Any Advice

[Steve V]

I started having dry eye problems in law school. I've been taking Restasis for about 4 years, also dry eye drops, compresses, fish/flaxseed oil, etc. The Restasis helps, I'm not sure about anything else. I just was prescribed Azasite.

I have been to several doctors and the last two have indicated that my eyes don't look too bad, but that I have decreased tear production on the Schirmer's test (5mm with my most recent doctor; 0mm with my last doctor). Neither seemed particularly concerned because my eyes apparently look ok, but I have a lot of pain. I also believe that it affects my vision. After a period of a lot of driving or meetings with a lot of pain my vision seems to be worse (permanently).

My biggest problems are 1) driving and 2) meetings. When I had trouble in law school, it was more a feeling like I had something in my eyes. Now I most feel pressure/pain at the bottom of or below my eyes. In the last several weeks, I am also getting dark circles under my eyes (not particularly pronounced).

Any ideas about the vision loss, the change in feeling from something being stuck in my eyes to pain? Could I have dry eye + some other problem? How about rosecea? My face gets red easily - I don't know if that is a symptom. Nothing else would lead me to believe I have rosecea, although I am not very familiar with it.

Sorry for the long post. Any thoughts would be appreciated.

[Lucy]

Steve posted:
"I have been to several doctors and the last two have indicated that my eyes don't look too bad, but that I have decreased tear production on the Schirmer's test (5mm with my most recent doctor; 0mm with my last doctor). Neither seemed particularly concerned because my eyes apparently look ok, but I have a lot of pain. I also believe that it affects my vision. After a period of a lot of driving or meetings with a lot of pain my vision seems to be worse (permanently"
*******************
If you read through this board, it is common for doctors to tell us our eyes "look good." We may be wincing in pain,but to hear your eyes "look good" just doesn't do much for the problem. Many doctors do not put much reliance on Schirmers tests because they call them "unreliable." If they are administered sloppily and without controls, they will be unreliable. To my point of view, at least with controls and done by the same doctor, it's some measure of success (or lack of) although not terribly reliable. Your eyes might feel the same with 5mm or 0mm readings.

It probably does affect your vision. Dry eyes, especially after a long drive, or computer usage, or reading will make your vision blurry and you'll notice you can't see as well. This, I doubt is permanent. For driving, you can try some moisture chambers (iePanoptx of similar) wraparound glasses. You may not want to wear these in meetings. It could help, though. Usually there is a draft in meeting rooms from A/C or heaters. There are clear glasses you can get with no prescription.
*********************
Steve posted:
"How about rosecea? My face gets red easily - I don't know if that is a symptom. Nothing else would lead me to believe I have rosecea, although I am not very familiar with it"
=======================
Steve, many of the patients on here have problems with rosacea. I'm surprised although I do not have it. It seems to be a tough nut to crack, too. Have you talked to your doctor about the possibility of rosacea? You probably require some different medications. I have not yet heard of Azasite and will google it as soon as I'm done. Good luck.
Lucy

[Brighteyes]

Steve V,

I too developed DES in law school and know how difficult it can be starting out. As for your rosacea question, you can have ocular rosacea without having manifestations on your skin. Rosacea is most common in fair skinned individuals of English/Irish ancenstry. If thats you then you should definitely seek a professional opinion.

p.s. Let us know how Azasite works for you. Thanks!

[calli66]

Steve,
You're not alone with the vision deterioration. Ever since my eyes got dry 6 years ago, my vision keeps getting worse bit by bit. I have a hard time driving at night. When I'm really stressed or lacking sleep, my astigmatism gets really bad. I've lost at least 2 diopters acuity (nearsighted--now at -8.25 D), and while my eyes definitely feel much better now, my actual vision hasn't gone back to what it was.

Calli

[Terri]

Steve: Also check to see if you have lagophthalmos. Since your eyes are most painful at the bottom, you may be sleeping with your eyes partially open. Even if they're closed when you fall asleep, they may come slightly open during the night, causing them to dry out.

[Steve V]

Thanks and some questions

Thanks for your thoughts. So I'm not the only one who gets the "your eyes don't look too bad" thing.

How do I know if I have lagophthalmos? I have tranquileyes - is it just that if the tranquileyes seem to work you have lagophthalmos and if they don't work then you don't?

I know that I see worse when my eyes are dry, but I definitely have had a steady downward vision trend since I started getting dry eye symptoms. I had no glasses at all before this started.

I'll let everyone know how the Azasite works out. I think someone asked - it is apparently a relatively new drug that is primarily used as an antibiotic to treat pink eye, but is also being tried for dry eye because of its anti-inflamatory properties.

[Terri]

Lagophthalmos can be hard to diagnose. Your eyes may open only slightly, so it's not apparent to someone looking at you while you sleep. They may also close when you sleep but open during the night. If you wake up feeling better when you sleep with Tranquileyes (or with your eyes taped shut) than when you don't, it might be a good indication you have it.

[Steve V]

Azasite

I've been on the Azasite for about a week now and it seems to be helping some. It is a little bit hard to tell because in November my eyes felt the worst they have in a couple years and now they feel more normal. The only thing is, I got two bottles which supposedly each have 2.5 ml, but I used up the bottle in 3 days. I've used the second bottle for 4 days now so we'll see if it keeps going. The restasis drops are 0.4 ml and I use one vial twice with no problem. So, I would have thought that each Azasite bottle should last me something like 12 days.

[stella]

Steve
Where do you get the Azasite from ?
Thanks
Stella

[Brighteyes]

Azasite

Steve V,

Is Azasite meant to be taken long term - like Restasis - or short term - like an antibiotic drop?

[soxboy]

Azasite

I too just recieved a prescription for azasite from Dr. Latkany. This drug , I believe was approved in July, and shoed signs of promise for blepharitis. I think the company is Inspire

[soxboy]

9 days

On their web site it says that this drop cures the bacterial infection in 9 days. My pharmacy had to order it on Friday, and said to pick it up tonight. I am expecting a very small portion........

[Steve V]

I got it by prescription. I got two small bottles 2.5 mls each and can get 2 refills (2 more bottles for each refill).

[Lucy]

You guys let us know how you do on this! Thanks for the PM sox.

Lucy

[Judy]

Can't wait to hear input on how you all do! Merry Christmas, Happy New Year to all my dry eye friends!! God Bless!