Can Muro 128 ointment be used long term?

[ebi1368]

Hi Can Muro 128 ointment be used long term?
Does it cause glucoma like other steriod?

[Milo007]

http://www.bausch.com/our-products/d...o-128-ointment

It's not a steroid at all. It's a hypertonic sodium chloride formulation supposed to dehydrate a swollen cornea.

Why are you considering to use this ointment?

[ebi1368]

my doctor prescribed me this for night time. My eyelid stick to my eyeball at night which is really painful.

If it dehydrates cornea, is it good for my severe dry eye?

[Milo007]

my doctor prescribed me this for night time. My eyelid stick to my eyeball at night which is really painful.

If it dehydrates cornea, is it good for my severe dry eye?

It will dehydrate the cornea only if you have corneal edema or swelling due to inflammation. The salinity of the ointment is so adjusted that it won't dehydrate normal corneal or conjunctival cells. So it's basically innocuous to a relatively healthy eye that's not severely inflamed. It will provide some relief if you have eye pain or photo sensitivity from corneal inflammation.

[Milo007]

My eyelid stick to my eyeball at night which is really painful.

Do you have aqueous deficiency?

[ebi1368]

Do you have aqueous deficiency?

I do. But with four plugs I have tear coming down my cheek. Even with lots of tear, my eyes are always painful. Should I try it for a few days?

[Milo007]

I do. But with four plugs I have tear coming down my cheek. Even with lots of tear, my eyes are always painful. Should I try it for a few days?

Well I asked if you have aqueous deficiency because I doubt if you are sleeping with your eyes partially open. I used to have the same problem for at least 10 months (woke up with eyeballs sticking to the inside of my eyelids that felt like ripping off raw skin when I tried to move my eyeball) before I realized that I was sleeping with my eyes partially open (courtesy to Dowork123). I had severely painful eyes those days after waking up in the morning (this was more pronounced in winter of 2017 since the other months of a year are like tropical rain forests here in terms of humidity). I started taping my eyes from the middle of October 2018 and I realized the massive difference (one of the leading cause of my dry eye). I think you also have nocturnal lagophthalmos. So you may try taping your eyelids shut for a week to see if you are still waking up with painful eyes. Don't use the ointment before troubleshooting this possibility or you may feel that it's the ointment that made the difference.

If you have nocturnal lagophthalmos ointments won't solve the problem. You have to either tape your eyes during sleep or use moisture retaining/releasing night time goggles.

Make sure you apply the tape properly to not let your eyelids open involuntarily. Sleeping with your eyes partially open is a more serious issue than one can imagine.

[ebi1368]

Well I asked if you have aqueous deficiency because I doubt if you are sleeping with your eyes partially open. I used to have the same problem for at least 10 months (woke up with eyeballs sticking to the inside of my eyelids that felt like ripping off raw skin when I tried to move my eyeball) before I realized that I was sleeping with my eyes partially open (courtesy to Dowork123). I had severely painful eyes those days after waking up in the morning (this was more pronounced in winter of 2017 since the other months of a year are like tropical rain forests here in terms of humidity). I started taping my eyes from the middle of October 2018 and I realized the massive difference (one of the leading cause of my dry eye). I think you also have nocturnal lagophthalmos. So you may try taping your eyelids shut for a week to see if you are still waking up with painful eyes. Don't use the ointment before troubleshooting this possibility or you may feel that it's the ointment that made the difference.

If you have nocturnal lagophthalmos ointments won't solve the problem. You have to either tape your eyes during sleep or use moisture retaining/releasing night time goggles.

Make sure you apply the tape properly to not let your eyelids open involuntarily. Sleeping with your eyes partially open is a more serious issue than one can imagine.

I bought the tape from dry eye shop to tape my eyes. The problem is whenever I put the tape on my eyes, my eyelid margin gets really itchy. Is it bc of MGD?.
I have tried swimming goggles and moisture chamber but for some reason, I wake up in the morning and moisture chamber is not on my eye. I tend to take it off whille I am sleeping.

[Milo007]

I bought the tape from dry eye shop to tape my eyes. The problem is whenever I put the tape on my eyes, my eyelid margin gets really itchy. Is it bc of MGD?.
I have tried swimming goggles and moisture chamber but for some reason, I wake up in the morning and moisture chamber is not on my eye. I tend to take it off whille I am sleeping.

I have tried custom made moisture chambers with perfect seal. They didn't work. I woke up with super painful eyes after just 4-5 hours of sleep.

The fact that your eyelid margins are getting itchy indicates that you might have demodex infestation.

Is it so that your lid margins get itchy right after applying the tape?

Also do you perform anything like lid margin debridement or aggressive eyelid scrubbing?

Are your eyelids sore to touch (especially near the base of your eyelashes?

[Guest]

Google, eyeglass ear grip. Put those on the back of your moisture chambers and they will keep them on at night. If you’re this bad however, I think you will need tape. I needed tape at my worst. Because even with a chamber or a shield, if the eye was open, it still got dry.

I believe eve if you have tears and arecstill in lots of pain. Something wise is going on that needs to be addressed. Based on what I now now, I would assume you have some odd lid disease. I wish you could get check for floppy eyelid. I say that because I’m wondering if you have chronic conjunctivitis. When I had tears or put in drops, I got no relief. Because the problem wasn’t dryness. The dryness was a result of the chronic conjunctivitis.

So once we healed the eyelid. They finally closed at night. I do not tape anymore. I refuse to do that. I know for a fact it increased my IOP and/or caused corneal edema. So people worry about glaucoma with steroids, and you should. However pressure on the eye will increase IOP too. So I’m this position, you gotta make a tough decision.

[Milo007]

Because even with a chamber or a shield, if the eye was open, it still got dry.

Totally agree with this. As I said moisture chambers didn't work for me. Tapes do.

So once we healed the eyelid. They finally closed at night. I do not tape anymore. I refuse to do that. I know for a fact it increased my IOP and/or caused corneal edema. So people worry about glaucoma with steroids, and you should. However pressure on the eye will increase IOP too. So I’m this position, you gotta make a tough decision.

The same thing happened with me. My IOP increased significantly after I started taping my eyes. My opthalmologist also said that I have red eyes right after removing the tapes because of a decrease in oxygen permeability while my eyelids are taped overnight. Normally our eyelids are slightly open when we sleep so small amounts of oxygen always seeps through and prevents hypoxia of the ocular surface. Taping eyelids shut completely induces marginal hypoxia so that the blood vessels dialate in an effort to supply more oxygen. Hence the reddish appearance of the palpebral conjunctiva and the corners of the eyes.

But he said anyway it's better to tape my eyelids than to leave the eyes vulnerable to dessication. The benefits outweigh the risks.

[ebi1368]

Is it so that your lid margins get itchy right after applying the tape?

Like withing a few minutes. Is that a sign of demodex?

Also do you perform anything like lid margin debridement or aggressive eyelid scrubbing?

I used to do lid margin debridement but I stopped it as I thought I did not help. One doctor told me that I do not have demodex. Not sure if it is something easy to spot.

Are your eyelids sore to touch (especially near the base of your eyelashes?

My eyes are always sore. When I touch the top of my eyelid, I can feel it is painful. I am not sure if it is my eyes that is painful or my eyelid. I feel like my upper eyelid is a bit puffy. I am not sure if it is normal or I am obsessed about it. My eyes in the morning are super red. Like the way that I do not look at the mirror because I get stressed. So painful.


Thanks for your informative response Milo007 and guest

[ebi1368]

I believe eve if you have tears and arecstill in lots of pain. Something wise is going on that needs to be addressed. Based on what I now now, I would assume you have some odd lid disease. I wish you could get check for floppy eyelid. I say that because I’m wondering if you have chronic conjunctivitis. When I had tears or put in drops, I got no relief. Because the problem wasn’t dryness. The dryness was a result of the chronic conjunctivitis.

I get rashes on my eyelid once a while. like outside of my eyelid. Is that a sign of chronic conjunctivitis?

Most of the time drop does not relieve my pain.

[Milo007]

Like withing a few minutes. Is that a sign of demodex?

No I think it's not demodex if the itching follows taping.

My eyes are always sore. When I touch the top of my eyelid, I can feel it is painful. I am not sure if it is my eyes that is painful or my eyelid. I feel like my upper eyelid is a bit puffy. I am not sure if it is normal or I am obsessed about it. My eyes in the morning are super red. Like the way that I do not look at the mirror because I get stressed. So painful.

I think that's the actual reason for both your MGD and itchiness after application of tapes.

Firstly if you are doing warm compresses absolutely stop it and give it a break. Heat will only worsen your cutaneous and ocular inflammation.

Try to remember when was the first time you noticed the puffiness and soreness of your eyelids.

Was it before you started doing warm compresses?

Or was it a consequence of warm compresses irritating your eyelid skin?

I assume that you are not using any irritating eyelid cleaning products particularly the ones with tea tree oil. If yes please stop them on a temporary basis.

If your doctor has never mentioned that you have ocular rosacea I think it's a consequence of either bacterial blepharitis or irritation from eyelid hygiene practices.

You should give hypochlorous acid a try. Also since your eyelids and eyes are inflamed if possible run a course of 20mg doxycycline twice a day for a month and use azithromycin ointment at night. This will kill the inflammation fast. You can also complement them with cold compresses.

Once the inflammation is under control you can start experimenting with the tape. Until then I think you should use tranquileyes or eyeseals to protect your eyes from dessication at night.

Trust me I believe you are sleeping with your eyes open.

You can share a picture of your eyelids if you are not sure whether it's normal or not.

[Milo007]

I get rashes on my eyelid once a while. like outside of my eyelid. Is that a sign of chronic conjunctivitis?

Most of the time drop does not relieve my pain.

I think you should consult a skin specialist for this particular concern. Rashes on eyelid skin maybe eczema or signs of ocular rosacea.

Treating skin problems that's contributing to inflammation is equally important.

Rashes on your eyelid skin is not a sign of conjunctivitis. But depending on the nature of the rash it could be blepharitis. A picture would be very useful in identifying what exactly is it.