I am going to talk to my MD about Doxycycline for my dry and painful eyes. Does anyone have any info pertaining to dosage and duration? I want to know as much as possible about Doxycycline before I address this with him.

Thanks to all.
Dave

Dave...You will get lots of good info from others who have been on Doxy. Many doctors put patients on doxy for dry eyes. It has worked differently for some people than others. Some better, some not. I'll let those folks tell you about their results. I was put on doxy because of infection of the meibolian glands (eyelid). I am finishing up about 3 months on it. I took 50 mg 2x day. This may be adjusted for a person's size. You will be well informed about what this can/will do for you when you approach your doc. Good luck. Phyllis

[This message has been edited by pknapp (edited 11-11-2000).]

Phyllis,

Just curious, how did your eyelid look when it was infected. Was it puffy looing and did it appear that it drooped??

Droopy, the morning that I was aware that I had an infection, my eyelid felt like I was getting a stye. Tender, red, then it became swollen. This was the upper lid only, right eye. You could tell by looking at my eyelid that something was wrong with it. Not from a stranger passing, but if I said "look at my eye" they could tell something was wrong.

I cannot say that it drooped, though. It sure was sore though for a few days. I got started on Doxycycline right away. Phyllis

I know this has been posted on other threads but think it is worthwhile to post it here as well. Doxycycline should not be taken together with dairy products, multivitamins, or anything containing calcium. Apparently the calcium interferes with absorption. I wish I had known this six weeks ago so I would have been taking the doxy properly from the start.

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Patti Brankov

i didn't know calcium interfered with absortion but i do know that antacids, alcohol, iron, and zinc all interfere with absorption and should be separated by at least 2-3 hours. i also think you get better results if taken on an empty stomache. (if you can tolerate the nausea that is).

Pknapp

You didn't say if the doxycycline has helped your meibomian gland infection. I am going through the same thing and am curious if it has helped.

Pizzo,

Doxycyline and tetracyline are used to treat meibomian gland dysfunction which can cause dry eyes. Some other causes of dry eye do not respond to this therapy. Do you know the underlying cause of your dry eyes?

The usual tetracycline dosage is 250 mg four times a day for three weeks initially, with subsequent tapering. The usual doxycyline dose is generally 50-100 mg twice daily initially, with subsequent tapering of dosage.

It is important to combine the systemic antibiotics with aggressive lid hygiene. Warm compresses, followed by lid scrubs with diluted baby shampoo, or commercially prepared eye scrubs should be used twice daily.

Carmel

I have no idea of cause. I only know that I am 6 weeks post LASIK, and around week 3 or 4 began to feel the burning sensation. I have of course been using drops, and rotating through the various brands.

However, even before I started to feel the burning sensation, my doctor told me at each visit that my eyes were dry and that I needed to lube more.

Thanks for the info, I will share this with my doctor.

Dave

Ann, yes the doxycycline helped the meibolian gland infection. I took doxy for about 3 months although the infection was gone much within a week or two. Phyllis

How does one know if a meibolian gland infection is present? Heck, I don't even know where the gland is located.

I do note however, that the little gland looking thing in the very corner of my right eye (corner near my nose)looks a bit enlarged (maybe my imagination) and feels somewhat sensitive. In fact I noticed at various times today, I could sense that it felt/was wet. Maybe I am just obsessing...

Dave

[This message has been edited by pizzo (edited 11-14-2000).]

Dave, I think we all obsess somewhat. Unfortunately. I could tell my meibolian glands were infected because the upper eyelid was swollen, red and tender. Infections are very common on here, almost as common as dry eyes. Some say that dry eyes set up the conditions for infection.

I have Herrick plugs in my left eye, both ducts and I have what you are describing about the little notch in the lower lid by the eye. I believe in my case it's the irritation from the plugs. But, I need the plugs, so they stay put. For me, getting the eyelid gland infection was very similar to getting a stye. I am not saying they are the same, but I know what a stye feels like when you get one and that is how I felt. The doc confirmed later that day. Phyllis

quote:

Originally posted by patti blair:
Doxycycline should not be taken together with dairy products, multivitamins, or anything containing calcium.

WTFBBQ! How are we supposed to take it twice a day without any of that other stuff? Milk (and maybe eggs) is probably the cheapest protein out there!

Does anyone know if whey counts as "dairy" for not taking with doxy? I have assloads of whey that I usually eat once a day because I don't normally buy meat (it is too expensive).

My pharmacist also said no alcohol. What the heck, and they expect us to get through the day? I think they make half of this stuff up...

.. thanks for any help y'all can provide.

A 100 mg dose once a day is just as effective. Take the tablet between meals with a full glass of water. Taking it with food retards absorption. If it upsets your stomach, then consider 2 50 mg doses between meals or take it with food if necessary.

Hello, can anyone explain how doxycycline works? I searched and read everything, but I don't get it. All the explanations use fancy terms that make no sense to me.

My second question is, how/why does LASIK cause MGD? Because that's what doxy is for, right? Thanks for any help you can provide.

http://webeye.ophth.uiowa.edu/dept/SERVICE/CORNEA/Doxycycline/index.htm

This is from the University of Iowa, Department of Ophthalmology and Visual Sciences.

Common uses for Doxycycline (or Tetracycline or Minocycline) include the following eye diseases:

Blepharitis
Ocular Rosacea
Corneal inflammatory diseases
Corneal infections
How does it work?

The medication is used for several reasons that are not related to its normal use as an antibiotic:

By concentrating in the Meibomian glands (lipid- or oil-forming glands at the edge of each eyelid), a more stable tear film is achieved. This can improve sensations of scratchiness and dryness.
Altering the lipid with doxycycline may reduce free fatty acid formation by bacteria on the eyelids. Free fatty acids are similar to household detergents and may cause a burning sensation of the eye.
Doxycycline blocks or inhibits some of the body's responses to infection and inflammation. Inflammation makes the eye and eyelids red and irritated. By reducing excessive inflammation, delicate tissues such as the cornea may be spared from scarring and / or destruction.
How often do I take it?

Doxycycline is usually started at 100 milligrams twice daily and gradually reduced or stopped over time. It can and should be taken with morning and evening meals. Tetracycline and Minocycline should not be taken with dairy products.

Are there any side effects?

As with all medicines, serious side effects are possible. The most common side effects with doxycycline are upset stomach and increased sensitivity to sunlight (possibly leading to sunburn). Less frequently, skin rashes and hypersensitivity reactions have been reported so if you experience any unusual symptoms while on this medication, you should notify your physician promptly.

Who shouldn’t take this medicine?

Doxycycline should not be used in the last half of pregnancy, infants, and children under the age of 8 because it may cause permanent discoloration of the teeth (yellow, gray, and brown). Nursing mothers should not take doxycycline as it may be transmitted to the infant in human milk. The safety of doxycycline in early pregnancy has not been established and should therefore not be used. It may also interact with other medications, including oral contraceptives (making them less effective) and methotrexate (making it have an effectively higher dose).

What else can I do to improve the oily layer of the tear film?

Your physician may also instruct you to perform warm, moist compresses one to four times per day to increase the flow of oil from the meibomian glands. These compresses are typically used up to ten minutes at a time, with care taken not to burn the skin. The meibomian glands open on the edge of each eyelid through about 30 orifices (pores). Warm compresses help open the clogged pores. Your physician may also recommend gentle brushing at the edge of the eyelid (lid scrubs) to help loosen debris that may be blocking the pores.

Regarding the rest of your post...

I don't think anyone believes that LASIK causes meibomian gland disease but it does cause dry eye symptoms. Dry eye can develop by a number of ways. Normal tears are constituted in three layers. The first (top) layer is lipid, the lipid layer being derived from the meibomian glands. Without the lipid layer, the aqueous layer (middle) is subject to more rapid evaporation and tear layer dysfunction. The aqueous is the salty, watery part of your tears produced by the conjunctiva. The deep tear layer, the one next to the cornea, is the mucin layer, produced by the corneal surface (epithelium).

Dry eye post-LASIK is reportedly worse in patients who had a superior flap hinge (more nerve damage) than those with a nasal hinge. Also, PRK (epi-LASIK, LASEK) produces less dry eye problems for patients than LASIK, which strongly suggests corneal nerve damage as the culprit to dry eye. In this regard, patients with mild to moderate meibomian gland disease who had NO dry eye symptoms prior to LASIK may become symptomatic after the corneal nerves are severed. Reducing the MGD may offset the dry eye sensation, unfortunately for too many patients, not enough.

I personally think that patients may experience more severe dry eye symptoms than what the corneal condition would suggest on examination. There are documented cases of corneal nerves re-growing within the potential space between the flap and the residual stromal bed. I think these cases, although not thoroughly studied, may be a factor for patients with persistent and severe dryness complaints. The severing of the corneal nerves supposedly reduces corneal sensation and yet patient's dry eye symptoms are increased. This is contradictory. I believe that the severing of the corneal nerves produces a type of phantom sensation and since the nerve endings may never re-grow to their original location within the flap and just beneath the corneal surface, this phantom sensation persists like an itch that can't be scratched, making the usual dry eye treatment modalities ineffective.