Eye Drop News for Sjoggies

One of my fabulous readers let me know that Refresh Optive Advanced Sensitive is now available in a preservative free version.  I've been mourning the loss of Refresh Endura since Allergan took it off the US market almost three years ago.  

I haven't been able to find as perfect an eye drop match since then.  There are so many on the market and believe me I've gone through boxes of different brands trying to find something that made my dry eyes feel better.  As those with Sjogren's and dry eye conditions know, finding an eye drop that works is a very individual choice and what provides relief for one person might not for another. There is lots of trial and error involved.

Last year, I had tried the Refresh Optive Advanced Sensitive as I wrote about here.  While I initially liked how they felt, because they were not preservative free my eyes burned.  I eventually had to stop using them.  So when I heard the news about these new drops, I had to go to the drugstore to see if I could find these artificial tears. Lo and behold, there they were and I've been testing them for the last week.  They come in a box of 30 individual vials as pictured above. 

I've had much more luck with the preservative free version.  No burning and my eyes are definitely getting more relief than from some of the other artificial tears on the market. The drops are basically a combination of Allergan's Refresh Endura and Refresh Optive since they contain glycerin,  polysorbate 80, and carboxymethylcellulose sodium as active ingredients. These might just become my go to drops.

Which artificial tears do you find to be the most helpful?

Can My Eyes Really Get Drier?

Sahara Desert

Although I did not think it was possible, my eyes have actually gotten drier.  I guess we’ve moved from a regional desert to the Sahara.

Now, my eye history is long and complicated. My symptoms are made worse due to a previous corneal infection and subsequent scarring, which my doctors attribute to Sjogren's. I also have had uveitits, another serious eye condition which needs to be kept under control or can lead to vision loss. I also have seriously dry eyes, related to my Sjogren’s as well.

Last week, my eyes started to really bother me in a way I have come to associate with serious flares. I became extremely sensitive to light (again!, but it had been a while) and developed constant eye pain, to the point that putting in my usual preservative free drops in my eyes was quite painful.  My right eye became so uncomfortable that I had to use an eye patch just to watch TV. Looking at a computer screen was out of the question.

Generally, when I have a flare up, I put extra drops in my eyes. This time that made my eye hurt more, so I immediately became particularly concerned.

Early Sunday morning my husband I bundled up and trundled off to the emergency eye clinic, where my doctor wants me to go if anything out of the ordinary happens to my eyes.

The good news is that there was nothing requiring emergency care like a flare of my uveitis or an infection.  However, the doctor did notice that my eyes particularly the right eye was extremely dry to the extent that the layer that covers the front of the cornea or corneal epithelium had been effected. This extreme dryness she explained was why I could not put drops in my eye without pain; dryness this severe can feel like a corneal abrasion. Ouch! 

Of course, my blepharitis and ocular rosacea were also simultaneously in full force, which also contributes to eye discomfort. 

The doctor suggested using my nighttime eye ointment (my preference is Refresh P.M. Sensitive but there are a number available) frequently during the day to improve the lubrication, more warm eye soaks, and re-starting steroid eye drops. It was a bit of a surprise to me that my eyes could still be so dry given how much time and how many steps I take each day trying to keep them moist. I guess that is what happens with Sjogren's.

I thought I would share my daily growing eye care routine for my dry eyes and blepharitis.  

What do you do everyday to help combat your dry eyes?

~ Preservative free drops about 8 to 9 times a day.

~ Restasis 4 times a day as prescribed by my doctor

~ Steroid eye drops as prescribed by my doctor

~ Warm eye soaks 2 times a day.

~ Ocusoft lid cleanser

~ Preservative free nighttime eye ointment

~ Humidification every night for dryness

Dry Eye Rituals

  

I know that dry eyes are a major problem for Sjogren’s sufferers.  For me, they have been a HUGE impediment to reading books or using a computer and hence returning to my work, which was highly research intensive.  Like most of my Sjogren's symptoms, each day is not exactly like the day before. One day I might be able to read for a couple hours, but then the next day my eyes will ache and hurt  no matter how many times I put drops in them or “keep them watered” as I like to say.  I also have some corneal damage, probably due to Sjogren's, which makes the pain in one eye more severe than the other. My eyes have windows of opportunity and I try to take advantage of them and then rest my eyes when they are beat and painful.   I thought that I would share my eye rituals and some of the products and techniques that I have tried to deal with the dryness.  I would love to hear your suggestions and how you combat your dryness.

Eye Drops -- Drops, Drops, and more drops.  If you spend any time with me, you will be sure to see me putting drops in my eyes. 

a.       I use over-the-counter (OTC) eye drops about eight times a day.  I tried almost every OTC eye drop over the last few years and the only ones that don’t cause burning and discomfort for me are Refresh Endura by Allergan.  They contain the same ingredients found in Restasis without the medicine cyclosporine.  I was mortified when Allergan replaced these with Refresh Optive in the United States Market.   My eyes were unhappy, dry, and uncomfortable.  It turns out that Allergan had stopped selling Refresh Endura in the US; after much Internet sleuthing we learned that the drops are still sold in Canada by www.well.ca. My eyes are very happy to have Refresh Endura again.  I know that OTC drops are a personal preference and everyone’s tears are different, but if there is anyone out there who has been looking for Refresh Endura I hope this helps.

b.      I also use Restasis four times a day as prescribed by my eye doctor.  The active medicine in Restasis is an ophthalmic solution of cyclosporine--an immunosuppressant used to prevent organ rejection in transplant patients and for autoimmune conditions such as rheumatoid arthritis.  These drops made a big difference for me as well and, sometimes, when I blink there are actually tears.  

c.       My doctor has also prescribed Lotemax by Bausch and Lomb, a corticosteroid eye drop to use only when my dry eye pain is extremely severe.  It is only to be used sparingly because it can result in side effects such as glaucoma and changes in eye pressure.  So, Lotemax is an option of last resort for me, and I only use it at most a few times a month.

In the evening, I always use a lubricant eye ointment.  My current ointment of choice is Refresh Sensitive PM, but I have also used GenTeal PM Lubricant. There are many others as well.  The ointments are a bit gooey and they make it hard to see. I always put the ointment in just before bed when there is nothing else that I need to do that night. Without using these ointments, it becomes very hard for me to open my eyes the next morning.  If I forget to use it one night, my eyes  feel like they are sealed shut and are then uncomfortable for the rest of the day.  Not worth it to forget the ointment.

Alas, my eyes are telling me it is time to stop or they will rebel and really start to hurt.  I am trying to learn to stop when my body starts to tell me to... so more on dry eyes in my next post.