lower chronic eye inflammation to the maximum extent possible

[Wendyyyd]

I have chronic eye inflammation due to sjs/ten and have been using a steroid drop and ivig drops to control the inflammation. If I add other types of eye drops that help with inflammation to my regiment will that further reduce the level of inflammation? Or is there a limit to how much the inflammation can be reduced?

[John C Hagan III, MD, FACS, FAAO]

Your profile indicates you live in the United States. So Ivig eye drops must be used in an experimental study as it is not an FDA approved medication that a regular RX can be written for. Also it is important you understand the risks of chronic steroid eye drops which include cataracts and glaucoma.  Generally speaking we do not want patients with Sjorgren's syndrome on steroids for long periods. Most of my patients with your problems I treat with Restasis twice daily for the rest of their life. I have said this before but both my wife and I have bad dry eyes and my wife has been on restasis with good results for about 15 years and me for about 10 years.  Note it takes 4-6 months for Restasis to kick in and work fully. There are too other drops that are in this family. Xiidra, which I do not use after having poor results and may complaints from my patients about stinging, burning and not being effective. If after a 9 months the person is still symptomatic on restasis twice per day and preservative free artificial tears 2 to 4 times/day than I switch from restasis to Cequa, which is the same medicine as restasis (cyclosporine) but twice as concentrated and is said to penetrate deeper into the cornea.  Cequa is more expensive. For restasis I personally use the preservative free drops and use up the entire dropperrte  before opening a new one. Each dropperette will give at least 2 days of treatment which reduces the cost by 75%.

[Wendyyyd]

The inflammation is not just due to t
ocular dryness. Hence the need for chronic use of antiinflammatory drops

[John C Hagan III, MD, FACS, FAAO]

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