ocular rosacea/dry eye and allergies

[celticgirlie]

Anybody have any suggestions on their regimen for these two? Right now, I do eyelid scrubs twice a day, use eye drops as needed (Refresh and Systane) and take an antihistamine every other night. Finding a balance with the dryness is very difficult. What do you do?

Thanks.

[irishgenes]

I have had ocular rosacea about 20 years, especially on the eyelids, but I don't have dry eyes. I take bioidentical estrogens (Tri-est) to help prevent menopausal flushing, and this also keeps my eyes lubricated. Everything dries up when estrogen declines.

[celticgirlie]

My skin turned from combination to dry when my rosacea kicked up a notch. That's when my ocular rosacea also began. My understanding is that rosacea and ocular rosacea can cause both dry skin and dry eyes. It is not necessarily hormonal (my rosacea was spurred on by harsh products). I mean, nowhere else in my body is affected by dryness.

I do wonder why the skin doesn't reverse to old ways, though, after removing the harsh products and having laser treatment.

Does this make sense? Or do I need to see an endocrinologist now?!!

Do I need to ask Dr. Nase?

[Kathleen Tartar]

Do you use a night time lubricant?
My optomologist suggested it and it helped a lot
I have been using Genteal Gel at bedtime but though it is temporarily off the market (and I think the best) there are several other brands out there
Hope this helps

[irishgenes]

If you are not peri- or post-menopausal, but really a Celtic girlie, then estrogen lack is probably not your problem, and you can skip the endocrinologist! Ocular rosacea can cause dryness of the eyes all by itself. I just haven't had that symptom, though I have every other symptom. I would like to have my eyelids lifted via plastic surgery, but I am afraid the constant swelling of my eyelids from ocular rosacea would interfere with good results. I wish I could find a laser eye specialist to do that photocoagulation treatment of the eyes and eyelids, like Dr. Nase talks about in "Hot Topics #6" on his website.

[celticgirlie]

Thanks Irishgenes,

My derm. claims that I'm probably too young to be having hormonal changes and my opthalmologist said that even if it was hormonally related that I wouldn't get any great relief from hormone help. Obviously, you prove that theory wrong!

Thanks for your help. Please report on any of your findings regarding the laser eye specialist. Hopefully, that kind of treatment will become more readily available as time goes by.

[celticgirlie]

Thanks Kathleen,

Something in the Genteal gel bothers my eyes. I should try another one. I guess I'm in "tired of trying failures" mode!!

My doctor also gave me patenol drops and restasis to try.....

Dr. Nase has also written some new information on drops.

[irishgenes]

Well, tell your opthalmologist that there is currently a trial for dry eyes going on in Hawaii using estrogen eye drops! (I have used Patanol with good results when I have a burning and scratching in my eyes, usually during seasonal allergy time.)


[Honolulu – May 23, 2005] Nascent Pharmaceuticals 90-patient Phase IIb clinical trial of NP50301, an ophthalmic therapeutic eye drop treating Dry Eye Syndrome (DES), has reached full enrollment. The trial is aimed at post-menopausal women, who represent the largest group afflicted with DES. DES is believed to affect some 13.5 million post-menopausal women in the U.S. and more than 300 million people globally.

Commented Michael J. Coy, CEO of Nascent, “We are on track for trial completion by September, and expect to present trial data to the FDA in the fourth quarter. With FDA approval, NP50301 will be ready to begin a Phase III trial early in 2006.”

The current clinical trial is single-centered, randomized, vehicle-controlled, double-masked, with 30 patients in each of three arms, and each arm receiving either vehicle without drug, or one of two doses of 17-ß-estradiol as the active pharmaceutical ingredient. Data collected includes both subjective symptoms and objective signs throughout the 14-week trial period. The trial design includes a 24-patient pharmacokinetic study, to measure the blood serum implications, if any, of topically instilled estradiol; as well as a study of MUC5AC levels, to assess the role that estrogen eye drops play in the production of ocular surface mucin protein.

Prior research has shown estrogen-based treatments to improve intraocular pressure, improve corneal health, slow the growth of cataracts, and slow the impact of age-related macular degeneration.

“The many implications of NP50301 for improved ocular health make it an attractive addition to an ophthalmology product pipeline,” commented Douglas Beekman, vice president of Advantage Capital Partners, Nascents lead investor.

[Blondie]

I developed severe dry eye syndrome after the 2003 wildfires in So Cal. After initial steriod treatment eye dr. prescribed Restasis. I find it very helpful with the tearing. Downside is it is VERY expensive. My ins. doesn't pay. Found cheapest at Drugstore.com. I use Refresh Gel drops during the day and Refresh PM lubricant eye ointment at bedtime. Ointment Active Ingredients: White Petrolatum (57.3%), Mineral Oil (42.5%) Inactive Ingredients: Lanolin Alcohols. I have mild rosacea. Until reading Dr. Nase's book I didn't know about ocular rosacea. Will be seeing eye dr soon. I am wondering if my "dry eye syndrome" isn't really ocular rosacea.

[celticgirlie]

Thanks Irish genes for that info!

Hi Blondie,

My opthalmologist won't actually say I have ocular rosacea. He says I probably do. He also said I have "a little" meimobian gland dysfunction. Another opthalmologist said my dry eye may be related to long term contact lens use or ocular rosacea, she didn't specify.

I get tired of specialists not seeming to specialize!!

I know the restasis is about $140 per month if your insurance doesn't cover it. He said Costco is the cheapest but online is cheaper?

I will try the Refresh lubricant you mentioned.

I live in Southern California which is a very bad place for allergies and is basically desert so pretty bad for dryness!!!

I have mild rosacea too.

Blondie, are you able to wear eye makeup? I can but only occasionally.

[Blondie]

Hi CelticGirlie!

Restasis was cheaper on line because I bought a larger quantity. Comes in boxes of single-use vials so you can store it.

My derm just put me on doxycycline so we'll see if that helps with my eyes.

I can wear eye makeup but usually take it off when I'm at home to give my eyes a break. Wish I could find a remover that didn't sting my eyes.

I'm a newbie to Dr. Nase's book and this forum.

Thanks for the support!

[irishgenes]

I can wear eye makeup but usually take it off when I'm at home to give my eyes a break. Wish I could find a remover that didn't sting my eyes.


Doesn't Vaseline work for eye make-up removal? It's been a long time since I was able to wear eye make-up, but that's what I used.

CelticGirlie, I always used to wonder why I couldn't wear even soft contacts, and now I realize that I had ocular rosacea all the time. I especially couldn't stand the contact lens solutions. They all stung me except for the one without preservatives. I would always develop a lot of film on the contacts, too, and have to be cleaning them all the time. I finally gave up and went back to glasses.

[celticgirlie]

Hi Blondie and Irishgenes,

For what it's worth I use Lancome bi-facils eye makeup remover. Of course, the Ocusoft eyelid scrubs also remove makeup. Irishgenes, did you ever try the CibaVision eyelid scrubs that Dr. Nase also mentions? I have looked at those - the ingredients are different.

I am mourning the loss of wearing contacts, having worn them since 1979!!! Sorry to hear about your problems with them, Irishgenes. I remember once about 14 years ago an Estee Lauder sales woman mentioned that I had rosacea. (I never looked into it) Anyway, imagine that!! It was about 12 years later that my derm. finally decided I had it. Apparently, about 60% of people with facial rosacea will also have ocular rosacea. Anyway, I am told that there is a new contact lens for people with dry eye. The opth. gave the okay to try them. I'm nervous.............. but I would just like to wear them for special occasions. Otherwise, there are some really nice frames these days.

Anyways, Blondie, I just stopped by Target and picked up the Refresh PM ointment so I will keep my fingers crossed!!

Here's to comfortable, white eyes!

[Karla]

Hi all,

Do any of you with Occular have yellowing of the whites of your eyes in addition to increased redness? Is that a manifestaion of Occular or another problem altoghether?

Thanks so much!

Karla

[celticgirlie]

Karla,

No yellowing for me. I've had my eye trouble for about 1 1/2 years so don't know about longer term problems.

[irishgenes]

Karla, I've had ocular rosacea 20 years and no yellowing. It sounds like you should have that checked out by an opthalmologist. If you've been to one recently, what did he say about it?

[Karla]

Thanks Irishgenes & Celticgirlie.

The yellow seems to come and go and be worse when the red is worse. I went to a GP a couple of weeks ago thinking I had pink eye because several of my friends did and she did a "stain" not sure what that's for, said probably no on the pink eye but gave me antibiotic drops for 5 days - didn't do anything one way or the other.

My eyes often ache, especially the back of them. They are constantly feeling gritty and like there's something in one or both of them so I'm constantly using eye drops (Refresh single vials and Similasan DryRedEyes). 5 years ago I had Lasik for vision correction and that's when Rosacea became occular, maybe because part of the followup treatment is steroid drops? When I recognized the symptoms and asked the Lasik doc at first he didn't believe I had Rosacea (face makeup covers it) but after looking inside my eyelids said "ok, probably a little, scrub the lids 2xdaily" and that has really kept the redness/irritation at bay, along w/the drops, until the last few months, when the red/yellow has just became chronic day/night, instead of episodes here and there. It's a rare day or few hours when they aren't red/yellow.

I take generic Claritin just about every day because living in the pollution of So. Calif. was causing repeated sinus infections, but maybe that's not enough to keep the irritation/alergy in the eyes away?

I'll make an appt. w/an Opthomologist and update you. If you have any other suggestions for things that have helped you I'd love to hear it!!

Thanks again,

Karla

[celticgirlie]

Hi Karla,

When my eyes ache they're usually drier than usual and/or I'm tired. Maybe taking antihistamines every day is too much for you too (like me). I take mine every other day and this doesn't seem to bother my eyes as much (actually I take mine at night because they make me tired).

Anyway, still don't understand the yellow part. It is hard to find a good doctor. I also live in So. Cal. - was curious to know where. Maybe we could compare doctors? If you like, send me a private message. :)

Dr. Nase has recently written about the latest drops for ocular rosacea - might want to read that.

Also, I have tried Similisan drops before and they made my eyes feel worse. Even if I use too much of the Refresh or Systane it bothers my eyes. For nightime Blondie recommended Refresh PM ointment to try (my eyes felt "tight" in the morning - I've only tried it once). Also, Genteal gel (when it's available is tolerated well by many but not me!!)

One more thing, drink lots of water - that helps with sinuses and rosacea! An air purifier and humidifier in your home help with allergies and dry eye respectively. Man, so much to think about!!!

[irishgenes]

At the risk of scaring you, here is a link which gives 21 possible reasons for yellowing of the whites of the eyes:
http://www.wrongdiagnosis.com/sym/yellow_eyes.htm

As you will see, rosacea isn't listed as a possible cause. Some are serious conditions and some are not so serious.

[LaurieD]

In regards to allergy meds and rosacea, remeber that Dr. Nase's book notes that Singulair appears to have a positive effect on rosacea. Singulair was first prescribed for asthma, but now is also used for seasonal allergies. It leaves with no appartent other side effects, also.

LaurieD

[dee]

is it possible that the "yellow" is smaller veins? I thought I saw yellowing on the sclera but I looked really close and saw it was very small veins.