Ocular surface damage by ophthalmic compounds

[Scout]

http://www.ncbi.nlm.nih.gov/pubmed/21822131

Curr Opin Allergy Clin Immunol. 2011 Aug 4. [Epub ahead of print]

Ocular surface damage by ophthalmic compounds.

Mantelli F, Tranchina L, Lambiase A, Bonini S.

Source

aDepartment of Ophthalmology, Campus Bio-Medico, University of Rome bDepartment of Biopathology, Ophthalmology Division, UOSD Glaucoma, University of Rome 'Tor Vergata', Rome, Italy.

Abstract

PURPOSE OF REVIEW:

To describe the changes of the ocular surface following chronic use of eye drop therapies. The possible pathogenetic mechanisms responsible for specific signs and symptoms are described and discussed.

RECENT FINDINGS:

Topical treatments for ocular diseases may trigger an inflammatory response in predisposed patients, with local activation of immune cells and ocular surface damage. The resulting clinical picture may vary substantially, from mild to severe, sharing a red eye as a hallmark presentation. Recent in-vitro, in-vivo, and clinical data suggest that these detrimental effects are not solely related to eye drop preservatives and may be caused by the medication itself, especially for patients with preexisting ocular diseases. However, no specific tests are currently available to make a clear cut diagnosis between what is caused by the disease and what is the effect of its therapy. Patients' history and clinical features remain essential to hypothesize the underlying pathogenetic mechanism.

SUMMARY:

Topical therapies may induce ocular surface allergic reactions, dry eye-like reactions, and epithelial damage. Patients in need of chronic therapies are at higher risk of facing these detrimental effects of eye drop therapies and should be treated with unpreserved compounds.

PMID:
21822131
[PubMed - as supplied by publisher]

Bold added by Scout

[littlemermaid]

Absolutely. LM age 11 was blitzed with random antibac and steroid drops during y1 of bad advice for undiagnosed bleph - no info from 'corneal specialist' <snort> on tear film replacement, compresses for MGD, environmental, goggles.

Surface desensitised immediately, reduced neuro prompt for tearing, moderate/severe neovascularisation only controlled by yet more steroid. 3y later surface still trashed but tear film improving on more gentle, skilled, informed approach, minimum drops. Medicamentosa.

[Scout]

This is such a difficult issue for any person who suffers from any form of dry and/or inflamed eyes.

But I think it is a worthy discussion to have. Doctors do try to help us, but many are so focused on symptoms that they don't understand the underlying problem and most don't understand the long-term side effects of chemicals on the ocular surface.

This past week I had a really bad eye week (the first in several years *knock wood*) and I was so wanting to haul the eye drops out to make my eyes more comfortable, or haul the allergy drops out to treat the inflamed/irritated tissue.

But instead, I used cold compresses twice a day and waited.

Because now I know that my eyes are (still) so sensitive and inflammation is so easily triggered, that I FIRST look around my environment to find the trigger.

It was a faulty automatic air freshener in the ladies room of my office complex. Seriously. It had somehow released the entire cartridge of air freshener in one day and the whole place was full of (apparently) highly toxic chemicals (at least to my eyes).

I used another restroom and cold compresses daily. It took almost a week but my eyes are almost back to normal.

For me, less is more.

Scout

[Gail L]

So true...

Underwent what was supposed to be minor surgery to remove a Basal Cell Carcinoma lump on my eyelid NINE MONTHS AGO! Surgery was routine but then all hell broke loose. Grew epithelials on the inside of my eyelid...and it went downhill from there. Discovered myself that the solutions given me to put into the eye were hurting and finally said NO!. To enhance healing my eyelid has been sewn 3/4 shut. (it did help with the pain)

What DID help was taking my blood, spinning it and extracting the serum. I put that in my eye 4 times a day and there was improvement over 4 weeks. However it has leveled off and the improvement has stopped. We have a horse with a similar problem and he was getting the serum but 6 time a day so I am putting it in more often.

Using Ibuprofen to control the pain on a bad day and hot compresses. Photosensetivity is awful and restricts outdoor activity and driving during sunrise and sunset.