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Thread: Eyelid Scrub

  1. #1
    Senior Member fut's Avatar
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    Default Eyelid Scrub

    Ever since starting accutane I have had problems with my eyes. Even when off it.

    I now have some bad dilated vessels and am looking for the eyelid scrubs Dr Nase recommenednd in his book.

    Does anyone know of any gentle eyelid scrubs or where I can buy them? Surprising enough my Duane Reade didn't have them. Perhaps online somewhere?

  2. #2
    Senior Member redhotoz's Avatar
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    On Nov 10 last year, this was posted in the RSG about OR. I saved it because it had loads of info in it, incase I ever need it. Touch wood, I don't right now! I vaguely remember Laura saying she had quoted it from a previous post. It's LONG!

    "Ocular rosacea is a disorder that affects both the eye surface
    and eyelid. Some of the most common symptoms include:

    . Bloodshot eyes
    . Burning sensations
    . Eye pain

    . Foreign body sensations of the eye surface
    . Excess tearing of the eye
    . Hyper-sensitivity of the eye surface

    . Eye irritation to wind, cold, smoke, indoor heating
    . Photophobia (pain and tearing of the eyes triggered by bright light).
    . Itching of the eye surface

    . Redness, crusting, and inflammation of the eyelids. In some cases, crust may form overnight that `glues' the eyelids together.
    . Chalazia (inflammatory bump on the eyelid)
    . Stye (inflammation of an eyelash follicle)
    . Excess discharge from the sebaceous glands of the eyelids.
    . Loss of eyelashes
    . Severe damage to the cornea and blindness

    Obviously, there is a great degree of overlap with eye symptoms
    from allergies. It is very wise to see an eye specialist. They will run
    a thorough series of tests to determine the most probable cause
    of your symptoms, and the physician should give you some effective treatment options.

    In all simplicity, ocular rosacea is a combination of dry eye and
    ocular inflammation. Surprisingly, relieving the dry eye symptoms usually results in substantial improvement of ocular rosacea.

    One of the main complaints that occular rosacea sufferers complain
    of is blurry vision. In 99% of the cases this actually has nothing to do with vision loss. It has to do with a disturbance in the three layers of moisture on your eye surface (mucus, water and oil).

    This (and sometimes the inflammation) plays a role. Good treatment
    focuses on getting back a normal tear film layer first, then seeing what
    happens.

    ARTIFICIAL TEARS are one of the best things you can do for your
    eyes. While treatment for ocular rosacea is usually multifactorial,
    severa studies have shown that daily use of artificial tears for three to
    four months can help the tear film stabilize by decreasing ocular
    irritation. Then patients can sometimes stop immediately or just use them
    upon flare ups. PLEASE DON'T USE VASO-CONSTRICTOR EYE
    DROPS!

    The challenge is to find the right eye drop for your eye. The eye
    vessels in general are a lot more forgiving then the facial
    vessels.

    Many folks recommend Refresh Plus Drops for Sensitive Eyes. I
    have found great success with Thera Tears eye drops, which are
    preservative free.

    In many cases, the normal eye drops are not strong enough.
    That is why the leaders in the industry have made gel drops. Several of
    these gel drops by themselves have been shown to improve the entire
    tear film layer, stabilize the water concentration and electrolyte
    balance, and reduce some forms of inflammation. Gels last 4 to 8 times
    longer than most normal eye drops.

    Some of the newer versions of gel drops worth a try are:

    1. GenTeal Eye Gel ^ Carbopol 980 gel. This is the strongest gel drop. For flat out moisturization without blurriness, Dr. Nase likes thise new preservative free gel by GenTeal.

    2. Bausch and Lomb Liquid Gel ^ Hypromellose gel.

    3. Systane ^ hydroxypropyl guar. This is the newest gel
    derivative and there is quite a bit of information on pubmed about the guar actions.

    Many like the Similasan I and II drops. For those with severe dry
    eye, the Lacriserts placed under the eyelid at night still have no
    match.

    Another good topical for ocular rosacea is an ointment called Lacrilube by Allergan. It is kind of thick and sticky so you won't really be able to use it during the day. It definitely makes your eyes feel better, especially when they have that foreign body sensation or irritation. You put it directly in the pocket of your eyes.

    If the inflammation is still severe, Doxycycline 100 mgs 2 to 4 times a day can be used. or Periostat 40 mgs. If this fails, then the mast cell inhibitor Patanol is always a good try.

    Two new eye drops/suspensions continue to show promise for moderate to severe ocular rosacea.

    1. 10% N-acetylcysteine drops (Mucomyst) -- This mucolytic agent can be used successfully in rosacea patients with abnormal tear film layer (mucus layer). In ocular rosacea, the superficial inflammation can alter goblet cells, which affects the production of the tear film layer. This is the first agent to address this specific problem.

    2. Cyclosporine ophthalmic (Restasis) drops -- Used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation. First eye drop to actually increase natural tear production, stabilize tear film layer and resolve ocular inflammation. Restasis eye drops are available by prescription. It can take up to 3 months to see their full effect.

    Oral cyclosporine can cause a number of side effects. Topical
    cyclosporine (restasis) should be used cautiously in moderate
    to severe occular rosacea patients, but it is generally much safer to
    use. Medical studies indicate it may be used safely long term 6 to 9
    months with a low side effect profile. In many patients, it relieves the
    inflammation and therefore stops the tear film layer from breaking up.

    Regarding rosacea, it specifically blocks several classes of inflammatory
    cytokines on the ocular surface, which this makes the ocular surface
    more "healthy". If you decide to start the eye drops, follow up with
    your doctor and get ocular surface testing every 3 to 6 months.

    Supplemental help for Dry Eyes & Ocular Rosacea

    There are two new oral products on the market for adjunctive
    treatment of dry eyes and ocular inflammation. While the web
    sites listed below certainly are promotional, they are quite informative
    and are consistent with the current medical information on dry
    eye syndrome, ocular inflammation, and treatment of both
    conditions.

    They both utilize essential fatty oil supplementation and one brand has added mucin to their mixture (which theoretically may help support the inner most layer of the tear film - the mucous layer). In addition to daily lid hygiene and eye drop/eye gel therapy, these might be worth a 60 day trial in those ocular rosacea sufferers with persistent problems.

    1. Hydroeye Softgels. Claims to:
    a. Decrease ocular surface inflammation
    b. Stabilize tear film by thickening outer oil layer
    http://www.agingeye.net/dryeyes/hydro.pdf

    2. TheraTears Nutrition Soft Gels. Claims to:
    a. Decrease ocular surface inflammation
    b. Stabilize tear film by thickening outer oil layer
    http://www.theratears.com/nutrition.htm

    Frequent facial flushing causes inflammation of the meibomian
    glands, the oil glands in the eyelids. With meibomian dysfunction, the oil
    is either too thick or too thin, and does not do its job. An
    abnormality in meibomian gland activity is therefore considered a secondary cause of ocular rosacea. This abnormality can take on two forms:

    1. A hypersecretion of oil: excessive amounts of oil are produced
    The oil is yellowish, and in some cases may take on a
    semi-solid form. Excess oil causes inflammation on the eye surface and within the eyelid.
    2. a hyposecretion of oil: not enough oil is produced. This
    usually results from inflammation or blockage of the meibomian gland
    pores.

    OcuSoft Lid Scrubs for Sensitive Eyes are recommended for
    removing that irritating, sandy debris that some get. Some use baby
    shampoo and washcloths to remove this debris.

    Another good option is the prescription C-Metron .75;
    Metrodianozole for the eyes. Its made at Leiters Pharmacy in San Jose, and has been in the making for several years. Sometimes all one needs to do is close the eyelids and apply the lotion to the outside of the eyelashes.

    For chronic blepharitis, some folks like eye cream for lids from
    Demodex Solutions (2% metro in it). It helps get calm down
    inflammation on the eyelids.

    Some Ocular Rosacea Treatment Suggestions

    STEP 1: FIND A QUALIFIED PHYSICIAN

    1. Search for an Ophthalmologist:
    Rosacea sufferers should be examined by medical eye specialists
    because ocular rosacea usually presents with multiple symptoms that
    may confuse general physicians. Most medical eye specialists(ophthalmologists) are qualified to treat ocular rosacea.

    2. Help the Ophthalmologist:
    Rosacea sufferers can help their physicians by answering a few
    key questions such as:

    . Do your ocular symptoms get worse during bouts of facial
    flushing?
    . Are your ocular symptoms the most troublesome in the
    morning, or do they get worse as the day progresses?
    . Do you experience blurred vision, eye pain, or vision loss?
    . What are your most bothersome symptoms?
    . Do you wear contact lenses and if so, what type?
    . What medications are you currently taking (include a complete
    list)?

    STEP 2: BASIC OCULAR THERAPY

    The major goals of ocular therapy are to decrease eye surface
    inflammation, reduce eyelid inflammation, and normalize the
    tear film (oil, water, and mucous layers). As with any disorder, it is
    wise to start with the simplest and safest therapies. Most ocular
    rosacea sufferers will get significant relief with eyelid scrubs,
    artificial tears, oral antibiotics, nutritional therapy, and
    elimination of eye irritants. So this is a good place to start.

    1. Eyelid Scrubs:

    Daily eyelid scrubs are one of the most important parts of the
    ocular rosacea treatment regimen. Ophthalmologists who
    specialize in ocular rosacea stress that meticulous eyelid hygiene must be
    performed daily (and sometimes twice daily) in order to keep this
    chronic disorder under control. Proper eyelid hygiene can relieve
    most eyelid and eye surface symptoms:

    . It removes eyelid crusting, scaling, and microorganisms (yeast
    & bacteria).
    . It decreases eyelid inflammation, itching, and burning
    sensations.
    .It increases tear film stability by unblocking meibomian glands
    and increasing flow of protective oil.

    General physicians routinely recommend that patients use
    "home-made" cleansing solutions with dilute baby shampoo to cleanse their eyelids. These "home-made" cleansing solutions work fairly well
    on simple cases like dry eye and eyelid crusting, but these
    solutions are not advisable for ocular rosacea sufferers. First of all, dilute
    baby shampoo causes eye irritation and stinging in many ocular
    rosacea sufferers. Second, dilute baby shampoo is not as effective
    as ophthalmologist-designed eyelid scrubs. For these reasons,
    medical experts strongly recommend that ocular rosacea sufferers use
    commercially available eyelid scrubs.

    Recommended Eyelid Scrubs for Ocular Rosacea
    a. Ocusoft Eyelid Scrub for Sensitive Eyes (Ocusoft
    Inc.)
    b. Eye Scrub Sterile Eyelid Cleanser (Ciba Vision
    Ophthalmics)

    Methods for Thorough, Gentle Eyelid Cleansing

    . Eyelid Scrubs with Q-tips (cotton swabs). It is highly
    recommended that ocular rosacea sufferers apply eyelid scrub
    solution onto a Q-tip and gently cleanse their upper and lower
    eyelids. Q-tips are recommended because they aid in removing
    crust and debris from the eyelid. The eyelid skin is very delicate, so
    close the eyes and use gentle side-to-side strokes across the
    eyelid margins and lashes, being careful not to rub harshly or irritate
    the skin. Patients should cleanse each eye for 30 to 60 seconds.
    Lather from the eyelid scrub should then be rinsed off or removed
    gently with a tissue. This method is also effective for removing
    eye make-up and mascara.

    . Eyelid Scrubs with Pre-Moistened Pads. Most commercial eyelid scrubs are also available in convenient pre-moistened cotton pads that are easy to use and lather up very quickly. For those sufferers who cannot safely use Q-tips around the eye, pre-moistened pads are an excellent choice for eyelid cleansing.

    . Note: Medical experts stress that eyelid scrubs should become
    a permanent part of the patient's routine. Patients should consider
    daily eyelid scrubs as important as washing their faces and brushing their teeth. Disciplined eyelid cleansing will make a difference in
    ocular rosacea symptoms.

    2. Artificial Tears:

    Artificial tears are similar to the eye's own tear layer. They lubricate the eyes and help maintain normal levels of moisture. Artificial tears do much more than just add water to the eyes; they also speed up healing of the eye surface, normalize goblet cell activity, and decrease ocular inflammation. Artificial tears are available in many types and brands. When choosing an artificial tear, ocular rosacea sufferers should only use non-preserved products, because preservatives can worsen ocular symptoms.

    Artificial Tears Recommended for Rosacea

    a. Thera Tears (Advanced Vision Research). This is a
    superb eye drop for mild, moderate, or severe dry eye. I highly recommend this eye drop because it is formulated with an electrolyte solution specially designed to protect and nourish the eye surface (Thera
    Tears replicated the electrolyte balance of the human tear film).
    Recently, Thera Tears has developed a new preservative-free
    eye drop that is available in a multi-dose bottle. Thera Tears in a bottle
    contains a patented preserving ingredient that turns into pure
    oxygen and water upon contact with the eye. Oxygen and water
    work with the Thera Tears formula to provide excellent soothing dry
    eye relief.

    b. Refresh Plus (Allergan). Refresh Plus is a popular
    moisturizing eye drop that is available in single use, preservative-free
    containers. This eye drop is a good choice for mild to moderate
    dry eyes.

    c. Hypo Tears Select (Ciba Vision). Hypo Tears Select
    is a new moisturizing eye drop that is available in a multi-dose bottle.
    Hypo Tears Select contains a patented preserving ingredient that
    turns into oxygen and water upon eye contact. This eye drop is
    good for mild to moderate cases of dry eye.

    d. Similasan #1 (Similasan Inc). This is a homeopathic
    eye drop that is used to soothe mild to moderate dry eyes. Similasan also
    relieves redness of the eyes and eyelids. Similasan is a
    preservative-free solution that contains extracts of eyebright,
    honey bee, and cevadillas.

    e. Celluvisc (Allergan). This is a thick eye drop that was
    developed for the treatment of severe dry eyes. In general, thicker
    eye drops are more effective because they are retained on the
    eye surface for longer periods of time. For severe dry eyes,
    carboxymethylcellulose sodium (the active ingredient in
    celluvisc) is a good choice for long lasting coverage and protection of the
    eye surface. Celluvisc is available in single use, preservative-free
    containers.

    f. GenTeal Lubricant Eye Gel (Ciba Vision). This is a
    clear gel that liquefies upon contact with the eye, spreading rapidly without
    leaving streaks or causing blurred vision. This gel is also preservative free -- it contains a unique preservative that turns into pure water and oxygen upon contact with the eye. Once in the eye, this gel forms a long-lasting protective film. This is an excellent choice for moderate to severe dry eye sufferers.

    3. Oral Antibiotics:

    Oral antibiotics are very effective at reducing ocular rosacea
    symptoms. Oral antibiotics have several important actions in the
    treatment of ocular rosacea:

    . They stabilize the tear film.

    . They improve oil secretion from meibomian glands.

    . They decrease eyelid inflammation.

    . They reduce eyelid bumps (chalazia and styes).

    . They decrease the leakage of inflammatory cells through blood
    vessels of the eye.

    . They decrease eye surface flushing and inflammation (for
    some unknown reason, antibiotics are quite effective against the
    vascular symptoms of the eye).

    a. Tetracycline Antibiotics. Oral tetracycline is very effective at
    reducing the symptoms of ocular rosacea. Systemic tetracyclines
    decrease eye surface inflammation, improve meibomian gland
    oil secretion, improve the stability of the tear film layer, reduce
    aqueous tear film evaporation, and improve the health of the
    ocular surface. In most cases, symptom improvement is noted within 4
    weeks of treatment (250 milligrams 4 times a day).

    b. Doxycycline. Ophthalmologists treat many of their ocular
    rosacea patients with doxycycline due to its anti-inflammatory
    actions and its positive effect on meibomian glands. Doxycycline
    (50 or 100 milligrams 2 times a day) is very effective at reducing
    ocular rosacea symptoms, and in some cases may be more
    effective than standard tetracyclines.

    4. Nutritional Therapy:

    The main action of nutritional therapy is to reduce ocular
    inflammation. Excess free radicals on the eye surface can cause
    eye inflammation by dilating surface blood vessels and disrupting
    the tear film layer. Increased oral intake of free radical scavengers
    (antioxidants) may play a role in decreasing eye surface
    inflammation and preventing damage to surface blood vessels:

    (a) Antioxidants that have Anti-Inflammatory Actions in the Eye:

    . Ester-C: Ester C is a form of vitamin C that is gentle
    on the stomach and highly bioavailable. It is recommended that
    rosacea sufferers slowly work their way up to 1,000 to 3,000 milligrams
    per day (in divided doses).

    . Grape Seed Extract: Grape seed extract is one of the most
    powerful antioxidants known to science. It is recommended that rosacea
    sufferers slowly work their way up to 150 to 300 milligrams per
    day (in divided doses).

    . Pycnogenol (pik-no-gen-ol): Pycnogenol has very similar
    actions to grape seed extract. It is recommended that rosacea sufferers
    slowly work their way up to 50 to 200 milligrams per day (in divided
    doses).

    (b) Essential Fatty Oils:

    . Borage Seed Oil: Supplementation with essential fatty oils such
    as gamma linolenic acid, the active ingredient in borage seed
    oil, may be beneficial to patients with ocular symptoms. Gamma
    linolenic acid (GLA) has two interesting mechanisms of action in the
    treatment of ocular disorders: (1) GLA supplementation decreases ocular inflammation, and (2) GLA supplementation increases mucous production from goblet cells, resulting in a more stable tear film layer.

    5. Eliminate Eye Irritants:

    Rosacea sufferers should be extra cautious when using products around the eye area because they can cause allergic/irritant reactions that may trigger ocular rosacea symptoms. Eye makeup, eyeliners, mascara, under-eye concealers, and cleansers are common triggers for eye irritation. Sunscreens and moisturizers (that run down into the eye) can also irritate the ocular surface.

    Hair sprays are problematic for many rosacea sufferers; the hair
    spray mist can fall onto the eye surface and disrupt the tear film
    layer. Eye experts emphasize that this is one of the worst ocular
    irritants for female rosacea sufferers. It is highly recommended
    that rosacea sufferers place a wide barrier, such as a hand-held
    mirror, between the hairline and eyes before applying hair spray
    (placing a hand over the eyes is usually not a sufficient barrier).
    Otherwise, many unsuspecting rosacea sufferers are starting off
    the day with a disrupted tear film layer and ocular irritation!

    Extreme caution must also be given to "Get the Red Out" eye
    drops that temporarily constrict blood vessels on the surface of the eye.
    These eye drops should not be used by rosacea sufferers
    because after the eye drop wears off, surface blood vessels usually
    become more dilated and hyper-responsive. Over time, this makes the
    ocular condition much worse.

    STEP 3: ADVANCED OCULAR THERAPY

    Ocular rosacea sufferers who do not respond adequately to
    basic therapy (or continue to worsen), will need more advanced
    therapy.
    Topical antibiotics, topical steroids, topical mast cell
    stabilizers, oral isotretinoin, oral antifungals, punctal occlusion,
    and photoderm offer moderate to severe ocular sufferers greater
    chances for clearance.

    1. Advanced Rosacea Therapy - First Tier:

    (a) Antibacterial Eye Drops and Ointments:

    Some rosacea sufferers have an overabundance of bacteria on
    their eyelids. In ocular rosacea sufferers with bacterial infection,
    topical antibiotics may help decrease ocular symptoms. Three
    popular antibiotic eye drops and ointments are:

    . Bacitracin Ophthalmic Ointment (Fougera)

    . Ilotycin Ointment (0.5% Erythromycin, Lilly Research
    Laboratories)

    . Polytrim Eye Drops (Trimethoprim and Polymyxin B
    Sulfate,
    Allergan)

    (b) Steroid/Antibacterial Eye Drops:

    Topical steroids should not be used to treat most sufferers with
    facial or ocular rosacea. However, in some cases, short courses
    of topical steroids may give considerable relief to ocular symptoms
    and may help break the vicious inflammatory cycle that often
    accompanies ocular rosacea. Topical steroids applied to the eye surface
    and/or eyelid margin can suppress inflammation and reduce the
    disease to a level that is controllable with standard "safe" therapies. Most
    eye experts who use topical steroids to treat ocular rosacea use
    a three-day treatment plan to break the inflammation (i.e. steroid
    treatment is prescribed two to four times per day for three
    consecutive days). This is followed by a 21 to 28 day break from
    the steroid. Three of the top steroid/antibacterial combinations
    are:

    . Blephamide Liquifilm (10% sodium sulfacetamide +
    0.2% prednisolone acetate in a microfine suspension; Alcon
    Laboratories, Inc.). This steroid/antibacterial liquifilm drop is extremely
    effective against eye surface symptoms (inflammation, redness,
    hypersensitivity and burning), and eyelid symptoms (inflammation, swelling, crusting, itching and seborrheic dermatitis). Personal
    communication with over a dozen ophthalmologists indicates
    that this is one of the most effective topicals for the treatment of eye
    surface and eyelid inflammation.
    Blephamide liquifilm may be applied via two methods:

    Method 1: Treatment of the Eye Surface and Eyelid

    (1) Tilt head back and apply 1 drop into the eye.

    (2) Close the eye and spread excess medication over the full
    length of the upper and lower eyelids.

    (3) Do not wipe any medication off the eyelids. It will dry
    completely within 5 minutes to a clear film that remains on the
    lids for several hours - it cannot be seen by others, nor will it
    interfere with vision.

    Method 2: Treatment of the Eyelid

    (1) Tilt head back and with eye closed, place 1 drop onto the lid -
    preferably in the corner of the eye close to the nose.

    (2) Spread medication over the full length of the upper and lower
    lids.

    . Tobradex (tobramycin and dexamethasone opthalmic
    suspension; Alcon Laboratories Inc.). This is an excellent steroid/antibacterial drop that is used to treat eye surface and eyelid inflammation.

    . Cortisporin (neomycin, polymyxin B sulfate and 1%
    hydrocortisone; Catalytica Pharmaceutical, Inc). This is an excellent
    steroid/antibacterial drop that contains a very weak steroid. It is
    a good option for eyelids and eye surfaces that are sensitive to
    strong steroids.

    (c) Mast Cell Stabilizer Eye Drops:

    Mast cell stabilizer eye drops prevent the release of inflammatory
    substances from mast cells on the eye surface. Mast cell
    stabilizer eye drops may decrease ocular rosacea symptoms by two
    different mechanisms; they decrease allergy-related eye inflammation,
    and reduce chronic inflammation on the eye surface.

    Patanol (olopatadine HCL, Alcon Laboratories, Inc).
    Patanol has two mechanisms of action; it blocks histamine receptors and
    stabilizes mast cells on the eye surface. This blocks the inflammatory actions of histamine, and prevents the release of half-
    a-dozen potent dilators from mast cells. Patanol is one of the
    newest topical eye drops that only requires twice daily dosing
    (one dose lasts up to 10 hours). More importantly, Patanol starts to
    work within minutes of application (unlike most other mast cell
    stabilizers that require 4 to 7 days of dosing before they become
    effective). Patanol is now considered to be the "gold standard"
    for stabilizing mast cells on the eye surface.

    (d) Very-Low-Dose Isotretinoin:

    In ocular rosacea sufferers with severe eyelid inflammation, eye
    surface inflammation, blocked meibomian glands, thick oil
    discharge, or recurrent chalazions, very-low-dose isotretinoin usually
    results in excellent clearance of symptoms.

    Oral isotretinoin has several important actions in the treatment of
    ocular rosacea:

    . It decreases eyelid inflammation and swelling.

    . It unblocks meibomian glands and normalizes thick oil
    discharge from these glands.

    . It decreases eye surface inflammation by blocking the
    production of inflammatory immune cells.

    . It treats chalazions and prevents future formation of these
    eyelid bumps.

    Note: For isotretinoin to be effective in treating ocular rosacea,
    it must be used at very-low dosages (10, 5, or 2.5 milligrams per
    day). Higher dosages, especially those used for acne, may have
    the opposite effect and worsen ocular symptoms.

    (e) Oral Antifungals:

    Moderate to severe ocular rosacea sufferers with seborrheic
    dermatitis may never truly get a hold on their ocular symptoms.
    In these sufferers, medical experts recommend taking swabs of
    the outer eyelids to examine for fungal infections. Personal reports from
    numerous eye specialists indicate that in cases with seborrheic
    dermatitis of the eyelids, short courses with oral antifungals can
    be a Godsend in reducing ocular rosacea.

    The goal of oral antifungal therapy is to decrease seborrheic
    dermatitis down to levels that can be maintained easily with daily
    lid hygiene and/or intermittent use of topical eye drops such as
    blephamide. Three popular oral antifungals are:

    . Ketoconazole (Nizoral Tablets, Janssen)

    . Fluconazole (Diflucan Tablets, Pfizer)

    . Itraconazole (Sporanox Capsules, Janssen)

    2. Advanced Rosacea Therapy - Second Tier:

    (a) Punctal Occlusion: Artificial tears are the most common
    therapy used for dry eyes. Artificial tears are available for the relief of
    symptoms but, unfortunately, improvement is short-lived
    because the tears drain through the canals in the sides of the eyelids
    (puncta).
    Conserving the eye's own tears is another approach to keeping
    the eyes moist and comfortable. An ophthalmologist can conserve
    natural tears by closing the canals via punctal occlusion. This is
    analogous to plugging up a bathtub with a stopper; the closure conserves
    your own tears and makes artificial tears last longer. Punctal
    occlusion is usually considered when artificial tears and systemic
    medications do not adequately control symptoms of dry eye, or when eye
    drops have to be used very frequently. Punctal occlusion usually results
    in dramatic relief of moderate to severe dry eye symptoms.

    Benefits of punctal occlusion:

    . It improves the tear film layer by increasing the aqueous
    component of tear film.
    . It improves the tear film layer by normalizing tear film
    osmolarity.
    . It improves the tear film layer by increasing the number of
    mucous-producing goblet cells on the ocular surface.

    Punctal Occlusion by Electrocautery. Electrocautery is the most
    common method used to permanently close the canals. A fine,
    needle-type cautery is inserted into the canals and seals them shut with
    gentle heat. To test if punctal occlusion will result in epiphora
    (a side effect where tears overflow from the eyes), eye
    specialists first touch the cautery against the outer edges of the canal in
    order to cause a thin scab to form over the opening. This scab
    usually lasts for 5 to 7 days and during this time the physician
    checks for adverse side effects. If the patient responds favorably,
    he or she can proceed with permanent punctal occlusion (i.e.,
    the cautery tip is placed deep within the puncta and heat is then
    used to seal the entire canal). Electrocautery is considered to be the
    best method for permanent closure of the canals.

    Punctal Occlusion by Silicone Plugs. Physicians also offer
    reversible methods for blocking the drainage canals. Silicone
    plugs can be used temporarily to plug the canals. These plugs give
    very good results for several years and can be taken out at any time.
    The Freeman silicone plug is currently the most popular brand
    among ophthalmologists.

    It must be warned that there are two main drawbacks to silicone
    plugs (or any other form of insertable plug). First, some plugs
    may cause irritation to the eyelid and/or slide deep into the canal and
    cause a local irritant reaction. Second, silicone plugs can pop
    out within 3 to 12 months.

    Important Note on Punctal Occlusion: Inflammation of the eyelid
    and eye surface must be under control before punctal occlusion is
    performed or else inflammatory substances will stay on the eye
    surface for longer periods of time, resulting in more inflammation.

    (b) Photoderm Treatment: Photoderm (ESC Medical
    Systems) is an intense pulsed light source that treats blood vessels of different sizes, shapes, thicknesses, and skin depths. Recent advances
    in Photoderm technology allow the system to safely remove
    inflamed blood vessels of the eyelids (note: metal shields must be placed
    between the eye surface and the eyelid before treatment to
    protect the eye). Eyelid treatment should only be performed by
    photoderm experts who have extensive experience with this form of vascular treatment. Patients should not be guinea pigs for well-meaning,
    but inexperienced practitioners.

    Photoderm can effectively remove damaged blood vessels of the
    eyelid, decrease flushing responses in the eye area, and reduce
    eyelid swelling (a very difficult symptom to treat by standard
    therapies). Photoderm may also normalize meibomian gland
    function
    by decreasing eyelid vascularity and flushing which have been
    implicated in meibomian gland dysfunction.

    -Laura"

    Hope this helps!

    Jen
    Currently trying: Apr 06 Bee Wilder's Candida (natural healing) Diet; May 06 Home made red LED array; Aug 06 ZZ ointment.

  3. #3
    Senior Member fut's Avatar
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    That, my friend is thesection straight from Dr Nase's book. If you don't have one already, I highly suggest you pick one up!

  4. #4
    Senior Member redhotoz's Avatar
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    Quote Originally Posted by fut
    That, my friend is thesection straight from Dr Nase's book. If you don't have one already, I highly suggest you pick one up!
    Well there you go! You don't have a copy though Fut?!

    Jen
    Currently trying: Apr 06 Bee Wilder's Candida (natural healing) Diet; May 06 Home made red LED array; Aug 06 ZZ ointment.

  5. #5
    Senior Member redhotoz's Avatar
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    Oh, and by the way, your'e welcome, in reply to your (lack of) thank you, for the effort I made to reply to your post! In copying it over from the e-mail I had saved, I wanted to make sure it was easily read and spent the time to remove the forward arrows and straighten things out. Ah well, hope it is good info for you none the less.

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    Good post. I have recently been suffering from terrible occular rosacea and its a nightmare. At times my eyes have looked like something from a horror show! So this information is much appreciated.

    Regards, Chris

  7. #7
    Senior Member redhotoz's Avatar
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    Hi Chris

    This came up a few days ago and the feedback has been good to date. Something very simple for OR:

    http://health.groups.yahoo.com/group.../message/82377

    "...Here I am, over a year later and virtually cured of this part of the
    condition. How did I manage it? Well, I altered the original
    suggestion, and took a black wash cloth and dug in the corner of my
    eye by my nose. As awful as it sounds, I was surprise to see the
    gore that was removed. I did it with the other eye and had the same
    results. Literally within the next couple of days of doing that
    procedure during the morning shower and in the evening, my eyes
    looked and felt tons better. They were regularly moist and the
    redness was no different than anyone else. I continued the ritual on
    a daily basis and have had ZERO issues with dry eye again over the
    past year..."

    The idea of a black wash cloth was to simply be able to SEE the "gore" on the wash cloth, nothing special about the colour black. It's in the follow on post from Scott, when he was questioned.

    Hope it helps.

    Oh, and just to clarify about the long quote I made from Laura, well she did follow up later with this to say on 15 Nov last year: "I didn't write it! Thanks, but I don't deserve credit. It's just lots of notes from other people, mostly Dr. Nase, pasted together and offered to help others. That's what we're here for, to share the knowledge. I try give credit to those who originally wrote the stuff, but sometimes I forget to note their names."

    Thought that I should make that clear as all I knew was that I saved that e-mail/post into my OR Folder for future reference.

    Jen
    Currently trying: Apr 06 Bee Wilder's Candida (natural healing) Diet; May 06 Home made red LED array; Aug 06 ZZ ointment.

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