New drops to try

[IanJ]

Hi all,

Had my 3 monthly visit with David Crystal today, primarily to get one of the plugs renewed in my right eye....but we also discussed my problems in general (always good to go back over everything).

We discussed the soreness/pain in my right eye when it gets dry.........David thought I might benefit from "Voltarol Ophtha" drops to reduce the inflammation. He said "might" because, so far, during all my visits to him my right eye has been good....in other words, a real pity he can never see it at it's worst and make a better diagnosis.
However, and assuming it's getting inflammed along with the pain he thought I could try these drops. They are expensive.

http://emc.medicines.org.uk/emc/asse...ocumentID=6718

David also gave me some other eye drops to test....."Clinitas Soothe".

Anyone tried these drops?

Ian.

[stella]

Hi Ian - I once asked Dr Latkany in Q&A about diclorfenac for eye pain and he said he had used it for patients with DE
I notice that novartis has listed in "expients" castor oil - may not suit everyone - definately not me

[brd888]

Ian,
I recently got some Clinitas "Ultra 3" - obviously different from yours but they have polyvinyl alcohol - as used in Dakrina etc.
Regards.

[Rojzen]

not all PVAs (and povidones) are the same; chemistry v. physics

I was on Voltaren, a U.S.-manufactured ocular NSAID, for a while, about 8 years back. . .Didn't help me at all, but it didn't seem to do harm, either. . .

On the non-Rx front, just wanted to share that when I first looked at Dwelle and Dakrina, I assumed that their including polyvinyl alcohol (PVA) and povidone was responsible for the way these products worked. . .So I went out and bought MiniDrops, locally, which are also made of PVA and povidone. . .The MiniDrops are not bad, but they did nothing really, for me. . .When I gave Dwelle a long chance to work, however, I noticed big reductions in my pain level, and longer hours of going without protective eyewear. . .

Then I started reading Dr. Holly's posts here, and understood that it is not the mere presence of polymers that accounts for how his drops work, but, rather, the way these polymers compounded (I think concentration makes a difference here), and the effect this manner of compounding has on oncotic pressure (which is a ratio, I think, between tissue and plasma osmolarity), that makes Dwelle and Dakrina ENTIRELY different from other PVA/povidone products. . .

Anyway, one has to try the Dr. Holly products to experience the difference. . .I'm learning, along the way, that chemistry may be less important than physics, to our DES conditions!

[stella]

I love your analytical mind Rojzen + your attention to detail.You are obviously v clever - Thats good 'cos you research and try stuff first -Kind of trailblazing -and then we can give it a try Thank you

[NYer]

Yes, I agree. We can see why such a smart guy married you, Rojzen!

[eva b]

very interesting points Rojzen - my word, you certainly are well informed

I have just been wondering about trying Dwelle or Dakrina, but unsure because I have in the past tried 2 different kinds of drops available here in the UK, one of which contained PVA and one with povidone, and neither of them worked. Or rather they were OK for a day or two and then started to make my eyes feel worse.

I wonder if I should give Dwelle a try, whether the combination would work better for me.

The other thing that concerns me is the presence of preservatives in Dwelle, even though they're not BAK. My eyes are so hypersensitised I've been told to use preservative free only drops....any thoughts, anyone?

all opinions gratefully accepted

[Rebecca Petris]

I have just been wondering about trying Dwelle or Dakrina, but unsure because I have in the past tried 2 different kinds of drops available here in the UK, one of which contained PVA and one with povidone, and neither of them worked. Or rather they were OK for a day or two and then started to make my eyes feel worse.

I just want to make a quick comment about this. I think there was another post recently like this that I was going to respond to but couldn't find it when I looked.

Drops can differ dramatically in properties without APPEARING to differ in terms of ingredients. And the corollary... similar properties can be achieved with different ingredients. So it just isn't always as simple as looking at the active ingredients and concentrations. (And even if it were... there are some things the label doesn't tell you about the ingredients... for example, a distinguishing feature of Dr. Holly's drops is that they use a certain proportion of 99% hydrolyzed PVA and 87% hydrolyzed PVA - but on the Dwelle label, it just says PVA.)

On the face of it, PVA and/or povidone are not by any means sexy ingredients. But with Dr. Holly's drops the uniqueness lies not so much in PVA or povidone singly as lubricants but rather in the very high oncotic pressure (a term most people in the industry have never heard of and which I'll never understand no matter how many times it's explained ) achieved with the particular blending of polymers. It is that property that gives Dwelle/Dakrina/Freshkote fans the results they get.

[liz56]

[snip]
On the face of it, PVA and/or povidone are not by any means sexy ingredients. But with Dr. Holly's drops the uniqueness lies not so much in PVA or povidone singly as lubricants but rather in the very high oncotic pressure (a term most people in the industry have never heard of and which I'll never understand no matter how many times it's explained ) achieved with the particular blending of polymers. It is that property that gives Dwelle/Dakrina/Freshkote fans the results they get.

Oh! This is interesting news. I could not understand why seeing comparable ingredients did not mean similar effects in products.

Thanks for that, Rebecca!

[eva b]

Thanks so much, Rebecca, for the explanation. I'm learning so much here

I'm still slightly concerned about the preservative issue, though...

thanks for providing such a fantastic resource for us all here - I feel as if I now know more about DES than all the specialists I've seen in the last 2 years.

p.s. the post you mention on this subject (which you couldn't find) was probably mine

[Rebecca Petris]

Regarding preservatives... I try not to get too far into discussions like this because I don't want people thinking that I am defending use of preservatives because of my financial involvement with Dr. Holly's drops. At the end of the day, I really don't want to encourage anyone to do something their doctor has not approved or which they have doubts about personally.

And just as an aside, if it weren't for my personal experience, my confidence in Dr. Holly, and the practical experiences of people I've known who have benefitted from these drops for more than 10 years, I'd probably be more unequivocally, absolutely-no-exceptions anti-preservative in general than I am. It's sort of like my LASIK experience in reverse. If I had happened to have a good result with LASIK, I shudder to think how easily I might have become an outspoken proponent - without having gone to the trouble of understanding the kinds of issues involved in poor outcomes. I might have been just another one of those people that go around saying Well, if you only pick the right doctor and do your homework you'll be just fine.

Anyway. Regarding preservatives, here's a link to an article I wrote awhile back explaining my views about preservatives.

[Rojzen]

thank you, friends

Praise for my analytical abilities is undeserved, dear friends, but thank you.

If ever I strike upon some useful observation, I owe this 1) to the years I spent trying to save sick companion animals from awful chronic diseases that the veterinary profession was not motivated to address aggressively, and 2) the way all of you tug at my heartstrings. . .I know I am not alone when I say that every single day, I find something here at DES that makes me so indignant that I cannot rest until some useful idea pops into mind. . .Our suffering is so poorly understood outside of our circle. . .It makes me need to DO something . . .and not to stop thinking 'till a lightbulb flickers. . .

[eva b]

Thank you for being so honest and open, Rebecca. I read the article with great interest, and will see how I go with the tranquileyes and eye spa before making the next decision!