Custom Eyedrops

Old-fashioned / New-fangled Compounding Pharmacies

If you have tried the standard treatments for dry eye without obtaining relief from pain, and you have also tried both vitamins and compresses and protective glasses and goggles, you might want to request your ophthalmologist to contact a compounding pharmacist who knows how to custom-make eyedrops specially designed to treat dry eye pain.

Important!     All information on this Web site is based on the experience and opinions of a very small number of individuals with severe dry eye. It is not provided by a doctor or other medical professional. Consult your eye doctor before you seek any particular type of treatment. Please see the Disclaimer below.

This page covers the following topics:

How to find a compounding pharmacy

No pharmacist can treat a patient directly. This is also true, of course, for a compounding pharmacist. Therefore, do not contact a compounding pharmacist directly yourself. Instead, if your eye doctor thinks that a specially compounded ophthalmic eye drop might help you, the eye doctor can contact the compounding pharmacist and, if appropriate, write a prescription for you.

Your eye doctor might already have a working relationship with a local compounding pharmacist in your town. If not, two U.S. pharmacies that create a large number of state-of-the art custom ophthalmic drugs, including custom eye drops for dry eye pain and meibomianitis, are the following:

Both pharmacists can provide preservative-free eye drops nation-wide in the U.S. by using overnight delivery services to ship them. Both pharmacists make hundreds of custom products for the eye. The following table lists a few of the eye drops that can be used to treat dry eye or meibomianitis.

Eyedrop Descripion
Cyclosporine Eye Drops Effective for some cases of hard-to-treat dry eye.
Retinoic Acid Eye Drops Effective for some cases of dry eye caused or made worse by vitamin A deficiency.
Castor Oil Eye Drops Effective for some cases of dry eye caused by meibomianitis.
(See, for example, Castor Oil Drops Safely Treat Meibomian Gland Dysfunction dated May 15, 2003, in OphthalmologyTimes.com.)
Medroxyprogesterone Acetate Eye Drops Effective for some cases of dry eye caused or made worse by menopause.
Dehydroepiandrosterone (DHEA) Eye Drops Effective for some cases of dry eye*.

* For information about DHEA see, for example, "Cornea: New Studies May Help Allergy and Dry Eye Sufferers," an article in Review of Optometry (search for DHEA to find this article, dated May 15, 2002), which states: "Researchers at Southern College of Optometry in Memphis, Tenn., compared the efficacy of artificial tears to tears supplemented with DHEA (a steroid hormone with 5% the androgenic activity of testosterone) ... test results improved with DHEA-supplemented tears. Dry eye patients may benefit from the addition of androgenic hormones to artificial tears."

Both pharmacies produce many more preparations for dry eye than those listed in the table above. Most or all of the compounded medications require refrigeration.

Tip!   Before you try custom eyedrops, try Refresh Lubricant Eye Drops (not to be confused with Refresh Plus, which contains carboxylmethylcellulose, an ingredient in many eye drops that some eyes cannot tolerate). Refresh Lubricant Eye Drops contain polyvinyl alcohol and povidone and are available at your local drugstore, or at MedShopExpress.com or Drugstore.com. Refresh Lubricant Eye Drops can be used by more people than products that contain methylcellulose.

Contact information

If your eye doctor wants to get in touch with either compounding pharmacy, here is the contact information.

Pharmacy Contact Information
LeiterRX.com

(if necessary, check this link for more recent contact information)

Leiter's Rx Ophthalmic Compounding
1756 Park Ave
San Jose, California 95126
Tel: 1-408-292-6772, 1-800-292-6773, 1-877-EYE-DROP
Fax: 1-408-288-8252
E-mail: cleiter@LeiterRX.com

Your eye doctor can ask for:

  • Morton Leiter, RPH.
  • Charles Leiter, Pharm.D., FIACP.
Apothecare (also called PVPSC.com)

(if necessary, check this link for more recent contact information)

Apothecare (Pawtuxet Valley Prescription)
59 Sandy Bottom Road
Coventry, RI 02816
Tel: 1-877-266-7686, 1-877-COMPOUND
E-mail: LRB@PVPSC.com

Your eye doctor can ask for:

  • Leo R. Blais, R.Ph. BS
  • Beverly Blais, Pharmacy Technician

Patience Pays     Although your eye doctor can evaluate compounded eyedrops and suggest one or more for you to try, as with any other dry eye medicine, there is no way to know in advance for certain what will work for you. Therefore, both you and your eye doctor must expect to experiment until you find the eye drop that will help your eyes.

Optimize medication use by starting early in the morning

Set your clock to an hour before you actually intend to get up. Put eyedrops in each eye (if you sleep in moisture chamber goggles, wash the goggles with baking soda before putting them back on), and then go back to bed. When you get up to start the day, put another dose of eyedrops in each eye.

For people whose eye pain increases at night and who are allergic to nighttime eye ointments, this early morning dose followed by an hour of sleep (or, at least, an hour with your eyes closed) can help eliminate or reduce pain once your "real" day begins.

How to keep custom eyedrops cold at work

Most or all of the compounded medications require refrigeration. If you are not comfortable keeping medication in a refrigerator in the break room at work that is filled with food, or if your place of work does not provide a refrigerator, take your own mini-fridge to work.

Snack Box One place you can buy a mini-fridge called a snack box is at SharperImage.com. At that Web site, search for "snack box." The snack box works electronically (it does not use liquid refrigerant nor does it have a noisy motor) to chill and keep your medication cold.

How to keep custom eyedrops cold when you travel

To carry the medicine when you travel, buy a stainless steel food jar (like a thermos, but with a wider opening). Keep the food jar in your refrigerator, and keep a small ice pack inside your freezer. When you leave home, put the small ice pack inside the food jar, put the medicine container inside a sandwich bag (to keep it clean), and put the sandwich bag with the medicine inside the food jar.

Thermos food jar To find a small stainless steel food jar, search Google.com for "stainless steel food jar" "wide mouth".

You can use the Koolatron to keep medicine chilled in your office and also in your car.

Koolatron bag cooler To find a Koolatron bag cooler, search Google.com for "koolatron bag cooler." It has a low power draw of 3–5 amps and operates on 12V, so you can plug it into your car's 12V cigarette lighter.

The items described here are merely suggestions. You can also search Google.com to find other products that might be more appropriate for your needs.

DISCLAIMER: Do not use any tip described on these pages without first consulting your physician.
All content on this Web site is for informational purposes only; it is not to be used for diagnosis or treatment; and it should not be construed as personal medical advice. Information published on this Web site is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the user's/viewer's medical care. Every effort has been made to present accurate and safe information, but the creator of the Web site is not a health care professional, does not warrant the correctness of the information, and is not liable for any direct or consequential injury or other damages that could result from the use of the information obtained from this site. Products are mentioned as examples only. No mention of a product constitutes an endorsement for that product; other products may be successfully used for dry eye and other conditions described here. It is not the intent of this Web site to promote any eye care products, procedures, or medications.