping any meds on your own.

Unoficially, however ....

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