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.
This page covers the following topics:
- How to find a compounding pharmacy
- How to keep custom eyedrops cold at work
- How to keep custom eyedrops cold when you travel
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:
- LeiterRX.com, located in San Jose, California
- ApothecareOphthalmic, located in Coventry, Rhode Island
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*. |
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* 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." |
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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
Your eye doctor can ask for:
|
|
Apothecare (also called
PVPSC.com)
(if necessary, check this link for more recent contact information) |
Apothecare (Pawtuxet Valley Prescription)
Your eye doctor can ask for:
|
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.
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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.
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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.
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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.