Patanol

[Plat]

Dr Bazan,

- is Patonal ok to take for 6 months or longer continously? will the relief be immediate or can it take weeks, months, to notice a difference in symptoms?
- if it is allergies, is it ok to keep taking it even if Patanol drys out your eyes even more than they already are until you take care of the allergen?
- if it is allergies, is relief immediate once the allergen is removed? Or can it take time to adjust?

Thank you

[Justin]

Dr Bazan,
- is Patonal ok to take for 6 months or longer continously?

Yes. I am unaware of any major adverse reactions in my pt base.

will the relief be immediate or can it take weeks, months, to notice a difference in symptoms?

Both. It has both fast action and a delayed onset long term effect.

if it is allergies, is it ok to keep taking it even if Patanol drys out your eyes even more than they already are until you take care of the allergen?

You should be using an artificial tear so it does not dry out your eye even more. ATs also flush the allergens off the ocular surface.

if it is allergies, is relief immediate once the allergen is removed? Or can it take time to adjust?

It often begins to improve immediately and then takes time to adjust. Remember the allergen set off a cascade of allergic reaction. Stopping and reversing the changes will begin to occur immediately but takes time to fully recover.

Thank you

You are welcome!

[BillyBoy]

Sore upper eyelids...

Dr. Bazan,

I've communicated with you on this board before and your advice is priceless. My eyes have been doing very good over the summer here in Northern Virginia. In fact I didn't use wetting drops more than half a dozen times. After my vacation in mid August, where I slacked on doing my warm compresses, taking my oils and doing my eyelid massages, my eye pain is coming back. Actually, just the last few days, my upper eyelids are quite tender and sore on the inside. I experienced the same eyelid pain last fall at this time. Is that a common symptom of fall allergies or do you believe it's because I took a week off of my regular routine? I just started Azasite 2 days ago in hopes that my problem is blepharitis and it will treat it.
Oh, one more question please. Since blepharitis is an inflammation of the eyelids, would taking 1/4 or 1/2 of an aspirin each day be helpful, with physician's approval of course?



Thanks as always for your time!

Bill

[BillyBoy]

Azasite is my new best friend!!

Alright everybody... Listen closely!! I apparently have Blepharitis. Since LASIK it has been a problem with frequent flare ups. I've tried everything! My symptoms would come and go like the wind..... Then 7 days ago I tried Azasite. 4 days into the treatment, my eyes were wetter and much more comfortable. Today (7 Days into it... Pain FREE and the wettest eyes since LASIK. If you have not tried Azasite.... RUN don't walk to your optometrist and ask about AZASITE! No I am not a company rep. I am a case example of my bleph being relieved / treated with Azasite. Dr. Bazan, what are your thoughts? My prescription is 2x/day for 7 days then 1x/day for 3 weeks.

I awake with Totally Clear Vision, nice wet eyes and I place two drops a day in my eyes. Email me if you have any questions. USREALTOR@GMAIL.COM

Loving Life!

[Justin]

GREAT! I had recently participated in a focus group on Azasite and heard many docs sharing a lot of successful cases. Azasite is a unique drug for treating lid margin disease and has great potential. It has the unique ability to get into and remain in the lid structures. The synergistic anti-biotic and anti-inflammatory properties are ideal for lid margin disease. But please keep in mind, the crux of managing lid margin disease still needs to be performed to optimally control the disease. Recently published studies have indicated that lid care in combination with Azasite is a better treatment that just the drug alone. Also, you commented your eyes are wetter. Here is a unique thought. If dry eye has an inflammatory component, specifically affecting our basal tears, will the tissue penetrating azasite also work on the similarly structured lacrimal accessory glands?

[BillyBoy]

Thanks Dr. Bazan. I am still doing the warm compresses, fish and flaxseed oils and lid massaging daily. I also at your recommendation use a tea tree oil shampoo every couple days and TT oil mixed with water and baby shampoo on my lids a few times a week. I will continue to update everyone here on the hopeful success of Azasite over the coming weeks. I hear that Inspire Pharm. (Maker of Azasite) is in FDA phase four studies of a bleparitis treatment. I think I'll buy stock in the company also. The price is at a low in this depressed market :-)

Bill

[Rebecca Petris]

Here is a unique thought. If dry eye has an inflammatory component, specifically affecting our basal tears, will the tissue penetrating azasite also work on the similarly structured lacrimal accessory glands?

Very interesting. Anyone engaged in looking at that presently?

[Plat]

Thanks Dr Bazan, you're awesome.

If someone has allergies and has bumps from allergies on the inner side of the eyelid such as in the link, can patonal work to reduce the swelling?

And if so, how long will it take? If the swelling is from allergies, will patanol resolve this immediately, or can it take, weeks, months for the bumps to subside?

I know you answered how Patonal works before, but I am just curious about its effect on the bumps.

http://www.centre-for-vision.com/cen.../allergic.html

Thank you

[Justin]

You're welcome. Good question. The patanol helps cease the allergic response, part of that response is what you notice as swelling. So kinda would be the right answer. But not all bumps are resulting from the same type of allergic reaction. I will try to locate the text that breaks down the different types of papillae and what the optimal therapeutic is. It also depends on what level of bumpiness the bumps are.

For the most part, I have changed my treatment to only consist of removing the allergen (most of the time its a CL) and hitting the eye with lotemax. Consistently better results for the majority of patients. I honestly see improvement at the 1 wk f/u on the majority of my patients. Also keep in mind that some patients may never experience total regression of the bumps. Although they may become asymptomatic, if a doc flips there lids (every doc should), he often will see a slightly abnormal appearance. I need to update this page but check out : http://justinbazan.wordpress.com/2007/08/04/89/

[Justin]

Very interesting. Anyone engaged in looking at that presently?

Not that I know of, but I put it on the radar with some OD/OMD thought leaders. If I had the #'s I would like to get a study going, but I do not have the same kind of volume as a clinic or a well established practice yet.