Autologous serum in 50% saline...what the heck is happening here?

[No tears in ATL]

Ok, need some help from people who have had autologous serum. Did the saline solution that it is mixed with burn your eyes at all? Two drops in and my eyes are pretty red.

By the way, I can't handle regular saline. Get bloodshot almost immediately. Must be that hyper-osmolarity phenomenon. I was hoping, though, that the serum would be much more dilute and not cause redness.

What the heck now? Am I allergic to salt or something??

This is all getting ridiculous. I am so ticked off that $150 is down the drain if these things do nothing but cause irritation, like everything else I have put in my eyes over the past year.

[vivian3090]

This makes me nervous! I wasn't able to start my serum drops yet cuz I'm in the process of moving, I plan on starting,them tomorrow. :/

[farmgirl]

Maybe if you can't tolerate the saline take them back and ask to have them remade with some other carrier. If you take them back right away they might not even charge you the full price, maybe only the lab fees for pulling the blood....it's worth a try. Get them to make just a small batch until you find something you can tolerate.

[No tears in ATL]

This makes me nervous! I wasn't able to start my serum drops yet cuz I'm in the process of moving, I plan on starting,them tomorrow. :/

Sorry--didn't mean to cause alarm. Maybe it is because my eyes were dry already since it was the end of the day. Still a bit burny, though, although nothing like Restasis or some of the over the counter drops. I will try a couple more days and see how this works out...

[vivian3090]

I started today. Although they didn't burn, I haven't noticed anything. My left eye is still getting inflamed. And they still feel like they are drying out. am I not going to get immediate results? I guess I'll Cal my doctor tomorrow and see what he says about it. In worried if this does work, what next? flarex was only thing that helped and now I can't use it anymore so I'm really upset.

[indrep]

vivian, autologous drops are an attempt to reverse the osmolarity of the ocular surface. They are not necessarily for comfort. It takes about 60-90 days for the osmolarity to change and then the healing process of cells takes another 60-90 days. Any nerve issues can take longer.

[SAAG]

Yes, Indrep is correct about the serum drops not being for comfort so much as for healing. I look at mine as medicine, rather than as an artificial tear substitute. Also, it might be hard for you to tell if they are doing anything since it sounds like you are simultaneously going off the Flarex... you eyes may get worse due to stopping the steroid drop, but for all anyone knows they might have gotten even worse if you weren't on the serum, know what I mean?

[vivian3090]

Yes, Indrep is correct about the serum drops not being for comfort so much as for healing. I look at mine as medicine, rather than as an artificial tear substitute. Also, it might be hard for you to tell if they are doing anything since it sounds like you are simultaneously going off the Flarex... you eyes may get worse due to stopping the steroid drop, but for all anyone knows they might have gotten even worse if you weren't on the serum, know what I mean?

Yeah I see what you mean, It's just hard when you THINK they are getting better and then you look in the mirror and you see they are inflamed/bloodshot. I hope that it's b/c I am going through withdrawals from Flarex, and that once that is "over" per say, that the serum drops will start helping more. I just want this discomfort and anxiety to go away. :/

[Cali]

This is didn't know - "It takes about 60-90 days for the osmolarity to change and then the healing process of cells takes another 60-90 days. Any nerve issues can take longer."

My doctor is new to autologous serum drops. She told me they are not a long term solution. However, it appears that maybe a least 180 days use is needed. And nerve issues? Can autologous drops help to heal nerve issues from LASIK?

[PotatoCakes]

I consider my serum drops a long term solution. Not a solution in that they will heal the cause of my dry eye but a solution in that they make my eyes feel better and heal the surface damage caused by my lack of tear production. I don't know if they can help with nerve issues, particularly since I have not had Lasik but, if anything can help at this point, the serum drops are more likely to than other products available as they do have healing properties.

When I was first prescribed serum drops, my doctor basically told me I'd be on them for the rest of my life. That thought horrified me at the time but with the relief they give me, it doesn't bother me at all. Diabetics test and take insulin, HIV patients take a variety of drug cocktails, heart patients have their thing, I have serum drops. Hopefully, some day, there will be a cure for what ails me but in the meantime, if I have to live the rest of my life with serum drops, it's worth it because they definitely impact my quality of life for the better.

[farmgirl]

Ditto, I'm with you potatocakes...F/G

[vivian3090]

I just wanted to post a mini update. it's been about a week and a half since starting serum drops.I can't say I have noticed a diiference. But I am just hoping it IS working, and that I am still going through withdrawals from the FLAREX.

For a few days my eye dryness was HORRIBLE. but I think it was b/c my psychiatrist had me try CYMBALTA. I didn't take it last night and today my eyes feel nothing like they did the past few days.

I am still needing to put drops in at least every15 mins.(such a hassle) and my boyfriend ordered some foam lined saftey goggles for me to try.

Also I am trying to keep hydrated by drinking A TON OF water.and I was advised to cut out caffeine as much as possible. I was also advised to drink lots of Cranberry Juice,eat nuts, fish, etc. Anti-Oxidant items. And keep up with fish oil,etc.

I will honestly say I am losing hope with this.I feel like I am going to miss out on my entire life. :/

[No tears in ATL]

Hang in there, Vivian. I'm not sure about any extreme withdrawals from steroids, since I can't even tolerate a regular dose (twice daily is all I can handle now), BUT my eyes would get red after I quit them, especially if they contained BAC. Lotemax was the worst of all. Eventually things seemed to get somewhat back to normal.

The foam glasses are a good idea. I use them as soon as I step in the door after work and I leave them on until bedtime. And, I'm ordering a set of (gasp!) foam sport sunglasses that I am going to put clear lenses in so I can do computer work. That's when I suffer the most. The frames almost look like regular glasses (from about 3 feet away) and they are a brown color.

Ten days into serum drops and I'm not sure I can tell a difference either. Maybe the changes are so small and incremental, slowly over time, that we're really not supposed to notice? The drops do feel better than regular eyedrops though, and are soothing when getting the burning sensation.

Best of luck.

[eyemech]

When I read these posts from patients who seem to be at the "edge" it really worries me. I am an eye care provider and I often wonder what the point of recommending the very same things over and over to patients who seem to get no relief.

"I will honestly say I am losing hope with this.I feel like I am going to miss out on my entire life. :/"

There are so many things that I never seem to see discussed here that I just wonder sometimes who you folks go to as providers.
For instance, I seldom see a reference to Lacriserts. Oh I know..those didn't work for this patient or that patient...so, they just don't seem to be mentioned. I seldom see reference to simple bandage contact lenses...oh I know, that didn't work for Sally or Suzy...so, its seems to seldom be discussed.

PROSE gets some attention, but it costs a fortune(upwards of 10K) and even those who use it have problems after a while. Can you say 24mm Hard contact lens without kind of swallowing hard? I see an occasional mention of hormone drops...they really really work.

I am personally experimenting with a new product for my patients...ProKera...its an amniotic membrane which promotes healing. I mentioned it directly to the administrator, but I still do not see any discussion.

Periodically I post, but seldom do I see my posts appear. Like some of you who feel like giving up, I occasionally feel like giving up on this site.
Because I am not a dry eye sufferer and so I cannot speak from personal experience. Instead I can tell you the experience of hundreds of patients. I do try to help patients and I try to offer suggestions on this forum because some of you seem to be in such pain that I want to offer a professional opinion.

I realize the rules for self promotion on this site, but I feel there is a lack of professional input because of those rules.
If this post does not appear..and it may very well never get posted because it always says..."your post will be reviewed by a moderator" and it never appears..I am going to quit watching this site. Few of you will miss that fact as I have not seen my suggestions appear.

BTW...I have personally never seen serum work. What I feel is really at work is a very expensive drop that patients actually use because it took a pint of their blood and $150. So, they actually use it.

I hope this actually appears because all I see are the same suggestions over and over again.

[vivian3090]

Hang in there, Vivian. I'm not sure about any extreme withdrawals from steroids, since I can't even tolerate a regular dose (twice daily is all I can handle now), BUT my eyes would get red after I quit them, especially if they contained BAC. Lotemax was the worst of all. Eventually things seemed to get somewhat back to normal.

The foam glasses are a good idea. I use them as soon as I step in the door after work and I leave them on until bedtime. And, I'm ordering a set of (gasp!) foam sport sunglasses that I am going to put clear lenses in so I can do computer work. That's when I suffer the most. The frames almost look like regular glasses (from about 3 feet away) and they are a brown color.

Ten days into serum drops and I'm not sure I can tell a difference either. Maybe the changes are so small and incremental, slowly over time, that we're really not supposed to notice? The drops do feel better than regular eyedrops though, and are soothing when getting the burning sensation.

Best of luck.

Read my most recent post I started "the im confused about my condition"...I really truly am!!

[vivian3090]

When I read these posts from patients who seem to be at the "edge" it really worries me. I am an eye care provider and I often wonder what the point of recommending the very same things over and over to patients who seem to get no relief.

"I will honestly say I am losing hope with this.I feel like I am going to miss out on my entire life. :/"

There are so many things that I never seem to see discussed here that I just wonder sometimes who you folks go to as providers.
For instance, I seldom see a reference to Lacriserts. Oh I know..those didn't work for this patient or that patient...so, they just don't seem to be mentioned. I seldom see reference to simple bandage contact lenses...oh I know, that didn't work for Sally or Suzy...so, its seems to seldom be discussed.

PROSE gets some attention, but it costs a fortune(upwards of 10K) and even those who use it have problems after a while. Can you say 24mm Hard contact lens without kind of swallowing hard? I see an occasional mention of hormone drops...they really really work.

I am personally experimenting with a new product for my patients...ProKera...its an amniotic membrane which promotes healing. I mentioned it directly to the administrator, but I still do not see any discussion.

Periodically I post, but seldom do I see my posts appear. Like some of you who feel like giving up, I occasionally feel like giving up on this site.
Because I am not a dry eye sufferer and so I cannot speak from personal experience. Instead I can tell you the experience of hundreds of patients. I do try to help patients and I try to offer suggestions on this forum because some of you seem to be in such pain that I want to offer a professional opinion.

I realize the rules for self promotion on this site, but I feel there is a lack of professional input because of those rules.
If this post does not appear..and it may very well never get posted because it always says..."your post will be reviewed by a moderator" and it never appears..I am going to quit watching this site. Few of you will miss that fact as I have not seen my suggestions appear.

BTW...I have personally never seen serum work. What I feel is really at work is a very expensive drop that patients actually use because it took a pint of their blood and $150. So, they actually use it.

I hope this actually appears because all I see are the same suggestions over and over again.

EyeMech,
I tired to PM you, but your inbox is full!

[bassfan]

Vivian - Do you have or have tried punctal plugs? I don't think you will really find anything that will make an immediate change with your eyes except those. Whether they help you at all is a different story. Plugs didn't help me because of evaporation issues but nonetheless its apparent they do something. I doubt we will ever have a magic pill to make things better. I've been at this dry eye nonsense for 7 years now I think and I've come to the general conclusion that less is more and throwing the kitchen sink at the eyes just makes them angry.

Eyemech - I would also like to PM or email you. Would you PM me please? I'm at least in the same state as you (so is Vivian).

[littlemermaid]

I am personally experimenting with a new product for my patients...ProKera...its an amniotic membrane which promotes healing. I mentioned it directly to the administrator, but I still do not see any discussion.

Eyemech, There is a lot of interest in amniotic membrane - please keep posting on progress

[vivian3090]

Vivian - Do you have or have tried punctal plugs? I don't think you will really find anything that will make an immediate change with your eyes except those. Whether they help you at all is a different story. Plugs didn't help me because of evaporation issues but nonetheless its apparent they do something. I doubt we will ever have a magic pill to make things better. I've been at this dry eye nonsense for 7 years now I think and I've come to the general conclusion that less is more and throwing the kitchen sink at the eyes just makes them angry.

Eyemech - I would also like to PM or email you. Would you PM me please? I'm at least in the same state as you (so is Vivian).

I have lower plugs. I just want to get to a point I don't have to put drops in every 15 mins. I go through so many drops in one day its getting expensive.....

[bassfan]

I have lower plugs. I just want to get to a point I don't have to put drops in every 15 mins. I go through so many drops in one day its getting expensive.....

Try uppers too then. It can't hurt other than the cost. I did a few years back. One fell out after a day so I pulled the other one out myself (which I am not advocating, but im capable). However, when I had those uppers in, it looked like I was crying the whole time. I would have to wipe away tears every few minutes. Was outside for a bit and the wind was blowing tears all over my face. I couldn't believe the difference between just lower plugged to all four plugged. I guess when the lowers are plugged the uppers flow a lot. I don't think plugs are right for me so I didn't go any farther than that otherwise I would have also tried the plugs that let a little through.

I'm no medical professional but I would stay away from the "fully inside the duct" plugs whatever they are called...been a while. I used Eagle Vision plugs. I think its a huge benefit to be able to see the little mushroom head protruding if it doesn't cause too much bother. It's nice to know its there.

PS - sorry for getting off topic No Tears in ATL. To your original question, if you can't handle saline it makes sense 50% saline would be an issue as well.

[vivian3090]

I am allergic to the mushroom ones. Which is why I have the ones that go right into the duct and dissolve after 3 months. My ophthalmologist doesn't want me to have upper ones. So I'm kinda outta luck there.

[bassfan]

I am allergic to the mushroom ones. Which is why I have the ones that go right into the duct and dissolve after 3 months. My ophthalmologist doesn't want me to have upper ones. So I'm kinda outta luck there.

Ok we'll I guess the dissolving ones are okay. Allergic to the materials? That seems odd. What is the reason for optho not wanting the upper ones? I can see an issue with something blocking the upper ducts for 3 months when you don't know if it would be good but I would be interested if the optho had other reasons than that. However if you have good tears and lack them, keeping them in your eyes is a sure way to comfort. If you have bad tears like me, then it's of little use and possibly counter productive.

[vivian3090]

Ok we'll I guess the dissolving ones are okay. Allergic to the materials? That seems odd. What is the reason for optho not wanting the upper ones? I can see an issue with something blocking the upper ducts for 3 months when you don't know if it would be good but I would be interested if the optho had other reasons than that. However if you have good tears and lack them, keeping them in your eyes is a sure way to comfort. If you have bad tears like me, then it's of little use and possibly counter productive.

Well I had a bad reaction to it regardless. My eye got extremely bloodshot with them in. When they were taken out the bloodshotness and stuff went away.

He said he doesn't recommend it because too much tears wont drain and i'll have over flowing tears. they can easily take the plugs out. I have no clue if i had good or bad tears...I do know I have instantaneous tear break up time thought... :/

[farmgirl]

I asked for 3 month dissolving ones and my specialist says he has never heard of them. i could only get 3 week dissolving ones. He told me if i ever found out what they were called to let him know. Why don't you ask your opht for 3 week dissolving ones that way you can at least try them. Uppers didn't help me, ditto for the lowers but when I got both upper and lower I went from needing drops every 20 - 30 min to needing only the serum drops and restasis and maybe the odd drop during a day INSTANTLY. If you should be so luck as to have so many tears that they are overflowing then at least you know that in 3 weeks they will be gone. You could try just one upper for starters (your worst). Maybe you need a new ophthalmologist??? IN my opinion, if they are as dry as you feel they are, he/she should at least let you try them....F/G

[vivian3090]

I asked for 3 month dissolving ones and my specialist says he has never heard of them. i could only get 3 week dissolving ones. He told me if i ever found out what they were called to let him know. Why don't you ask your opht for 3 week dissolving ones that way you can at least try them. Uppers didn't help me, ditto for the lowers but when I got both upper and lower I went from needing drops every 20 - 30 min to needing only the serum drops and restasis and maybe the odd drop during a day INSTANTLY. If you should be so luck as to have so many tears that they are overflowing then at least you know that in 3 weeks they will be gone. You could try just one upper for starters (your worst). Maybe you need a new ophthalmologist??? IN my opinion, if they are as dry as you feel they are, he/she should at least let you try them....F/G

I'm so sorry, they are actually 4-6 month plugs. I believe this is what they are called http://www.lacrimedics.com/plugs-dis.htm

I am seeing a new optometrist tomorrow. I have only seen one opthamologist (who did my lasik) and a cornea specialist. This doctor I am seeing tomorrow speacilses in dry eye. I figured getting a second opinion from someone not associated with my lasik procedure will be good. Maybe he wont automatically shrug it off as lasik induced dry eye, but actually attempt to see if something else is causing it as well. WIsh me luck! I will try to ask him about putting uppers in, but I'd rather have the doctor who put in my original plugs in do it though, that way i wont be bouncing back and forth between doctors and wasting more money...

[spmcc]

Maybe he wont automatically shrug it off as lasik induced dry eye, but actually attempt to see if something else is causing it as well.

You can print off your early posts from when you joined DEZ in Feb to show the doctor that you recorded your eye problem before you had Lasik. DEZ can be a place to keep your "medical diary"!

[vivian3090]

You can print off your early posts from when you joined DEZ in Feb to show the doctor that you recorded your eye problem before you had Lasik. DEZ can be a place to keep your "medical diary"!

That's right!

Reading those make me so pissed off at myself though. You all WARNED me not to get lasik...but I went ahead and got it b/c the doc said my dry eye was under control, I wanted to believe it and that I wasn't going to the be that 1% of people to get worse after lasik. but ALAS I am.

[spmcc]

I was so confused by the thread you started on Sept 16 asking when to use steroid drops (and more confused when you tried to clear up the confusion) that I went back to re-read all your posts. I think, aside from your posts on make-up etc., you can use all your posts as a diary to remind you of what has *really* happened.

If you condense everything, you can present it to a doctor... easy to read and understand.

And please avoid using the word "inflammation" because it's meaningless as a symptom (and you just mean "redness"). Stick to your actual symptoms (not what you think is happening i.e., "inflammation")... see this page http://www.dryeyezone.com/encyclopedia/symptoms.html

Tell the doctor when your symptoms happen (AM, PM, sleep on left side, blink a lot, etc.). If you want an article by Scheffer Tseng published in Cornea 2011 (http://www.ncbi.nlm.nih.gov/pubmed/21912234), PM me your email address and I'll send you the pdf. It may help you explain your DE symptoms to a doctor (and us).

The important thing is to get a real diagnosis... and you need to know what your eye problem was BEFORE Lasik. So perhaps go back and get the records from the ophthalmologists and optometrists you saw before your surgery. Concentrating on post-Lasik dry eye (IMO) isn't going to work... your problem started BEFORE surgery.

[farmgirl]

Thanks for the link Vivian, I'll pass that on to him...F/G

[vivian3090]

And please avoid using the word "inflammation" because it's meaningless as a symptom (and you just mean "redness"). Stick to your actual symptoms (not what you think is happening i.e., "inflammation")... see this page http://www.dryeyezone.com/encyclopedia/symptoms.html

So the dry eye specialist I saw says I have severe inflammation.... (I PROMISE I didn't mention ANYTHING about inflammation at all, HE SAID IT!)

He is saying to keep up with what I am doing with restasis and serum drops.

He gave me a sample of FreshKote to try 3x a day.... (I'm not sure if I see any difference? only have used it twice so far, but yet again something dramatic happened and I had a good cry)

He also is telling me to use Lotemax 4 times a day in my Left eye and 2 times a day in my right (I think for about a week, since I see him next thursday for a follow up).

He is saying something about a new drop he is going to start using next week, which I have a feeling I will recieve it when I do the follow up, but I have a feeling I have seen some posts regarding it. It is some new revolutionary drop that is supposed to stay on the eye for quite some time and help with dry eye and stuff...IF and when I get it I will post about it..