Fixpost started causing severe stinging

[SteveBass]

Hi from a newbie. I was prescribed Fixpost for high eye pressure about 6 weeks ago.. The drops seemed fine for about 5 weeks but now they make both eyes sting badly all day. I did stop taking them for a day and my eyes recovered. Tried them again the next day and same problem.

I have contacted the eye clinic but nothing heard back yet.

Due to other health issues I haven't slept well for nearly 4 weeks and my eyes are quite dry. I used Evolve artificial tears (no preservatives) to help with the stinging which I think helped for a while.

Has anyone found a way to reduce the amount of stinging? With the artificial tears, has anyone tried putting them in first before applying the glaucoma drops, or maybe after? Any other ideas which might work?

I'm hoping to try something like Monoprost to see whether I'm intolerant to the beta blocker timolol in the Fixapost.

[Rainyday2024]

Hello SteveBass, Sorry to hear about the stinging eyes. I find that when I put in Cosopt drops they are usually very uncomfortable for a little while, especially if I use too much! They are a combination of Dorzolamide and Timolol. I have used Timolol in the past without any problems, so think the Dorzolamide stings my eyes. Having said that, you may not be suited to Timolol. I also use Monopost in the evening, that has never stung my eyes. I’ve read that using some dry eye drops a few minutes before instilling the “painful” drops can help, but I usually forget. I wouldn’t recommend putting in the dry eye drops AFTERWARDS as they might wash away the previous medication.

I hope you manage to get it sorted soon. Regards, Gill

[SteveBass in reply to Rainyday2024]

Hi Gill, Thanks for your reply.

When I was initially diagnosed with high eye pressures (mainly left eye, but turned out right eye was also fairly high too) I was precribed Dorzolamide for the 'bad' left eye and Fixapost for both eyes. I applied both drops in the left eye for 2 days but my eye became very sore for most of the day and my eye came up red all over, so I discontinued the drops.

I should point out that when this all started I originally saw a GP about my left eye being red and having foggy eyesight in the mornings which cleared towards the evening. Then it seemed to resolve all by itself, I nearly cancelled my referal to the eye clinic as a result. It was only at that visit that I was told of the very high pressure in the left eye, hence being precribed the above drops despite my eye looking much better and no foggy vision in the morning.

So when I couldn't tolerate the drops and stopped using them I hoped things would settle back and heal naturally. Unfortunately after a further 3 weeks the foggy vision came back. That's when I was referred back to the eye clinic again by an optician due to high eye pressures. After I mentioned to them about the intolerance to both drops, they suggested I try the Fixapost again without the Dorzolamide. I'm guessing that's because the Dorzolamide had preservatives (Fixapost doesn't). They also wanted me to try Iopedine (preservative free) in my left eye too but held off to see how I got on with the Fixapost on it's own first bearing in mind my first intolerance issues.

The Fixapost has been fine until a few days ago, so not sure what has changed. It is possible my sleep issues are contributing to dry sensitive eyes.

I have asked to try Monopost to eliminate the possibility of suddenly becoming intolerant to timolol. Still no reply from the eye clinic so I'll try the GP tomorrow.

I think the whole subject of glaucome eye drop intolerance is a minefield, especially when multiple drops are precribed and some contain two drugs like Fixapost. Then when there are other health conditiins or alergies involved it's even harder to track down causes of intolerance.

Until I get any official advice I'll try using dry eye drops as you and Kieran suggested before the eye drops. Might also just try the Iopedine tomorrow instead to see if my eyes can cope with that for now.

Sorry for the long reply and I hope you and Kieran are Ok.

[KieranGlaucomaUK Administrator]

Hello SteveBass. Putting in dry eye drops before your Fixapost can help and offer your eyes some protection. Please make sure you leave 20 minutes after using your dry eye drops before using your Fixapost to ensure that the medication is not washed away. Persevere with the eye clinic if you don't hear back from them, as you might need to try a different drop. As Fixapost is a combination drop, you could also speak to your GP about getting the latanoprost and timolol prescribed separately, so you can identify which one is the culprit.

[SteveBass in reply to KieranGlaucomaUK]

Hi Kieran, Thanks for the reply. I'll try that and try to get hold of Monoprost to see if timolol is the culprit. Not sure if you can get timolol as preservative free though?

[Choirlover]

I recently referred myself to Specsavers emergency support for sore gritty eyes which sometimes felt like there were pins being stuck in them plus a very red and painful corner in one eye. I am on Fixtapost too for closed angle glaucoma. I saw an extremely helpful opthalmologist who carefully examined my eyes and recommended that I not only use dry eye drops more often ie at least 4 times every day, but to use a heat pad twice a day as well. She removed an in-growing eyelash from the corner of my eye which I could never have seen and which could be due to the medication. She also said my eyeball showed signs of scratches. I have done as she suggested and there is definitely an improvement although I think that you have to keep at it - there is no quick fix - she said I had to do this for at least 6 months. Some other opticians offer this service too but I did not know until recently you could self refer. It might be worth you investigating this treatment.