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Medical Forum / General / Vision / June 2007Having trouble stopping tobradex or fluorometholone. Can someone help.
I am having trouble stopping tobradex or fluoromethalone. Tobradex was originally prescribed for inflammation after an incident of my recurrent corneal erosion that was not going away. My doctor tried to wean me off and also switched me from tobradex to fluorometholone. I am down to 1 drop every two days but I can't seem to go much longer. After two days without it my eye bothers me almost to the point that I feel like it can cause another erosion. Can someone help me understand what is going on with my eye and how can I get off of this medecine now that it has done it's job. Thanks so much... > I am having trouble stopping tobradex or fluoromethalone. Tobradex was > originally prescribed for inflammation after an incident of my [quoted text clipped - 5 lines] > what is going on with my eye and how can I get off of this medecine > now that it has done it's job. Thanks so much... 1) You are likely using TWO ophthalmic drugs that are BOTH preserved with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to corneas. I would recommend that you stop using them until you talk with your eye doctor. You may need a few weeks recovery time FROM the BAK; 2) You may want to consider a trial of the over-the-counter drug Muro 128 -- the OINTMENT -- for a week or two. http://www.drugs.com/cdi/muro-128-solution.html I'm not a doctor, so you may want to run these comments by YOUR doctor. Good luck! > 1) You are likely using TWO ophthalmic drugs that are BOTH preserved > with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to [quoted text clipped - 9 lines] > I'm not a doctor, so you may want to run these comments by YOUR > doctor. Gee, for not a doctor, you're pretty quick yourself to dispense advice. > > 1) You are likely using TWO ophthalmic drugs that are BOTH preserved > > with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to [quoted text clipped - 11 lines] > > Gee, for not a doctor, you're pretty quick yourself to dispense advice. actually, his advise is pretty reasonable. Muro 128 is a common treatment for this problem. BAK is rough on the cornea and could possibly exacerbate corneal erosions. whats more interesting to me is that you are using steroid preparations for corneal erosions to begin with. corneal erosions are caused by slow, incomplete healing of the epithelium so that it is inadvertently pulled away from the cornea by adherence to the lids before it is well "stuck-down". steroids slow the healing process so would seem to be contraindicated if this were the real problem. could it be that you have a punctate keratitis that is slow to heal, or punctate erosions that are slow to heal? did your episode with corneal erosions begin with a corneal injury that is not completely healing or did it begin with a red, irritated eye not caused by traumatic injury? sometimes red irritated eyes are caused by inflammatory conditions that DO respond well to steroids and then recur when you try to withdraw them. i suspect that is your situation. whether it is that, or recurrent corneal erosions, it really just a terminology issue. I have a few suggestions if the problem is true recurrent corneal erosion. first try using heavy lubrication. that amounts to using thick artificial tears often throughout the day and then using a gel or ointment based lubricant at night before going to sleep. using salt-water based lubricants in the day and an ointment at night (=Muro128) can be very effective. i would have to include that you discontinue steroid use-- again, it slows healing and is working against you IF you really have recurrent erosions. secondly, if this problem persists, using a bandage contact lens allows the epithelium to form across the eye and become firmly attached while protecting it from the shearing effect of lids moving over it. after about a week I would remove the contact and then continue with heavy lubrication. if that doesn't work then it is possible to slightly puncture the epithelium down into the stroma in a grid configuration thereby inducing a small amount of controlled scarring the binds the epithelium quite well. firstly, check whether you really have recurrent corneal erosions or punctate epithelial erosions/keratitis that is difficult to wean from steroid treatment. On Jun 10, 11:17 pm, p.clar...@gmail.com wrote: > > > 1) You are likely using TWO ophthalmic drugs that are BOTH preserved > > > with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to [quoted text clipped - 15 lines] > treatment for this problem. BAK is rough on the cornea and could > possibly exacerbate corneal erosions. I take muro nightly that is a treatment for my recurring erosion. Normally my erosions heal after one day of eye rest but about 4 months ago it was not healing. It was very inflammed and that is why my doctor had to prescribe the eye drops. > whats more interesting to me is that you are using steroid > preparations for corneal erosions to begin with. corneal erosions are [quoted text clipped - 7 lines] > healing or did it begin with a red, irritated eye not caused by > traumatic injury? It was a corneal errosion that was not healing that got very inflammed. > sometimes red irritated eyes are caused by inflammatory conditions > that DO respond well to steroids and then recur when you try to [quoted text clipped - 17 lines] > inducing a small amount of controlled scarring the binds the > epithelium quite well. My issue right now is that I can't get off of the drops. My eyes seemed to have developed some kind of dependency on them. That was the reason for my initial post. Thanks!! > firstly, check whether you really have recurrent corneal erosions or > punctate epithelial erosions/keratitis that is difficult to wean from > steroid treatment.- Hide quoted text - > > - Show quoted text - It sounds like you're due for more aggressive treatment like anterior stromal puncture, or a laser procedure called PTK. Ask your doc. -MT > On Jun 10, 11:17 pm, p.clar...@gmail.com wrote: >> [quoted text clipped - 72 lines] >> >> - Show quoted text - > > 1) You are likely using TWO ophthalmic drugs that are BOTH preserved > > with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to [quoted text clipped - 11 lines] > > Gee, for not a doctor, you're pretty quick yourself to dispense advice. and for a guy who doesn't like retorts that don't address the underlying argument, you're pretty quick to throw one out yourself. Darling Davie: you have a problem with either my disclaimer or my particular advice? >>> 1) You are likely using TWO ophthalmic drugs that are BOTH preserved >>> with benzalkonium chloride (BAK)--a preservative KNOWN to be toxic to [quoted text clipped - 13 lines] > Darling Davie: you have a problem with either my disclaimer or my > particular advice? One who is so quick to castigate others for giving possibly dangerous medical advice shouldn't be recommending that someone stop using a prescribed medication before discussing it with the doctor. Your disclaimer was fine, it was the advice that seem hypocritical... >seem hypocritical Damn it, he's already figured me out... Hopefully my girlfriend Brainy will help me out of this (rather sticky) situation. *Fingers crossed* >seem hypocritical Damn it, he's already figured me out... Better belch out another "wittty" ad-hominem slashing -- about all that I'm capable of it seems. >seem hypocritical Damn it, this one could be dangerous. Better belch out another "witty" ad-hominem attack - or as a backup plan, one of my camp chum-buds could suck up to me in a variety of ways. Anything is better than yet another exposing of yet another of my hypocrisies - surely!!? >seem hypocritical Damn It - This one could be dangerous. Better belch out another "witty" ad-hominem attack - and hopefully one of my chum-buds will suck up to me (in a variety of ways). Anything is better than yet another exposing of yet another of my hypocrisies - surely!!? On Jun 11, 6:20 am, Neil Crooks <absolutelyinvinci...@hotmail.com> wrote: > >seem hypocritical > > Damn It - This one could be dangerous. Better belch out another > "witty" ad-hominem attack - and hopefully one of my chum-buds will > suck up to me (in a variety of ways). Anything is better than yet > another exposing of yet another of my hypocrisies - surely!!? And again ... for our little British cretin friend ... Go back through my years of posts and find me one example of advice that I gave that led to harm. When I have no knowledge, I don't give advice. When I do give advice, I always disclaim so that people know that they should appropriately weight MY advice and discuss MY ideas WITH their doctor. The two of you have developed quite the little cottage industry, eh? > One who is so quick to castigate others for giving possibly dangerous > medical advice shouldn't be recommending that someone stop using a > prescribed medication before discussing it with the doctor. Your > disclaimer was fine, it was the advice that seem hypocritical... Aw, Dave. Care to explain the risks that I posed, and the basis for your assertion that I've posed them? , The OP IS under doctor's care. He's being monitored. I recommended that he talk with his doctor about this. The information that I gave is both scientifically AND medically supported. I happen to know a great deal about BAK--likely more than the vast majority of eye doctors, sadly. Having YOU hump MY posts is going to be lovely fun. >seem hypocritical... 'Oo - ME? A hypocrite? NEVER. On Jun 11, 7:15 am, Neil Crooks <absolutelyinvinci...@hotmail.com> wrote: > >seem hypocritical... > > 'Oo - ME? A hypocrite? NEVER. Maybe you should go back to your 12 year old brother ... in whatever horrid sense that may imply. > I am having trouble stopping tobradex or fluoromethalone. Tobradex was > originally prescribed for inflammation after an incident of my [quoted text clipped - 5 lines] > what is going on with my eye and how can I get off of this medecine > now that it has done it's job. Thanks so much.. maybe you can ask you eye doc about a "bandage" contact lens for overnight wear (oasys, night&day). they can sometimes be helpful in treating erosion, along with other therapy (lubrication). |
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