Acuvail standard for dry eyes?

[jlw0606]

My new eye Doc started me out on Acuvail for 3 weeks due to severe dry eyes (this due to prev. radiation), I have been through the plugs and he resorted to cauterizing the lower ducts. I dont see much improvement after the procedure. He still has me doing 3 months of Acuvail.  What's the purpose of this?  he doesnt think my watery eyes are allergy related too.  Would having the upper ducts cauterized help any? I am only 48 yrs old, with no other eye problems too.

thnx for any input  
      

[John C Hagan III, MD, FACS, FAAO]

First many dry eye patients cannot wear contacts comfortable or safely or both.  Restasis is contact friendly. You use one drop twice/day. Use 10 minutes before putting in contacts.

Both restasis and omega threes' take 4 to 6 months to work bt often contineue to get better and better for up to a year.

JCHMD

[jlw0606]

Dr Hagan, is the Restasis contact friendly?  if not, i may have to give up the contacts and start using my glasses on a full time basis.  Being I am in the Cleveland area I have the best Dr''s too choose from.  My eyes are severly dry & Restasis seems to be the best treatment option for me.  Also I will starrt taking the Omega -3 suppl. as you suggested.  

thankx again for your comments
take care
j.
      

[jlw0606]

Your right Dr Hagan, the Acuvail is costly and I have to pay the max for the scrip, as my insurance wont pay too much.  Since I dont see any improvement, I will discontinue using the product. The Dr, did not indicate a return follow up also.
At this point I may switch to a Dr of my choice, this Dr was a referral from the optometrist.  thanks for the helpful suggestion on the Restasis, I wasnt aware that this med maybe helpful too and cheaper in the long run.    

Thnx
jen          

[John C Hagan III, MD, FACS, FAAO]

I have used Acular for many years, acuvail is more expensive in the form of acuvail so I don't use it.

Dry eyes is an off label use. Most dry eye patients will do MUCH better with long term use of Restasis, and 2 or 3 enteric coated fish oil (Omega 3 s) than with ketorolac.

Restasis is probably less expensive.

JCH MD

[jlw0606]

Thank you Dr Hagan for your response.
As a response to your Acuvail comment, I do live the in the good old US of A -
With repsects to Acuvail;  its nelwy approved by the FDA:

ACUVAIL™ (ketorolac tromethamine ophthalmic solution) 0.45% is a member of the pyrrolo-pyrrole group of nonsteroidal anti-inflammatory drugs (NSAIDs) for ophthalmic use.

take care

[John C Hagan III, MD, FACS, FAAO]

I am not familiar with Acuvail. Perhaps you don't live in the USA? Use the search feature and archives to read the extensive list of other options, also go to Dr. Hagan's blog and read the article on advanced treatement of dry eyes. Plugging the upper ducts would not likely help.
JCH MD