Dry Eye

[God_Loves_Me]

Hello

I am part of clinical trials, and one of the worst side effects is dry eye. I have drops that include OTC and prescribed eye drops for dry eye, but no help.

What's the best way to handle dry eye? What worked for you?

[KocoPr]

besides clear eyes drops i also use a gel and that stays much longer in eyes. I like it especially at night. Only happens around pollen season for me.

Read your bio. Very interesting trial you’re on. (Also do you mean ALP instead of APL in your bio)?

Your trial is phase 1 testing maximum tolerated dose. You have had three treatments so far?

Thank you for doing this trial and please keep us informed.

clinicaltrials.gov/study/NC...

Study Overview

Brief Summary

This is a phase 1 study to assess the safety and tolerability of ARX517 in adult subjects with Metastatic Castration-Resistant Prostate Cancer (mCRPC).

Detailed Description

This is a first-in-human, Phase 1, multicenter, open-label study to evaluate the safety, PK, PDy, and preliminary anti-tumor activity of ARX517 in adult subjects with mCRPC with serum testosterone level < 50 ng/dL at screening who are resistant or refractory to standard therapies. Phase 1a (dose-escalation) and Phase 1b (dose-expansion) stages will identify the MTD and/or RDDs.

Show less

Official Title

A Phase 1, Multicenter, Open-Label, Dose-Escalation, and Dose-Expansion Study to Evaluate the Safety, Pharmacokinetics, and Anti-Tumor Activity of ARX517 in Subjects With Metastatic Castration-Resistant Prostate Cancer Who Are Resistant or Refractory to Prior Standard Therapies

[God_Loves_Me in reply to KocoPr]

APL I mean Alkaline Phosphatase, I hope I tracking right one

[GP24]

With ADT dry eye is cause by a low estrogen level.

This is an article about the study, as usual, no significant side effects are reported: onclive.com/view/arx517-dem...

[Tall_Allen]

Have you tried "artificial tears" available over-the-counter? Is it giving you dry mouth, as well? Anti-PSMA pharmaceuticals attack tear duct glands and salivary glands. Hopefully, it will resolve over time.

[God_Loves_Me in reply to Tall_Allen]

Yes I did try but did not work well. Severe dry eye and dry mouth..

[Tall_Allen in reply to God_Loves_Me]

The only success they had with dry mouth from 225Ac-PSMA-617 was with "sialendoscopy." That involves sticking a flexible tube into the opening of salivary glands to dilate the opening so that saliva can flow out. The opening gets constricted due to inflammation (hopefully, the same inflammatory response in prostate cancer tissue is what will make your experimental ADC medicine work!). A similar procedure can dilate your lacrimal glands as well.

prostatecancer.news/2021/01...

[God_Loves_Me in reply to Tall_Allen]

Thank you so much I will talk to my dr about it.

[God_Loves_Me in reply to God_Loves_Me]

Tall_Allen How do I start the conversion about sialendoscopy ? Just trying to learn what are best way to coordinate with MO

[God_Loves_Me in reply to God_Loves_Me]

Here is the message I sent to dr today

Hello,

I am trying to share future concerns here rather than current situations. My goal is to continue treatment and get the best outcomes from the treatment.

My biggest concern for future risks and side effects is the current side effect. Dry mouth and dry eyes are at a medium level, which is manageable, and it should not cause any issue with continuing the treatment. However, if it gets worse, I would not like to get into a situation where we have to consider stopping the treatment just because of dry mouth and eyes.

Again the goal is to fix side effects in a way that we can continue the treatment.

From my research I came across one of the clinical trials 225Ac-PSMA-617  which also reported similar side effects and many patients went under sialendoscopy procedure.

My understanding of the procedure is that it involves sticking a flexible tube into the opening of salivary glands to dilate the opening so that saliva can flow out. The opening gets constricted due to inflammation which causes mouth to be dry. Similar procedure can dilate your lacrimal glands as well.

Can we do that ?

I do understand the sponsor's limited support here, but at the same time, insurance can cover that if not I can pay out of pocket if that benefits him in his daily quality of life.

[God_Loves_Me in reply to God_Loves_Me]

Here are the dr recommendations after my message to them

- Dr can reduce the dosage of drugs

- Dr can stop the treatment

- They are not ready for sial endoscopy or lacrimal glands

[Bigdo58]

Nova Tears retail product best works for me now, had dry eye for about 40 years on and off when using contacts, then PC drugs. Worst in winter, aircon dries the eye. Also use an eye pack (get it from your optometrist), heated in micro, which softens the wax in eyelid ducts, you squeeze it out then manually and ducts unblock.

[HTN10]

Here's why it happens:

Tear Film Instability: A healthy tear film has three layers:An oily layer (produced by meibomian glands in the eyelids) to prevent evaporation.A watery layer (produced by lacrimal glands) for hydration and lubrication.A mucous layer (produced by goblet cells in the conjunctiva) for spreading the tears evenly.

The Culprit: In dry eye disease, the problem often lies with the oily layer. If the meibomian glands aren't functioning properly, they don't produce enough oil. This allows the watery layer to evaporate too quickly, leaving your eyes feeling dry and irritated.

The Body's Response: In response to the dryness, your lacrimal glands might go into overdrive, producing more tears in an attempt to compensate. However, these excess tears are watery and unstable, and because they lack the oil layer to hold them in place, they simply spill over, causing your eyes to water.

So, the watery eyes are actually a sign that your eyes aren't getting the proper lubrication they need.

Here are some additional points to consider:

There are other causes of watery eyes besides dry eye disease, such as allergies, irritants in the environment, or even emotional crying.

A doctor can diagnose dry eye disease and recommend treatment options.

If you're experiencing watery eyes and a dry sensation, it's a good idea to see a doctor to determine the underlying cause and get the most appropriate treatment.

[hopeful1956]

Systane Complete works great for my dry eyes. It was recommended by my ophthalmologist.

[Demosthenes in reply to hopeful1956]

I like Systane Ultra PF better since the Complete seems to sting. Also, 'thera tears' seem like the same product only cheaper.

[guciu]

Fish oil worked for me when anything I tried didn't. Had severe dryness in both eyes no PC related and tried all brands of eye drops, no matter how expensive they were. One day while searching the internet I found someone whose case was like mine and saying that stopping eye drops and taking fish oil helped him after some time. As reluctant I was, from desperation rather than anything else, I tried to do the same. It took a few weeks or so before I felt the change and then it improve to the degree that I've been comfortable since. Not a medical advice of course, just sharing my thing.

[KocoPr in reply to guciu]

Now that i never thought of! Wouldn’t vitamin A oil work better since it is more refined for your eyes, plus lake of Vit A can cause dry eyes.

[j-o-h-n]

From Monsieur A and Mademoiselle i

Dry eye syndrome, also known as dry eye disease or keratoconjunctivitis sicca, is a common condition where the eyes do not produce enough tears or the tears evaporate too quickly. This can lead to inflammation and damage to the surface of the eye. Here are several strategies and treatments to manage and alleviate dry eye syndrome:

Lifestyle and Environmental Changes

Blink Regularly:

Make a conscious effort to blink more frequently, especially when reading or using digital screens for extended periods.

Reduce Screen Time:

Take regular breaks from computers, smartphones, and other digital devices to reduce eye strain and dryness.

Humidify the Air:

Use a humidifier in your home or office to add moisture to the air, which can help keep your eyes from drying out.

Wear Sunglasses:

Protect your eyes from wind, sun, and dry air by wearing wraparound sunglasses when outdoors.

Stay Hydrated:

Drink plenty of water throughout the day to maintain overall hydration, which can help with tear production.

Over-the-Counter Treatments

Artificial Tears:

Use artificial tear drops to lubricate the eyes. There are many types available, including preservative-free options for sensitive eyes.

Lubricating Eye Ointments:

These can provide longer-lasting relief than eye drops, especially useful at night.

Warm Compresses:

Applying a warm, damp cloth to your eyes can help loosen clogged oil glands and improve the quality of your tears.

Prescription Treatments

Anti-inflammatory Medications:

Your doctor may prescribe eye drops to reduce inflammation, such as cyclosporine (Restasis) or lifitegrast (Xiidra).

Corticosteroid Drops:

These are sometimes prescribed for short-term use to reduce severe inflammation.

Punctal Plugs:

Tiny devices inserted into the tear ducts to block drainage and help keep the eyes moist.

Autologous Serum Drops:

Made from a patient's own blood, these drops can be highly effective for severe cases of dry eye.

Dietary and Supplementary Approaches

Omega-3 Fatty Acids:

Consuming omega-3 fatty acids through diet (e.g., fish, flaxseed) or supplements can improve tear quality.

Flaxseed Oil:

Supplements can also be beneficial for some individuals.

Advanced Procedures

Intense Pulsed Light (IPL) Therapy:

IPL can help treat underlying eyelid inflammation (blepharitis) that contributes to dry eye.

LipiFlow:

A device that applies heat and pressure to the eyelids to unclog blocked oil glands.

General Tips

Avoid Smoke and Other Irritants:

Stay away from cigarette smoke and other environmental pollutants that can irritate your eyes.

Adjust Your Work Environment:

Position your computer screen below eye level to prevent your eyes from opening too wide and drying out.

Follow Up with Your Eye Doctor:

Regular check-ups are important to monitor your condition and adjust treatments as necessary.

Conclusion

Dry eye syndrome can be a chronic and uncomfortable condition, but with proper management and treatment, symptoms can be significantly reduced. It's important to work with an eye care professional to determine the most effective treatment plan for your specific situation.

Good Luck, Good Health and Good Humor.

j-o-h-n

[garyjp9]

You have a lot of suggestions here. Like one other respondent, I also prefer the OTC gel remedies over just the drops. I also use the warm compresses to loosen the oil glands. I lowered my computer screen below eye level. And, I have been using cyclosporine drops (Restasis) for a number of years (prescription only). Most of these are described in j-o-h-n's response above.

[annjohannsen]

My eye doctor recommended using a Bruder eye mask. It works! Heat it up in the microwave per instructions and place it over the eyes twice a day. It thins out the oil that has thickened too much in the oil glands around the eyes. Easy and comfortable. I bought mine at his office but they are available online. He also recommended Avenova eye spray to be used with the mask, although I have yet to purchase that. The mask is great! Disclaimer - I am the wife of a man with prostate cancer. Maybe the PC drugs cause dry eyes through a different mechanism. But the mask is definitely worth trying.

[Union98]

Try a humidifier. My husband doesn't like the "heavy" air, so I use it in my office/spare room. My eyes were so dry my lid would stick to my eyeball. I also use Systane Night Time severe dry eye relief.

[CrackerOcala]

Dear Dry Eye,

I have suffered from dry eye and extreme light sensitivity for some years (since cataract surgery). I mostly used light and heat avoidance techniques but last year came across a game changer called Hydroeye (suggested by my ophthalmologist). Google it. It is a combination of vitamins and black currant seed oil. Within a few weeks of taking the capsules there was a quality-of-life change with respect to dry eye. I continue to take one 3 times a day.

I continue to use a gel on some nights and drops several times a day.

best wishes.