Trying to reach Rebecca

[Marsha G]

Hi Rebecca
I tried to call you yesterday to ask you a question. I guess you were not available. I went to a cornea specialist as you advised me to get my meibomian glands checked to see if they were the cause of my dry and burning eyes. He said he thought my glands were okay and recommended to get the punctal plugs as well as trying Azasite on my upper and lower lids twice a day and continue using the Restasis twice a day. My question for you is how long can you use Azasite on your outer lids near the lashes? The doctor did not have any samples but he had something similar called Zylet. It really helped. I have only used it 2 times but the burning and my vision has improved. The other question is do you think I should get the plugs if this medicine stops the burning and dryness?
Thanks
Marsha

[Rebecca Petris]

Marsha... so sorry, I've been out of the office a lot this week and am way behind on callbacks. I'll do my best to call today.

I'm not too comfortable answering questions about Rx drops because that should come from the doctor however I know that a lot of people are advised to use Azasite that way (on the lid margins) for extended periods.
Zylet is an antibiotic/steroid combo-drop - glad to hear it's giving you a relief... you can't stay on it too long because of the steroid, so chances are you would need some other method to maintain things. Is he seeing a lot of aqueous dryness - is that why he recommended plugs? For a lot of people lower plugs can be a good idea (at least as something to try) and there are some short-term dissolving plugs that might be a decent way to try it out.

[Marsha G]

Marsha... so sorry, I've been out of the office a lot this week and am way behind on callbacks. I'll do my best to call today.

I'm not too comfortable answering questions about Rx drops because that should come from the doctor however I know that a lot of people are advised to use Azasite that way (on the lid margins) for extended periods.
Zylet is an antibiotic/steroid combo-drop - glad to hear it's giving you a relief... you can't stay on it too long because of the steroid, so chances are you would need some other method to maintain things. Is he seeing a lot of aqueous dryness - is that why he recommended plugs? For a lot of people lower plugs can be a good idea (at least as something to try) and there are some short-term dissolving plugs that might be a decent way to try it out.

Glad you responded. He told me to try the Zylet samples and if it helped switch to the Azasite Rx which cost a lot. Wellthe zylet stopped the burning but I still feel dry. He said he thinks I have enough tears (15) with the tear test measurement test. He said he was surprised my opthalmologist had not tried the punctal plugs already. The opthalmologist said he was going to put in punctal silicone plugs that are permanent. The cornea specialist said the permanent ones can be removed with tweezers by the doctor if they don't work. Is this true? Also you mentioned lower plugs; are there upper plugs also? My doctor did not mention short term plugs. Which should I do?
Thanks,
Marsha

[Rebecca Petris]

G The cornea specialist said the permanent ones can be removed with tweezers by the doctor if they don't work. Is this true? Also you mentioned lower plugs; are there upper plugs also?

Yes that's true. There are types that can't but if he said this it means he intends to use punctal plugs which can be removed. Sounds reasonable to me...

[Marsha G]

Yes that's true. There are types that can't but if he said this it means he intends to use punctal plugs which can be removed. Sounds reasonable to me...

I am having the punctal plugs put in next Friday. Will let you know how it turned out. Thanks for your advise.
Marsha

[Marsha G]

Got the plugs

Rebecca
I had the punctal plugs inserted at 10AM today. The doctor did not sound like he felt they would do any good. He said I would have to use Restasis for the rest of my life. He gave me some Optive Refresh Sensitive and told me not to use any drops with preservatives. He gave me some drops with cortisone when the pain gets really bad. He said I should continue using the Azasite twice a day for one month.(He said he is not a big fan of Azasite) He wants me to let him know one way or the other how I am doing and come back in 3 months.

Do you know a Dr. Paul Gilwit in Fort Lauderdale? I read in the internet that he does use a fugo blade and performs fugolysis. Maybe if this does not work I'll try that. Any ideas?
Marsha G

[jope]

Rebecca,
I'm new to this forum. I was having a horrible problem with dry eyes (Sjogren's Syndrome) since last November. Have tried both of the above medications and both help me. In the last 2 weeks, the problem subsided somewhat. The opthamologist was ready to put punctal plugs in my eye (was going to do last Friday) but he said they looked so much better he would wait until they start up again, in October or November. I live in Ohio. He said the problem always eases in the hot, humid summers and is severe again in the winters.
I've been on restasis for 3 years and it's helped but for an unknown reason became unmanageable last November. Do you happen to have rheumatoid arthritis? I was diagnosed 18 years ago. It's a whole different problem but I've been treated with multiple drugs and live a normal life. My dr said the Sjogren's is very, very common with RA -- just another autoimmune disease I have to deal with. I've also been considering going to the Jerome L Greene Sjogren's Syndrome Center at Johns Hopkins University for evaluation. Does anyone on this forum have experience with a medical facility that is treating this disease very well? I am at a loss to deal with it and no doctor gives me any hope at all.
Thanks for answering,
Joy

[Marsha G]

Rebecca
How long does it take before you feel relief after getting the punctal plugs?

[Rebecca Petris]

Rebecca
How long does it take before you feel relief after getting the punctal plugs?

Sorry Marsha but I've been out sick for a couple of days and I don't always read the board. i haven't been plugged in a long time so I don't recall personally but I'd expect some improvement pretty soon, i.e. within days.

[Rebecca Petris]

He said I would have to use Restasis for the rest of my life.

Personally I wouldn't accept that advice.

He gave me some Optive Refresh Sensitive and told me not to use any drops with preservatives.

Fine, fair enough

He gave me some drops with cortisone when the pain gets really bad.

Just so long as you're having your pressure checked regularly if you're using them.

Do you know a Dr. Paul Gilwit in Fort Lauderdale? I read in the internet that he does use a fugo blade and performs fugolysis. Maybe if this does not work I'll try that. Any ideas?

Sorry no... I don't know anything about fugolysis. I know Dr. Gilwit by name but not much about him.

[Rebecca Petris]

Hi Joy, welcome,

Rebecca,
I've been on restasis for 3 years and it's helped but for an unknown reason became unmanageable last November. Do you happen to have rheumatoid arthritis?

No I don't. indrep's wife does so he knows a lot about it and other members here do. I'd suggest (if you haven't already... sorry, I'm a bit behind on reading here) posting with RA in the subject line in the open forum to get some more info.

[Marsha G]

Rebecca
Hope you are feeling better.
Thanks for answering my questions. Since I am knew to this web site I was not aware I was doing something wrong in asking questions directly to you. Kitty, another administrator of Dry Eye, said I should e-mail you directly. Only problem she told me where to find your e-mail address but I could not find it. My eyes are still burning and it has been almost a week now since the lower plugs were inserted. Could you give me your e-mail address so I can ask you questions in the proper manner? It pains me to read(my eyes are burning). I try to blink more often but it does not help.
Marsha G

[Rebecca Petris]

You're doing fine... I know it's hard to navigate the boards at first, there's a lot of forums! If you look where my name is, in dark blue heavy print in the top left corner above my post, click on my name and several options should pop up. The last one is "Email". That will bring up a form where you can email me, or just send direct to rebecca@dryeyezone.com.

[Marsha G]

I tried clicking on your name . A box pops up but it only has 6 choices none of which are titled e-mail.(View articles is the last choice). Could you tell me how often I should put drops in my eyes? What I am doing now is starting my day by using a warm compress for 5 minutes, then rubbing Azasite to the eyelid edge waiting 20 minutes and then using Restasis. If they are still burning after I do this then I use either Genteal Gel with some Soothe Drops or Refresh Optive Sensitive. Thereafter if the burning returns I use more Refresh Optive Sensitive. This usually happens in a few hours. Then the next time I do the same in a few hours. I end the day by cleaning my face, using the heat pack for 5 minutes, applying the Azasite on the lids, wait 20 minutes and add Restasis drops. Seams like the only time I am not in pain is when I am sleeping and maybe a few hours after the drops are added. I read somewhere that ice compresses might help. What do you think? I have tried all kinds of drops but I never have seen Dwelle or Dakrina in the stores. Would you think they might help? I am wasting so much money on drops I just wish I could find the right one. Why is preservative free better? Are there other preservative free drops that are good other than Refresh Optive Sensitive? They only seem to help me for a few hours. Today is one week since the plugs were placed in my eyes and I really don't feel any difference. Do I leave them in or have the doctor remove them or have I not waited long enough? I stopped wearing eye make-up today to see if that would help but did not notice any difference.
Thanks so much for listening to me.
Marsha G

[Rebecca Petris]

I'm hoping to be back to work tomorrow and if so I'll give you a call then.