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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 8467
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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I suffer from Dry Eye as part of Sjogrens Syndrome... i have

Resolved Question:

I suffer from Dry Eye as part of Sjogrens Syndrome... i have been prescribed Vismed drops for 3 years now. I am beginning to suspect I may be allergic to the Sodium Hylauronate in the drops. My eyes are more irritable and lid edges sore. i also seem to have a slippery saliva in my mouth and throat and i wonder if this is and inflammatory reaction to the Sodium Hyalauronate which has entered through the sinus drainage.
Any advice about this or alternative drops to try will be welcome.
Thank you.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr Uzair replied 3 years ago.
Dr Uzair :

Hi. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

Dr Uzair :

How are you using the drops?

Dr Uzair :

Please enter chat and use reply to respond so that we can interact.

Customer:

I use the drops 4 times a day as instructed by Doctor = lacrilube drop at night

Dr Uzair :

Alright and when do you experience the eye irritation most?

Customer:

irritation now is during the night and on waking ,then all through the day. i am rarely free from soreness irritation. i have also used an allergy drop, as prescribed by the optician but no improvement in reducing irritation

Dr Uzair :

Alright, just to confirm, has the irritation started more recently or has it been there for the past 3 years?

Customer:

The irritation has developed in the past year. The very hot summer, sun and general heat has been a problem m. i have reactor lite glasses as protection and also goggle typeglasses with darker lens. Both sets ofglasses are prescription lens. Cold winds are also a problem but we haven't had many of those this year

Dr Uzair :

Alright, first of all, this does not sound like an allergic reaction to the eye drops. Since, the irritation has started a year back, if you were allergic to the Hyaluronic acid, then you would have not tolerated the eye drops for a long time. Secondly, the irritation remains all day, where as in allergic reactions the irritation would have been more pronounced after application of the eye drops, third reason, the anti allergic drops did not provide any relief.

Dr Uzair :

Now, there are two things, that could be causing the irritation and the chemosis.

Dr Uzair :

First, inflammation is a part of the Sjogren's disease process, an exacerbation of the inflammatory pathways can happen in the course of the disease at any time and this can lead to the persistent eye irritation and the lid margin redness.

Dr Uzair :

Second reason is that you have developed corneal or conjunctival ulceration or abrasions due to constant dryness or suboptimal application of lubricants, however, the above can develop with the most optimal care regimens as well.

Dr Uzair :

I suggest that you see your Rheumatologist to see if the disease is flaring up again, and if the blood inflammatory markers are high, you can be started on either a course of steroid eye drops or systemic steroids for some time, till this remits.

Dr Uzair :

Other drug options are also available.

Dr Uzair :

If the inflammatory markers are not high, then you should have an ophthalmology exam (eye exam) to rule out the presence of keratoconjunctivitis, corneal ulcers, abrasions and conjunctival ulceration and abrasions.

Dr Uzair :

If this is the case, then increase your frequency of lubrication.

Dr Uzair :

Or add Genteal gel to your eye care regimen.

Dr Uzair :

If this does not take care of the problem, then surgical approaches like lateral tarsorraphy can be considered.

Dr Uzair :

Let me know if you have more queries or need more information about the above.

Customer:

i need to digest the information you have given me. i think my best approach is to have another Eye to start with . Thank you for your help

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