Dry eye

[olga8814]

I had clear lens extraction (Oh God do I regret this) 10/07 and have had lots of trouble since.  I have the resoom in the R eye and restore in the L eye.  Since then I have had a yag in both eyes, lindo relaxing incision in the L eye which did not help the astigmatism and 5 months ago I had PRK in the L eye.  Now I have SEVERE dry eye.  First my doctor told me to try over the counter eye drops and gels.  They did not help and the gels make my vision blurry.  Now he has me on AzaSite which is an antibiotic and it does clear my vision for a short time.  Every one asks me to speak to my doctor but that is not as easy as it sounds.  I could get more information talking to a tree.  Anyway the azithromycin eye drops (AzaSite) helps to clear my vision for a few hours and then it is cloudy again.  I honestly told my doctor he was fishing to help me and he agreed which did not make me feel good.  He was not sure how long I would be on AzaSite or what the consequences of long term antibiotic use were.  
Has anyone been on this antibiotic and are there side effects other than the usual
resistance, infection etc. How is this antibiotic helping my dry eyes?  How long should I be on it?  Would appreciate any information on this subject.

[hsum4]

Dear Doctor Kutryb:

Can dry eyes after cataract surgery cause the eyes to ache and give you a headache?  I need a new prescription in glasses for my left eye as it is off a little and I have a second lens forming after the surgery.  Could these problems cause my eyes to ache or is it just the dry eyes as both eyes ache and it is hard to sleep.

Thank you
hsum4

[hsum4]

Dear Doctor Kutryb:

Does dry eye severely affect everyone after cataract lens replacement?  Isn't this something people should be told after the surgery?  I find the follow-up care after cataract lens replacement very poor.  My doctor gets very upset and pompous when I ask him questions and it is hard to get a new doctor for your follow-up care afterwards without imbalancing the eye medical community.

Thank you
hsum4

[Michael J Kutryb, MD]

One other note.  Azasite does have a revolutionary new lubricant in it.  I suppose it is possible your doctor is trying to kill two birds with one stone.  I still think you need to use preservative free artificial tears at least every hour.

MJK MD

[Michael J Kutryb, MD]

Azasite will not itself benefit your dry eyes.  It can be effective in helping with chronic lid margin disease which can be a co-existing condition with the dry eyes.  So your doctor seems to be indicating that there is lid margin disease as well as dry eyes.  I don't see a problem with using azasite for a month or so - but I have no expectation that it will help CHRONIC dry eyes.  For that you will need punctum plugs, restasis, artificial tears, oral flax and fish oil supplements.  Oral doxycycline might be an option to use if you truly have chronic lid margin disease.  In the end your problems are much more complex than you realize and just taking a simple drop of azasite a day might be some benefit - it's just one piece of the puzzle.

MJK MD