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Thread: lacriserts

  1. #1

    lacriserts

    I have been having problems for several years with dry, red, irritated eyes and have tried about everything. Has anyone tried lacriserts and what do you think of them

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    Did you try searching the forum? That subject has come up a number of times....

    Neil

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    Sarah, I tried Lacriserts several years ago. They were hard to get (ie backorder from the manufacturer, waiting list etc.). The supply may now be better and easier to obtain, I don't know. On the other hand, I never hear much about anyone using them.

    They did not work for me. It was like having a blob of jello floating in my eye and disturbing my vision even more than it was. I told my doc that "I must not have enough moisture to melt the pellet" and he told me "it's not moisture, but heat that melts the pellet." So-there you go. I guess my eyes were not warm enough. I think if they work for you that you REALLY, REALLY like them. I dropped more on the bathroom floor than I got in my eyes.
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen

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    I'll keep you posted on how they work for me. I am going to try them starting on Monday. I'm an avid biker and outdoor enthusiast, and biking is really hard on my eyes, even w/ wraparound glasses. Hopefully Lacrisert will help!

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    Good luck, Ryan. My doc told me he has one patient who loves Lacriserts.
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen

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    Quote Originally Posted by neil0502
    Did you try searching the forum? That subject has come up a number of times....
    Since I don't think I've ever said this here before -- and since it is NOT always well received in other forums -- I feel an obligation to explain my thinking here:

    I always think of a suggestion to search the forum as a way to let people know that there may be additional information already covered, and that they might want to try that route, too.

    In an old bicycling forum that I used to frequent ... it was considered the height of insult to suggest that somebody "search the forum," somehow tantamount to refusing to answer their question directly. In reality, though, I found that people who had already shared didn't always share as completely the second or third time (though, in fairness, sometimes the NEW information IS vastly different from the OLD information), or that former posters--say somebody for whom Lacriserts, for example, as much as CURED their dry eye condition--posted a hearty thanks and then left.

    I hope nobody here thinks that a "search the forum" suggestion is in poor taste, non-responsive, or otherwise a negative thing.

    To the OP, however, if I didn't have to wear contact lenses (all sorts of reasons, in my case), I would use Lacriserts daily. When I HAVE TO stay out of the contacts for some medical reason, I virtually ALWAYS use the Lacriserts. I found they did an excellent job of stabilizing my tear film and providing moisture. They have a tendency, however, to blur the vision with contact lenses in place (not for everybody, I imagine....).

    The biggest secret, for me, that I learned was: they should go in the deepest part of your lower lid (inferior conjunctival cul-de-sac)--almost always in the center of your eyelid--not the extreme inside or outside.

    I have always said that--whether your issue is aqueous-deficiency OR evaporative dry eye ... these should be among the first things you try. I still get e-mail from a guy who is NOW traveling the world, (he says) BECAUSE I "turned him on to" Lacriserts.

    Best,
    Neil
    Last edited by neil0502; 14-May-2006 at 11:19.

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    A brief aside, about assisting new users

    I certainly wouldn't consider it rude to suggest searching, as long as it's done politely. However, personally I try to combine the suggestion with some practical pointers. Some new users are new to forums in general and don't know HOW to search. Some topics bring up so many hits that - especially when you're new and possibly not at all sure what you're looking for - it's very hard to leaf through it all.

    I have a couple of other suggestions for efficient ways to help others towards useful information without re-writing the same stuff every day:

    1) PTT ("Pop to top"): Back on the old SurgicalEyes bulletin board, we often popped useful, relevant old threads to the top when someone posted a question that needed a lengthy answer or where there was another patient we knew with a closely similar experience.

    For those who don't know, PTT just means that you go find an old thread that you'd like to draw someone's attention to, then post a very brief response to it (such as "PTT for Jane Doe"), which flips the old post up to the top of the chain, drawing it to others' attention.

    2) Sticky threads: You may notice me occasionally "sticking" a thread - making it permanently positioned at the top of the forum, such as the ongoing Depression or Post Your Routine threads. If you run across a thread you think should be permanently visible, or at least for a while, just send me an email with a link. For example, you could let me know some of the most useful threads in the topical category forums and I could stick them so that new readers can find them easily.
    Rebecca Petris
    The Dry Eye Zone

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    Neil:
    I hope nobody here thinks that a "search the forum" suggestion is in poor taste, non-responsive, or otherwise a negative thing.
    Neil, I doubt anyone thinks it's in poor taste or otherwise but a nudge to "look it up." There is vast info in this bb and others and if a person doesn't take a few minutes to look, they are missing a lot. It's easy for someone to come on and say "what, when, why" and "tell me what to do."
    I have been on the bbs a long time as you, and many others. We have written a lot about our experiences over a period of years. You just can't repeating the same old thing word for word. At least I get tired of it, myself. Also, others on the boards are sometimes tired of reading our posts of the same thing over a period of time. They let us know by calling us names on other places. True, they are of little importance, but we do put ourselves out there for them to pick it up and then ridicule.

    Rebecca:
    I certainly wouldn't consider it rude to suggest searching, as long as it's done politely. However, personally I try to combine the suggestion with some practical pointers. Some new users are new to forums in general and don't know HOW to search. Some topics bring up so many hits that - especially when you're new and possibly not at all sure what you're looking for - it's very hard to leaf through it all.
    Rebecca has a different responsibility than the rest of us. We have no responsibility or obligation to respond. It is kind and useful if we have information and will, and can, respond. Reading a post on a bb does not obligate me to do anything. Since I have garnered so much help, support and information for myself over the years, it's always nice to share. I put in my 2 cents about Lacriserts because I know most people do not know about them, especially newer posters. My info wasn't very helpful, but I tried to tell what I could and that included the fact they were hard to obtain at times.

    I think most people using a bb know about a search feature. If they don't, there is no time like the present to learn. If I want info on some new happenings, damn right I'll find the search feature and use it. If I'm feeling rather lazy that day, I might leave it for another time.

    These bbs were put in place by people that cared enough to do so. It's a freebie to the readers. It is time-consuming to the "owners" and administrators of the board(s). They get not one red cent as far as I know.
    I think new readers can help out by going through the forums, doing a little research on their own. Most of us had few to turn to and we were literally pissing in the wind while trying to find any information. We've spent literally thousands of hours reading this, reading that and trying to share it with others.

    There comes a time when "all of this" becomes more chore for us than anything else. It feels good to help others and give them a hand if they need encouragement. "We" have seen many come aboard (this and other bbs) and toddle along for awhile, complain, begin to heal perhaps, and move on. Usually we never hear from them again. They have gone on with their life, family and work. This is good.

    What I'm trying to say is for people to not take the good word for granted. Do not think Neil comes here to glance about to see if he can search for someone to help! He looks in and if the opportinity presents itself, he's up to the challenge. Same here. I try to encourage, offer info and privately talk if it will help someone. But, don't take it for granted. It's a long road, often tiresome, repetitive, sometimes with no thanks, and certainly with no gain personally.

    People should be aware that bulletin boards such as this were not always in place for us to pull up at will and ask someone a question and expect an answer. Sometimes I'll look at a post that says "tell me (this and that)" and even though I may be able to help, I don't. We're getting weary. At those times, I'll ask someone to use the "search" feature. They should be thankful the information is there for the taking.

    I just noticed that "sarahj3j" has not been back to post since her original question 24 hours ago.
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen

  9. #9

    thanks

    Thanks for all the info on the lacriserts. I am trying to get my ophthamologist to give me a prescription. For some reason he doesn't think much of it. From the different replies and searches it seems like some really like it and some don't. So it is worth a try to me. (Now if I can just get the prescription)

  10. #10
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    This is my second day using Lacriserts, and although they aren't a miracle, my eyes do feel better. I am not using as many drops and my eyes aren't as sensitive to light.

    One good example of this is - I work in an office building with a lot of circulating air, very large windows and very bright flourescent lights. Usually, this combination of bright lights and dry air kills my eyes during meetings in conference rooms. Today, my eyes have been able to tolerate it much better. (Although I'm still considering buying some glasses with a slight tint to wear in certain circumstances to block the bright light).

    I also bike to work, and Lacriserts definitely helped today while biking.

    Again - not a miracle, but my eyes do feel better. I'll probably keep using them. If you can find a doctor to prescribe, I'd say give them a shot. (The one downside for me is putting them in - that can be a little tricky. But if you've ever worn contact lenses, you can probably put these in no problem).

    Sorry to keep rambling, but one other thing - my eyes become bloodshot as the day goes on, and Lacriserts help a little with that; not as much as I was hoping.

  11. #11
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    I'm not at home at the moment, but ... I may have posted the Prescribing Information for Lacrisert once. The drug maker says that, over the course of about a year, Lacriserts actually IMPROVE the underlying dry eye condition.

    Best of luck...

  12. #12

    Lacriserts

    sarahj3j,

    I use lacriserts everyday now for about 3 years. I could not make it in this world without them. I do not have any trouble getting them from Merck. I get me prescription from my family doctor because my ophthalmologist would not recomend them. If you have any questions feel free to email me.

  13. #13
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    I get me prescription from my family doctor because my ophthalmologist would not recomend them
    WOW! Another GP doc comes through when the "specialist" won't. FaithHope, I have had my family doc help me when the eye doc wouldn't/couldn't. This might be important for people to put away under their hat until needed. Thanks.
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen

  14. #14
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    Faithhope:

    What does the lubrication from the lacriserts feel like? is like artificial tears that keep being released over your eyes, is it gel like or normal watery drops? how long does one have to be in once you put it in, if you dont like it can u take it out?
    I want a cure

  15. #15

    Lacriserts

    Hi Sazy123,

    When I have the Lacriserts in I cannot feel them at all. The lubrication feels very normal (like healthy eyes should). However, if I leave them in too long (or do a lot of computer work or reading) say more than 11 hours a day they will start to feel sticky and uncomfortable. That is when I put one drop of Threa Tears in and remove them very simply (you must put in a drop of lubrication first for easy removal) I had to learn that the hard way. You can take them out of your eye at an point. The longer they are in the more they melt down and the stickier they become. They will take a little practice to know what length of wear time is best for each person.

  16. #16
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    Hydroxypropyl Methylcellulose (Ophthalmic)

    The active ingredient in Lacriserts is Hydroxypropyl Methylcellulose. From what I have read, many people are allergic to this. The following drops all contain this ingredient, so maybe a trial of one of the OTC counterparts might be in order before investing time and expense in the RX? Might the allergy issue be why this product is not more popular?

    Hydroxypropyl Methylcellulose Opthalmic



    Brand NamesReturn to top

    In the U.S.—

    * Artificial Tears
    * Bion Tears
    * Gonak
    * Goniosoft
    * Goniosol
    * Isopto Alkaline
    * Isopto Plain
    * Isopto Tears
    * Just Tears
    * Lacril



    * Moisture Drops
    * Nature's Tears
    * Ocucoat
    * Ocucoat PF
    * Tearisol
    * Tears Naturale
    * Tears Naturale II
    * Tears Naturale Free
    * Tears Renewed
    * Ultra Tears


    In Canada—

    * Eyelube
    * Isopto Tears
    * Methocel
    * Moisture Drops



    * Ocutears
    * Tears Naturale
    * Tears Naturale II
    * Tears Naturale Free
    Every day with DES is like a box of chocolates...You never know what you're going to get.

  17. #17
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    Can't remember if I posted it or not ... too lazy to look.

    In addition to Kitty's post, here's the actual Lacrisert Prescribing Information chock full of info...

    http://www.merck.com/product/usa/pi_...rt_uspc_pi.pdf

    Here's the Bad and the Ugly as Merck sees it:

    ADVERSE REACTIONS
    The following adverse reactions have been reported in patients treated with LACRISERT, but
    were in most instances mild and transient:
    Transient blurring of vision (See PRECAUTIONS)
    Ocular discomfort or irritation
    Matting or stickiness of eyelashes
    Photophobia
    Hypersensitivity
    Edema of the eyelids
    Hyperemia

  18. #18
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    Hydroxypropyl methylcellulose is also the active ingredient in the Genteal product line, including the gel.

    There is an excellent reference sheet over at agingeye.net listing all lubricants grouped by their active ingredients.
    Rebecca Petris
    The Dry Eye Zone

  19. #19
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    AKA Hypromellose

    Correct. The other name for the same thing is Hypromellose.
    Every day with DES is like a box of chocolates...You never know what you're going to get.

  20. #20
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    Hi Faithhope,

    I see your dry eye is from lasik. Do you have more problems with evaporative dry eye (low TBUT) or just with lack of tears (low schirmers), or maybe both? I guess I'm trying to figure out exactly what type of dry eye the lacriserts might help. I might ask my doctor about them next week just to see what she thinks.

    Also, just curious, when was your surgery, and did you see any improvements in your dryness at all afterward? At what point? Is any of your relief from your eyes actually healing, or is it mostly just coming from the lacriserts? My dry eye is due to lasik (11 months ago), so I'm just curoius to hear others experiences. Anyway, I'm VERY happy to see that you have found something to keep you comfortable! Thanks!

    -Shells

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    Quote Originally Posted by shells
    Hi Faithhope,

    I see your dry eye is from lasik. Do you have more problems with evaporative dry eye (low TBUT) or just with lack of tears (low schirmers), or maybe both? I guess I'm trying to figure out exactly what type of dry eye the lacriserts might help.
    Both, Shelley.

    Lacriserts provide more tears AND they "thicken the precorneal tear film," thus reducing the evaporation rate.

    CLINICAL PHARMACOLOGY
    Pharmacodynamics
    LACRISERT acts to stabilize and thicken the precorneal tear film and prolong the tear film
    breakup time which is usually accelerated in patients with dry eye states. LACRISERT also acts to
    lubricate and protect the eye.
    LACRISERT usually reduces the signs and symptoms resulting from moderate to severe dry
    eye syndromes, such as conjunctival hyperemia, corneal and conjunctival staining with rose
    bengal, exudation, itching, burning, foreign body sensation, smarting, photophobia, dryness and
    blurred or cloudy vision. Progressive visual deterioration which occurs in some patients may be
    retarded, halted, or sometimes reversed.
    In a multicenter crossover study the 5 mg LACRISERT administered once a day during the
    waking hours was compared to artificial tears used four or more times daily. There was a prolongation of tear film breakup time and a decrease in foreign body sensation associated with
    dry eye syndrome in patients during treatment with inserts as compared to artificial tears; these
    findings were statistically significantly different between the treatment groups. Improvement, as
    measured by amelioration of symptoms, by slit lamp examination and by rose bengal staining of
    the cornea and conjunctiva, was greater in most patients with moderate to severe symptoms
    during treatment with LACRISERT. Patient comfort was usually better with LACRISERT than with
    artificial tears solution, and most patients preferred LACRISERT.
    In most patients treated with LACRISERT for over one year, improvement was observed as
    evidenced by amelioration of symptoms generally associated with keratoconjunctivitis sicca such
    as burning, tearing, foreign body sensation, itching, photophobia and blurred or cloudy vision.
    During studies in healthy volunteers, a thickened precorneal tear film was usually observed
    through the slit-lamp while LACRISERT was present in the conjunctival sac.

  22. #22
    Who makes them? Arent they quite hard to get hold of?

  23. #23
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    They are made by Merck and require a prescription. If you want to try them I'd suggest you print out the manufacturer's product information sheet (click here to download) and take it to your doctor.
    Rebecca Petris
    The Dry Eye Zone

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    Quote Originally Posted by Rebecca Petris
    They are made by Merck and require a prescription. If you want to try them I'd suggest you print out the manufacturer's product information sheet (click here to download) and take it to your doctor.
    I'm reminded of a great exchange from the old (dating myself...) TV series, M*A*S*H

    "Be persuasive."
    "Be persistent."
    "Use force!"

    Doc's and pharmacists seem notorious for saying that they've never heard of it or can't get it. Work past that. Use the above methods. It worked for me

  25. #25
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    Cost of Lacrisert

    I checked my Rx plan and note that Lacrisert is a Tier 2. The price quote I have for a one month supply (60 packs) is $53.29. I'm sure prices may vary. My co-pay is $20. I'm willing to spend $20 to give it a try. I will be interested to hear what my eye doc thinks of Lacrisert. I will ask him on Wednesday. I will share anything earth-shattering of course!
    Every day with DES is like a box of chocolates...You never know what you're going to get.

  26. #26

    Lacriserts

    Hi Shells,

    I have both low TBUT and low schirmers. My surgery was in 2002. I had no improvement in my dryness after my surgery. I do not feel that I have had any healing since my surgery. I do not think that the lacriserts will heal my eyes, just give me daily relief. Lacriserts have most definitely helped me with my anxiety and depression by keeping my mind from obsessing about my eyes.

    Give Lacriserts a try and let me know what you think...

  27. #27
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    Revised POA re Lacriserts....

    Quote Originally Posted by kitty
    I checked my Rx plan and note that Lacrisert is a Tier 2. The price quote I have for a one month supply (60 packs) is $53.29. I'm sure prices may vary. My co-pay is $20. I'm willing to spend $20 to give it a try. I will be interested to hear what my eye doc thinks of Lacrisert. I will ask him on Wednesday. I will share anything earth-shattering of course!
    Today is a lovely day. I just learned that my drug plan will no longer cover Lacrisert after 6/1/06, and my Restasis is going to Tier 3 ($50 co-pay) on that date. I can't afford to do both, so if I am to continue Restasis, I will be forgoing the Lacrisert for now. Maybe when I win the lottery I can afford to maximally treat my DES.
    Every day with DES is like a box of chocolates...You never know what you're going to get.

  28. #28

    lacriserts

    I go my prescription for Lacriserts yesterday. (from my Opthamologist!!!)
    I picked them up today. About $50. It didn't seem to be a problem for my pharmacist to get them. So, do you continue the Restasis along with the Lacriserts? I have been using Restasis for over a year now and I can't really say that they have helped all that much. the reason I am still using them is because I had so many free samples. Tomorrow I start the Lacriserts. But if they don't work, I will be okay with that. The Dwelle drops that I started last week are doing wonders for me. (And they are a lot cheaper than the Lacriserts)

  29. #29
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    Kitty, can you try and get Lacriserts BEFORE June 1 so you'd have a supply to try at your leisure? That's what I'd do.

    As for Restasis, it did not seem to be helping me at 7 months and my RX copay went to 50% for it. I just stopped because I couldn't afford to take it any more.
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen

  30. #30
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    I thought about it Lucy, but I fear if I get Lacrisert and like it, then I will be all the more disappointed when I cannot afford to continue it. I may still ask my doc what he thinks about Lacrisert when I see him tomorrow. Much depends on whether or not I am to continue Restasis. The Restasis $50 co-pay is about 40%, and that is a bit much. I can certainly understand how you would not want to continue if it was not helping you and having to pay 50%. It might be different if I thought it was helping and did not drive me nuts for an hour or more after I put it in. I'm starting to understand how the poor elderly people feel about having to make decisions between buying meds vs. other necessities. I guess I should not complain so much, it could be worse.
    Last edited by kitty; 23-May-2006 at 22:05. Reason: forgot something
    Every day with DES is like a box of chocolates...You never know what you're going to get.

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