Does or Has anyone use(d) AzaSite® (azithromycin ophthalmic solution) 1%?

[littlemermaid]

Almondiyz, We are using erythromycin on the face for p&p rosacea flares, which works well to keep the eyes good even though we use it nowhere near the eyes. Some people here are saying that using an antibacterial facewash, even when there are no obvious skin problems, helps the eyes.

Do you have a skin regime that helps?

[Santaklauzz]

Santaklauzz, Assuming you've read everything you can find in PubMed and Medscape http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130918/. We used Azyter for short courses of 6 days maximum. I would use it again for persistent chalazia, but only in a short course. If it's burning your eyes, maybe it's causing damage?

It's difficult, I know, but can you find a regular Ophthalmologist to work with? Maybe visit 3 or 4 times a year, and email or phone for advice meanwhile? Someone needs to monitor your eyes and help you. You deserve that at least.

I just can't seem to accept that now I finally got my hands on one of the only decent medications for MGD, it might not work for me.
I've read about this drug for more than a year, every time more convinced it would help and now it may make things worse.
So I'm giving it another week (the treatment was a month) and then I'll see.
Azithromycin has a halflife of 5 days in the eyelid tissue. Maybe the effect will linger on for a few days or weeks and maybe it will get better then.

I have an appointment with a prof. dr. opthalmologist specialized in the lacrimal passages at the hospital of my university. It's a two minutes drive by bike from my dorm.
I'm going to ask her to monitor me. I've already seen her a year ago but she couldn't diagnose me. But I've been diagnosed with MGD by dr. Geerling, so maybe now she can take up the thread.

[spmcc]

Are you putting the drop IN your eye or ON the lid margin? When I was prescribed Azasite, I was told to put it ON the lid margins (near the MGs). Perhaps try that to cut down on bad reactions to the eye surfaces.

[Santaklauzz]

Are you putting the drop IN your eye or ON the lid margin? When I was prescribed Azasite, I was told to put it ON the lid margins (near the MGs). Perhaps try that to cut down on bad reactions to the eye surfaces.

I'm only putting it on the lid margins, but the second I blink, it gets into my eyes and starts burning. It burns more in my right eye, which is the worse one.
Maybe it burns because of dry spots on the cornea. Normally, your tear film would protect your cornea. Then it would make sense that my left eye is much better than the right one the morning after instilling Azyter.
The leaflet states that severe side effects are very rare, but perhaps in dry eye patients it is the rule rather than the exception.

[littlemermaid]

I have an appointment with a prof. dr. opthalmologist specialized in the lacrimal passages at the hospital of my university.

If they haven't given you all your medical assessment notes and test results and scans from all other appointments, I would request them. We have a file of all that, and typed a Summary (date, symptoms, diagnosis, meds) in short form. The docs tell me it helps them.

The main difficult thing to convey in the consultation has been the impact on daily life. It's useful to include that, using scores for pain, like the docs' notes.

Hope you can work with this Ophthalmologist or she can help you find someone specialised. We've done well in university teaching hospitals too. I guess you know, but this is where they hang out http://www.eucornea.org/ and http://www.escrs.org/ so conference lists and publications can be useful, although obviously not the refraction guys for us.

Would you be able to ask Prof Geerling or team who to see ongoing?

I just wonder if since this started with contact lenses in dry eyes and you've had problems with drops, maybe more random meds in the hope of a cure are damaging you (here's a time when you were doing OK till the drops stung http://www.dryeyezone.com/talk/showt...ght=#post81295). It's very understandable to try everything but maybe healing would happen with protecting the eye surface more. Have you got the computer goggles and wraparound sunglasses etc?

We've just been told to use a lot more lubricant eyedrops through the day. And be really careful on the computer because of staring. The surface gets desensitised, that's for sure.

We are just using antibacs and anti-inflammatories when absolutely necessary. And doing better. But that approach needs frequent monitoring.

Hope it goes well at the appointment.

[Santaklauzz]

If they haven't given you all your medical assessment notes and test results and scans from all other appointments, I would request them. We have a file of all that, and typed a Summary (date, symptoms, diagnosis, meds) in short form. The docs tell me it helps them.

The main difficult thing to convey in the consultation has been the impact on daily life. It's useful to include that, using scores for pain, like the docs' notes.

Hope you can work with this Ophthalmologist or she can help you find someone specialised. We've done well in university teaching hospitals too. This is where they hang out http://www.eucornea.org/ and http://www.escrs.org/ so conference lists and publications can be useful, although obviously not the refraction guys for us.

Would you be able to ask Prof Geerling or team who to see ongoing?

I just wonder if since this started with contact lenses in dry eyes and you've had problems with drops, maybe more random meds in the hope of a cure are damaging you (here's a time when you were doing OK till the drops stung http://www.dryeyezone.com/talk/showt...ght=#post81295). It's very understandable to try everything but maybe healing would come about with protecting the eye surface more. Have you got the computer goggles and wraparound sunglasses etc?

We've just been told to use a lot more lubricant eyedrops through the day. The surface gets desensitised, that's for sure. We are just using antibacs and anti-inflammatories when absolutely necessary. And doing better. But that approach needs frequent monitoring.

Today my eyes are particularly bad, especially my right. It's still the effect of the azithromycin. I guess I should stop this madness. I knew something was wrong the moment I first instilled it.
You're absolutely right about protecting the eye surface. I'm going to buy a Churada Airshield very soon. I only need a prescription from my doc for rx.
And when I see him, I'll ask him to prescribe me diquafosol. I'm not going to sit here suffering every day while there is a potential cure out there.
This drop really does everything. It stimulates mucus production, tear production AND meibomian gland anatomy. When talking about protecting the eye surface, this might be invaluable.
Pictures before/after of meibomian gland anatomy and corneal staining are absolutely unbelievable. As far as I can tell, this drop is being used extensively in Japan for all kinds of dry eye.

I've also contacted the doctor that diagnosed me at dr. Geerling's department. They had a special apparatus, which I recognised only yesterday as an Oculus Keratograph 5m after reading about it on the forum.
I don't know whether or not they have made a meibography. I seriously doubt it, but I've asked them nonetheless and the next time I go there, it might be an option.
I was already considering going to the Dry Eye Clinic in Oslo to have it done.

Keeping a summary is a very good idea, thanks.
I'll ask my doc to write something about my quality of life so the docs on new appointments can be sure I'm not kidding them, saving me frustration and time...

As I see it now, I'm going to try to combine these treatments in the (hopefully) very near future:
- Diquas 5x a day to improve corneal health, tear stability and meibomian gland anatomy (if I can get it)
- Azithromycin for short periods of time (a week maybe) every month or so to keep the oil clear.
- Doxycycline for the same purpose. After 4 months of doxy, my acne is much much better and although my dry eye symptoms are the same or worse, it must be doing something.
- probing every four/five months to keep the glands open
- Churada Airshield when driving, gaming etc. to protect the corea

Sorry to go a bit off topic sometimes, but I felt that I needed to share this. Thanks for your advice, littlemermaid.

[littlemermaid]

Any time. Feels like I'm talking to my daughter 5y from now

Just looking through Eucornea invited speakers, there's a Carina Koppen in Belgium looking at eye surface, keratitis, scleral lenses http://www.vision-research.eu/index.php?id=50

Best advice we've had on derm: use minimum harsh chemicals, gentle antibacterial frequently, moisturise to 'support the dermal matrix'. All with whatever works, but rotate maybe 3 brands/prescriptions in 2/3wk periods. Have you seen a Dermatologist? They might suggest eg topical metronidazole. We are using erythromycin at the moment.

For sure, my d. is sensitive to chemicals. The wisest ophthalmologists have reduced them. Which lubricant eyedrops are best for you?

Watch the diet, if anything flares up your skin and eyes. Drink plenty water. We are wheat and sugar-free.

We do a TTO shampoo demodex eyelid scrub regime, intensive 4wk, then weekends only. Eyes are better for a while after that.

We use anti-dandruff shampoo in the shower sometimes, just in case.

It's still interesting, I think, that LyndaT cleared her MGD with an antibac face cleaner. Sometimes the ophth forget the eyes are in the face or don't know what to suggest about skin. And the Derm tell us they are not interested in the eyes

Any chance of eg seeing Prof Geerling's team regularly?

[Santaklauzz]

Any time. Feels like I'm talking to my daughter 5y from now

Just looking through Eucornea invited speakers, there's a Carina Koppen in Belgium looking at eye surface, keratitis, scleral lenses http://www.vision-research.eu/index.php?id=50

Interesting. She's a prominent ophtalmologist at the hospital of the university of Antwerp. If I studied there instead of Leuven, I would most likely have visited her instead.

[littlemermaid]

Hmm, yes. Look at these guys listed in red on the right - cornea, tear film, dry eye, aqueous, anterior segment http://www.vision-research.eu/index.php?id=623. Anyone doing grafts works on these problems, although may be less hesitant to eg use steroid.

There's also the TFOS conference lists. And PubMed, of course.

I just wonder if attacking this with various miracle drops may not bring about the healing as much as working on the regime with someone nearer home who is interested in helping you manage this. All the tests are just a means to an end, that is working out how to help someone heal. Some of that is about the basics of the daily regime. There is skill involved here.

I've also contacted the doctor that diagnosed me at dr. Geerling's department

Yes, if you've seen good eye docs and got the contacts now, it is possible to ask advice from them again about who to see regularly or what they would do, for example.

[Almondiyz]

AzaSite® (azithromycin ophthalmic solution) 1% arrived. Also called my doctor about my concerns with the preservative benzalkonium chloride (BAK). Was told to apply the med on my eyelid area (lash line) with closed eyes instead of trying it directly in my eyes as drops for sensitivity test. My doctor still feels that AzaSite + Doxycycline is best for my meibomian gland dysfuction (MGD) & ocular rosacea & said it was safe to use. I'm desperate for relief. I hate how desperation controls my life.

[spmcc]

AzaSite® (azithromycin ophthalmic solution) 1% arrived. Also called my doctor about my concerns with the preservative benzalkonium chloride (BAK). Was told to apply the med on my eyelid area (lash line) with closed eyes instead of trying it directly in my eyes as drops for sensitivity test. My doctor still feels that AzaSite + Doxycycline is best for my meibomian gland dysfuction (MGD) & ocular rosacea & said it was safe to use. I'm desperate for relief. I hate how desperation controls my life.

That's exactly how my doctor told me to apply Azasite. Good luck, Almondiyz.

[Santaklauzz]

AzaSite® (azithromycin ophthalmic solution) 1% arrived. Also called my doctor about my concerns with the preservative benzalkonium chloride (BAK). Was told to apply the med on my eyelid area (lash line) with closed eyes instead of trying it directly in my eyes as drops for sensitivity test. My doctor still feels that AzaSite + Doxycycline is best for my meibomian gland dysfuction (MGD) & ocular rosacea & said it was safe to use. I'm desperate for relief. I hate how desperation controls my life.

Apart from Azithromycin and Doxycycline, there are not much alternatives in prescription medication today.
So frustrating they have limited efficacy and can only help a few people.

We feel the same way. Good luck!

[Faith1989]

Can you get it in Canada yet? I find it crazy that it is not available here when we have most of the same stuff as the U.S.!!

[Almondiyz]

Can you get it in Canada yet? I find it crazy that it is not available here when we have most of the same stuff as the U.S.!!

I wonder if Canada has Azithromycin 1% Opthalmic solution under a different name? I thought I saw it sold under different names some where on the forum in the UK.

[Almondiyz]

That's exactly how my doctor told me to apply Azasite. Good luck, Almondiyz.

It still goes in the eyes rubbing it on the lashes & lid margins. So far, used it 2x & it didn't burn or irritate.