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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2436
Experience:  MS Ophthalmology with 13 years of surgical expereince
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My wife has recently been prescribed restasis for chronic

Customer Question

My wife has recently been prescribed restasis for chronic dry eye. Everytime she applies it it stings, burns and causes redness. Been taking it for 4-5 weeks now but 2 weeks ago she has decided to scale back to once a day (nightime) due to the stinging and redness. Not due back to our specialist until end of this month so we are going out of our minds worrying about it and need help. It also seems to have not worked in anyway vis a vis inflammation burning and stinging caused by the dryness. She also has 2 lower temp punctuals inserted.
History is that lasik was performed in June 2008 and was fine until Nov 2009 when the inflammation, stinging and burning set in and has continued to date. The eyes really burn and flare up, so much so the only relief is from an ice pack. Another factor (and perhaps not relevant) is that there might be a temporary hormonal issue as she stopped taking the contraseptive pill in Nov 2009 and has not had a period since, and is not pregnant. Awaiting bl
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 7 years ago.

Welcome to Just Answer

She has been given the best possible options for the treatment of severe dry eyes. Punctal blocks are more effective than eye drops. Restasis is definitely the drug of choice for refractory dry eyes as cyclosporin is supposed to bring down the inflammation.The side effects she is experiencing are commonly noted. But it appears to have been ineffective in her case. In such a case , permanent punctal plugs can be considered ( if temporary plugs have given relief). You can consider reducing the dose of restasis or stop it if the side effects continue. If there is inflammation , as of now you can use zaditor eye drops, 1 drop four times a day. Once your appointment is due you can discuss about stopping restasis .Role of oral anti-inflammatory like steroids can be considered

Thanks and best wishes

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Customer: replied 7 years ago.

Thank you and apologies for the delay in response. We have not since discovered that my wife has a hormonal imbalance, insofar as since she stopped taking the pill (after ten years) in Nov 2009 (at the same time that the dryness occured), it seems she is not generating any estrogen at all. Bloods came back 2 weeks ago and our GP advised us that estrogen levels did not even register on that set of bloods and more than likely as a result of being on the pill for so long. I know there is some linkage in menopausal women around dry eye and hormonal imbalance but as she is 33 years old she is not in menopause. However, given that the pill stopped in Nov and the dryness started at the same time and she is generating no estrogen, do you think that there is a high probability that this could be the underlying problem? The GP thinks yes but our eye specialist is not convinced. Our GP has put her back on a pill (not the same one). Your thoughts would be appreciated



Expert:  Dr. A.S. Desai replied 7 years ago.
Hello Ian,

It is ironical that dry eyes is more often seen in those who are on the contraceptive pill rather than once the pills are stopped. There are various causes for dry eyes which cause a reduction in the production of tears. For any further details you can follow this link on dry eyes-

Thanks and regards

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