Having trouble stopping tobradex or fluorometholone. Can someone help.

Discussion in 'Optometry Archives' started by momez, Jun 11, 2007.

  1. momez

    momez Guest

    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...
     
    momez, Jun 11, 2007
    #1
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  2. momez

    Neil Brooks Guest

    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!
     
    Neil Brooks, Jun 11, 2007
    #2
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  3. momez

    Dave Bell Guest

    Gee, for not a doctor, you're pretty quick yourself to dispense advice.
     
    Dave Bell, Jun 11, 2007
    #3
  4. momez

    p.clarkii Guest

    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.
     
    p.clarkii, Jun 11, 2007
    #4
  5. momez

    Neil Brooks Guest

    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?
     
    Neil Brooks, Jun 11, 2007
    #5
  6. momez

    Dave Bell Guest

    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...
     
    Dave Bell, Jun 11, 2007
    #6
  7. momez

    Neil Crooks Guest

    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*
     
    Neil Crooks, Jun 11, 2007
    #7
  8. momez

    Neil Crooks Guest

    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.
     
    Neil Crooks, Jun 11, 2007
    #8
  9. momez

    Neil Crooks Guest

    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!!?
     
    Neil Crooks, Jun 11, 2007
    #9
  10. momez

    Neil Crooks Guest

    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!!?
     
    Neil Crooks, Jun 11, 2007
    #10
  11. momez

    Neil Brooks Guest

    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.
     
    Neil Brooks, Jun 11, 2007
    #11
  12. momez

    Neil Brooks Guest

    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?
     
    Neil Brooks, Jun 11, 2007
    #12
  13. momez

    Neil Crooks Guest

    'Oo - ME? A hypocrite? NEVER.
     
    Neil Crooks, Jun 11, 2007
    #13
  14. momez

    Neil Brooks Guest

    Maybe you should go back to your 12 year old brother ... in whatever
    horrid sense that may imply.
     
    Neil Brooks, Jun 11, 2007
    #14
  15. momez

    momez Guest

    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.
    It was a corneal errosion that was not healing that got very
    inflammed.
    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!!
     
    momez, Jun 11, 2007
    #15
  16. 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).
     
    michael toulch, Jun 11, 2007
    #16
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