Side effects of long term use of genteal gel...

[Milo007]

Hello everyone,
I am considering using an eye gel for daily use as lubricating drops don't last more than a few minutes as you might know. After some research I have found "genteal" eye gel to be one of the few available options in my country.But it isn't preservative free and that's what's worrying me. I am aware of the cytotoxic effects of preservatives on the ocular surface specially after prolonged use.

Anyone having experience on using genteal gel for more than a year?

If yes has it worsened your condition in any way?

I read that the preservative sodium perborate in genteal gel breaks down to harmless oxygen and water upon contact with the ocular surface. But these are the company's claims and might be a marketing gimmick anyways. Looking forward to patient's experiences and opinions more than anything else.

[Hokucat]

If it’s Genteal Severe Dry Eye Gel you are referring to, I used it for at least 5 years, day and night. A few times I started to get a slight allergic reaction to the gel where my eyes would itch and get a little red, but I would lay off the gel for awhile and try it again and I could continue using it. I’ve read of a few others who got a reaction to it after awhile as well. Other than that, I’ve experienced no other side effects. I have not used it for three years, now that I’m better and managing my condition.

That gel literally saved my life during my worst years. It was the only thing that consistently gave me a little relief from bone dry eyes (I had zero tear film). It gave my eyes a moist, smooth, soothing feeling nothing else could, and I really feel it protected my eyes...I never had an abrasion or erosion while using the gel, even though doctors told me the surface of my eyes were like sandpaper during those years. And it did stay on my eyes a longer time, unlike regular drops that only lasted a few minutes for me.

As far as it not being preservative-free, well of course it would be better without the preservative it has. At least it’s not BAK which is known to damage the eyes, and I personally have not experienced any detrimental side effects with relatively long term use. I would not smother my eyes in it, just a few drops per eye then close the eyes and roll the eyeballs around to spread it around the entire surface. Wearing moisture chambers at the same time helped extend the time between putting in the Genteal as often, and also provided another layer of protection.

Still keep looking for resolution of the root cause of your dry eyes since the Genteal only addresses symptoms, but finding something like Genteal that might make you feel better is just as important. I hope it provides some relief for you too!

https://dryeyeshop.com/collections/g...ts/genteal-gel

[Milo007]

If it’s Genteal Severe Dry Eye Gel you are referring to, I used it for at least 5 years, day and night. A few times I started to get a slight allergic reaction to the gel where my eyes would itch and get a little red, but I would lay off the gel for awhile and try it again and I could continue using it. I’ve read of a few others who got a reaction to it after awhile as well. Other than that, I’ve experienced no other side effects. I have not used it for three years, now that I’m better and managing my condition.

That gel literally saved my life during my worst years. It was the only thing that consistently gave me a little relief from bone dry eyes (I had zero tear film). It gave my eyes a moist, smooth, soothing feeling nothing else could, and I really feel it protected my eyes...I never had an abrasion or erosion while using the gel, even though doctors told me the surface of my eyes were like sandpaper during those years. And it did stay on my eyes a longer time, unlike regular drops that only lasted a few minutes for me.

As far as it not being preservative-free, well of course it would be better without the preservative it has. At least it’s not BAK which is known to damage the eyes, and I personally have not experienced any detrimental side effects with relatively long term use. I would not smother my eyes in it, just a few drops per eye then close the eyes and roll the eyeballs around to spread it around the entire surface. Wearing moisture chambers at the same time helped extend the time between putting in the Genteal as often, and also provided another layer of protection.

Still keep looking for resolution of the root cause of your dry eyes since the Genteal only addresses symptoms, but finding something like Genteal that might make you feel better is just as important. I hope it provides some relief for you too!

https://dryeyeshop.com/collections/g...ts/genteal-gel

Thanks for the reply hokucat!

Well I am glad that you are doing well to manage your dry eyes now. You wrote that your tear film was almost almost zero. I am wondering if you have lacrimal gland malfunction or a meibomian gland dysfunction. If you have the latter it must be severe meibomian gland loss. Did you do a meibography to asses your glands back then when you first had symptoms? If yes can you please share the results of your meibography then and most recently?

My meibography results indicate a 24%,24%,23%and 44% gland loss on my right eye lower lid, right eye upper lid, left eye lower lid and left eye upper lid respectively. My ophthalmologist said it's not "that bad" but my TBUT is just 3 seconds both eyes! She said however that my tear film is unstable. When I press my lower eyelids after wiping them clean with a q-tip I can see lipids oozing out of the glands. At least they are not blocked but still my TBUT is that low.

Any thoughts on what could be the issue?

I am on warm compress twice daily and chloroquine phosphate eye drops twice daily.

[MGD1701]

Hi Milo
Meibographe: Which machine your doctor emplied? I know LipiView does not show %. It is great to have % so we can monitor. Thanks.

[Milo007]

Hi Milo
Meibographe: Which machine your doctor emplied? I know LipiView does not show %. It is great to have % so we can monitor. Thanks.

I don't know about the instrument brand but it's most probably infrared meibography. The images are similar to those of the meibomian glands viewed under an infrared imaging system.

The instrument assesses the gland morphology using some AI and encircles the healthy glands with green color and demarcates the total area that should be full of glands in red color. The gland loss area is then calculated using the outlined areas.


Maybe this is the instrument :

https://www.ophthalmic.com.my/produc...ease-analysis/

The green colored demarcation of glands in the picture is pretty similar to my images.

[MGD1701]

Thanks Milo for sharing.

So this is called I.C.P. MGD (Meibomian Gland Desease) Analysis?

so advanced and much better than LipiView with more info & %. so this is picture you got?


I got infrared meibography too, one was camera in slit lamp in green and red and show % of loss but above is much much better/precise.

I also got images from LipiView but they are actually not so precise/clear (like above)
Dr Toyos mentioned in his video that NOT all glands can be shown in meibography and after IPL some glands would come back.

[Milo007]

Thanks Milo for sharing.

So this is called I.C.P. MGD (Meibomian Gland Desease) Analysis?

so advanced and much better than LipiView with more info & %. so this is picture you got?



I got infrared meibography too, one was camera in slit lamp in green and red and show % of loss but above is much much better/precise.

I also got images from LipiView but they are actually not so precise/clear (like above)
Dr Toyos mentioned in his video that NOT all glands can be shown in meibography and after IPL some glands would come back.

Yes I have pictures similar to that!

The eye speciality where I visited didn't offer lipiview to me. They had this instrument. I am attaching scanned meibography images of my glands.

Can you share your lipiview images for comparison?

The scans are not of that great quality though and the printed report was not of excellent print quality either.

[Rebecca Petris]

I read that the preservative sodium perborate in genteal gel breaks down to harmless oxygen and water upon contact with the ocular surface. But these are the company's claims and might be a marketing gimmick anyways. Looking forward to patient's experiences and opinions more than anything else.

I don't think of it as a marketing gimmick, but... what I've heard is that the breakdown process happens best when the eye isn't that dry. (Yes, counterintuitive for us...) If I were to use something thick at night, I'd personally rather use this gel with the preservative than use an ointment without, but that's just me. I would also probably put a watery drop like refresh plus or theratears in about 15 minutes beforehand, just as I would do with a potentially irritating Rx drop - so that it's not landing right on an already dry/irritated surface if poss.

I know a ton of people who are intolerant to ointments and have used genteal gel forever... but then, I also know others who hit a point where they couldn't tolerate the gel. I really like her point about rotating between things if needed.

[Milo007]

I don't think of it as a marketing gimmick, but... what I've heard is that the breakdown process happens best when the eye isn't that dry. (Yes, counterintuitive for us...) If I were to use something thick at night, I'd personally rather use this gel with the preservative than use an ointment without, but that's just me. I would also probably put a watery drop like refresh plus or theratears in about 15 minutes beforehand, just as I would do with a potentially irritating Rx drop - so that it's not landing right on an already dry/irritated surface if poss.

I know a ton of people who are intolerant to ointments and have used genteal gel forever... but then, I also know others who hit a point where they couldn't tolerate the gel. I really like her point about rotating between things if needed.

Thanks for the response Rebecca!

Is the gel suitable for daytime use specially for reading?

I am not thinking of using it as a lubricant for bedtime but I am considering it more as a substitute of my compromised lipid layer during both daytime and bedtime. I am into academics so it demands a lot of reading. Would the gel make my vision blurry as long as it lasts?

I really want a way to manage and pursue my academic career for now.

I am also looking into moisture chambers glasses as suggested by some.

Any further advice is equally welcomed.

[diydry]

Have you tried the genteal gel yet? I suspect you’ll know pretty quickly whether it provides you relief. It’s got a sort of unusual consistency.

Genteal gel was about the only thing that provided me relief during my worst months after my lasik surgery. It let me function for 30 minutes to an hour when artificial tears weren’t helping at all (this was while working at a computer job... things were blurry for 5 mins or so). I also would occasionally experience unusual reactions when administering the gel... about once a week... irritation and redness and I’d have to flush it out with artificial tears. No idea why this happened.

Definitely recommend giving it a shot. I haven’t needed to use it for the past several months but I still have it handy just in case, like a security blanket.

[Milo007]

Have you tried the genteal gel yet? I suspect you’ll know pretty quickly whether it provides you relief. It’s got a sort of unusual consistency.

Genteal gel was about the only thing that provided me relief during my worst months after my lasik surgery. It let me function for 30 minutes to an hour when artificial tears weren’t helping at all (this was while working at a computer job... things were blurry for 5 mins or so). I also would occasionally experience unusual reactions when administering the gel... about once a week... irritation and redness and I’d have to flush it out with artificial tears. No idea why this happened.

Definitely recommend giving it a shot. I haven’t needed to use it for the past several months but I still have it handy just in case, like a security blanket.

Do you have an aqueous deficiency or an MGD?

I too got reactions with gel based antibiotic eye ointments. Not sure if they were hypromellose. I usually don't need anything while on frequent blinking mode. But it's getting problematic while I am reading or focusing on something hard.

[diydry]

I have MGD. But when I was using the Genteal Gel throughout the day, I believe I was suffering from aqueous deficiency induced by my LASIK surgery. The consensus now from my doctors is that MGD is the main culprit not the aqueous deficiency (although I'm sure that still plays a role). Reading and focusing definitely absolutely aggravate my symptoms, in fact I almost always try to wear my scleral lens if I know I'm doing a lot of reading or computer work.

[MGD1701]

Hi diydry
interesting to know you believe aqueous is your issue yet your doctors think MGD is the main culprint.
What tests did they perform to make such conclusions?

Genteal Gel seems not perservative free??

[Milo007]

Hi diydry
interesting to know you believe aqueous is your issue yet your doctors think MGD is the main culprint.
What tests did they perform to make such conclusions?

Genteal Gel seems not perservative free??

Yes genteal gel is not preservative free. It comes with a preservative named sodium perborate. The company claims that upon contact with the ocular surface sodium perborate finally breaks down to harmless by products thus making it preservative free in the eye.

[Milo007]

I have MGD. But when I was using the Genteal Gel throughout the day, I believe I was suffering from aqueous deficiency induced by my LASIK surgery. The consensus now from my doctors is that MGD is the main culprit not the aqueous deficiency (although I'm sure that still plays a role). Reading and focusing definitely absolutely aggravate my symptoms, in fact I almost always try to wear my scleral lens if I know I'm doing a lot of reading or computer work.

Doesn't scleral lenses aggravate MGD or lacrimal glands also as contact lenses are believed to do?