Iritis

Dry Eyes, Uveitis and Rheumatoid Arthritis

Another quick update—my eyes are still stable and I’m approaching the one month mark after stopping all steroids (Pred Forte and Lotemax).  I still do a drop of Nevanac at bedtime, but I’m not sure how long I should continue this.  Not much information out there regarding long term use of NSAIDs as they are mostly used for cataract operations.  I would rather be using Bromfenac but at this point most of those products are unavailable due to Bausch and Lomb’s rebranding of the drug.

Not much has changed in my protocol—you can read that in detail a few posts back.  I’m still on a no starch diet, and I don’t know if that is having an effect at all, but I can tell you that it does affect my overall stiffness.  Still doing the Celebrex 200mg BID, but if I am clear for a few more months I might taper that to once a day and see how it goes.

Some recent posts on KickAS.org have been discussing dry eyes and their relation to autoimmune diseases such as rheumatoid arthritis, etc.  Add to this the damage done by steroids, BAK preservatives and inflammation and even though it is not a preventative of uveitis, care of the ocular surface is a pretty clear need for anyone with these conditions.

Here are a few of my thoughts on treating dry eyes and the remedies that accompany them:

Punctal Plugs

Haven’t tried them, but most people swear by them as the best outcome for dry eyes.  These are quite simply inserts in your tear ducts that block or slow the drainage of natural tears and keep the eyes wetter longer.  An alternative to surgery to seal the tear ducts, punctual plugs are non-invasive and as far as I know fully reversible. Can’t really comment much more as I haven’t tried them personally.

Restasis

This seems to be the mainline pharmaceutical treatment for dry eyes.   There’s a lot of information about this on the net—mostly that it is very irritating to the eyes to use the drops, but that it often yields good results. The important thing I learned is that this is a immunomodulatory drug that reconditions the lacrimal glands but also has some good anti-inflammatory effects on the eye (although not enough to be a uveitis treatment or preventative). I’ve tried this with mixed response.  Early on, I used a preservative free generic for almost a year with good results.  Recently, my eye gets too irritated after using it (and I’m still using the NSAID drop). There’s lots about this on Google.

Calf Blood Dialysate

Solcoseryl is an ocular salve that is used to heal corneal ulcers and regenerate eye tissue.  I have found it to be very effective—more so than normal eye gels.  It took a bit to get around the Calf blood bit, but studies have shown it to work well.   The reason I use it is not only for eye moisturizing, but also after damage caused by the preservatives in most pharmaceutical grade eye drops.  The most common preservative is still Benzalkonium Chloride (BAK)—the only drugs I’ve seen that don’t use this preservative are some of the new glaucoma/pressure drops because of the negative effect in that disease.  BAK kills the corneal surface, period.

Flax Seed

Omega 3 supplementation in the form of fish oil and flax seed has personally been helpful to me.  I feel that I have a thicker tear film after eating flaxmeal (I eat a few tablespoons like oatmeal in the morning with a little coconut cream and honey). Again, lots about this on Google.

Washes, compresses and eye pillows

These are all helpful.  I haven’t tried any specific eye washes, but have used a Neutrogena Salicylic acid face wash around the eye area with great effect against allergic itchy eyes.  Compresses both hot and cold work, but I find them messy and cooling/warming too quickly.  The best result I’ve had is to fill a sock with rice, flax seed or beans (don’t make it too heavy or it will blur your vision from pressure) and either cool it in the freezer or heat it in the microwave.  I’ve found the coolness helpful for the eye itself, but I’ve been reading that meibomian glands are stimulated by a warm compress so I’ve been trying that.

Again these are merely what I’ve investigated and not an exhaustive list.  For further reading, I suggest you start with a recent study posted at KickAS.org which gives a pretty good rundown.  There is a website called http://www.dryeyezone.com/
Re: Solcoseryl Gel
Hi Zac,

First off, really sorry for the delay in replying. I have been moving overseas and your comment came on the eve of my departure.

I buy my Solcoseryl eye gel in Hong Kong when I'm there so I haven't sourced a supplier outside of Asia. I can give you this information though.

The tube that I buy is 5g of Solcoseryl Eye Gel and it is made by Legacy Pharmaceutical Switzerland GmbH, Birsfelden, Switzerland for Invida Holdings Pte Ltd. They list two importers as well, Phillippines and Thailand, but I've seen it for sale online--a quick Google search brings up e-bay, not the most reputable pharmaceutical dealer, I guess, but it's a start if you were desperate.

Anyhow, again, apologies for the delay and that I haven't been much help. I hope you find something on your quest for better eyes.

J.