Drew scare
Thought Drew was flaring. Complained of "dots", light sensitivity, severe eye pain. Saw doc yesterday. Uveitis still in remission but he has corneal infection. Zymar drops hourly while awake and recheck tomorrow. Wish him luck! And say a prayer!
Re: Drew scare
Tricia,
does he also have severe dry eyes? Blepharitis?
if yes, do you genlty massage his eyelids while washing them with a solution of Baby shampoo and warm water?
do you have lubricating eyedrops to instill periodically throughout the day and night?
wish the poor little guy the best for me please,
Mike
Re: Drew scare
if you can get him PRESERVATIVE free single use vials of a lubricating eyedrop to use, that is the best. over time the preservatives in eyedrops can cause allergic reactions. the term is medicamentosa (thanks Liz for this term).
do his eyes become very crusty? that is the lubricant part of the eye tear film from the plugged up meibomian glands of the eye lid margins along the lash line. if they are plugged, the gentle massage and shampoo will help open the glands up again. put a drop of lubricating eyedrop in so that the goo will have a fluid to mix with.
I don't know if Restasis is available for use in children. it is a solution of .o5% Cyclosporine which stops the inflamamtion of the lacrimal gland which in turn starts producing fluid again. this can take up to six months to happen. it will BURN LIKE HELL the first couple of weeks but as the surface of the eye starts healing the burning will go away. another option is to put punctal plugs in to close off the drains of the eye and to keep the fluid on the surface of the eye before it can evaporate.
please address these issues for drew. corneal inflammation and possible infection can occur with severe dry eyes. in some ways potential blindness can result more easily with severe dry eyes than with uveitis.
I get my lubricating eyedrops at Costco. they have REFRSH PLUS single use vials. I don't know what other options are available to you. SAMS club may also have a good preservative free eyedrop or BJ's wholesale on the East Coast.
Re: Drew scare
More good and bad news... infection is looking great! he said infiltrations are almost completely gone! Yea! But looks like he may be beginning inflammation in that eye- no surprise! We have follow up next week with Dr Rao.
Mike thanks again for info- I'll discuss in depth with Dr Rao next week. I think he is using refresh plus but it's multidose vial. I'll look out for single use.
Re: Drew scare
Theratears makes a lubricating eyedrop that has a different kind of preservative which disipates immediately on contact with the surface of the eye. it is in a vial as well.
Refresh liquidgel eyedrops work very well at bedtime and prevent the eyelid from sticking to the eyeball.
they don't come in a single use vial however, look for eyedrops which DON"T use benzylkonium .......... as the preservative, can't off hand recall the three word compound so look for the key word Benzylkonium and you will know tha you DON"T want anything with this in it. cheap eyedrops will have it for sure as they aren't meant for long term use.
Dr Foster has written on this topic and there is a paper on Severe Dry eyes as well as keratoconjunctivitis SICCA that you can read at his site. If you need help finding stuff, post a note to me in the LEARNING ABOUT OID forum at this site. I Don't always read here at the Parent's forum.
Drew appt today
Saw Dr Rao today- corneal ulcer is healed. He has pinpoint scar. Occassional inflammatory cell but he thinks its related to infection and will clear. Continuing zymar drops. Will be seen again next week. Told Drew no more contacts- too risky. Drew was a little pouty at first but I think he understands and he also remembers how bad it hurt! His vision is not too bad and since he has implanted lens, he has "mono-vision". Rt eye sees near, lt eye sees far. So, he told him that as long as he can see the board at school and is doing well, he doesn't have to wear his glasses if he doesn't want to. Discussed dry eye- he said lots of people with autoimmune eye disease develop dry eye. We got preservative free lubricating drops. He doesn't complain everyday, so I think he'll just use them occassionally. All in all a good day.
Re: Drew appt today
if he is on the computer a lot, Remind him to BLINK. when we stare at things we forget to blink and then the cornea dries out when one has dry eyes. how is he doing with the dry eyes stuff at night? do his eyes appear 'crusty' in the morning? have him put in a lubricating gel eydrop before bedtime. it will keep his eye lubricated. we don't blink and spread the tearfilm over the eye when we sleep and if tear film is low, ones eyelids will stick to the cornea (very painful to get loose by the way from my own experience with this stuff). the crusties in the AM thing indicates thick meiboiman gland secretion and possible blockage of the outflow of lubricant part of the tearfilm. adding an occasional eyedrop helps get the lubricant into the tearfilm and the crusties goes away somewhat.
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