man putting eye drops in his bloodshot red eyes

If you watch television chances are pretty good that you have seen commercials for Restasis for Dry Eyes. In one you are asked: “Do you use artificial tears often?” In another you are told by the beautiful TV patient, “But when my eye doctor said I have a disease that got my attention. ‘You have a disease called chronic dry eye caused by reduced tear production due to inflammation. I do too. I use Restasis’…”

We bet that when people watching these ads they hear that word disease and begin to worry. It sounds ominous. This person noted a side effect of Restasis for dry eyes not mentioned in the TV commercial:

Q. I have been bothered with dry eyes for a number of years. Recently I asked my optometrist if I could use Restasis for dry eyes, which I’d seen advertised on TV. He wrote the prescription and I’ve been using it for 10 weeks, one drop in each eye twice a day.

Quite honestly, I’ve noticed no improvement in the dry eye problem, but there is a disturbing side effect: blurred vision, which is getting worse by the day. Because of the blurred vision I’ve decided to stop using Restasis.

A. Restasis contains cyclosporine, an immunosuppressing drug. It was first approved in 1983 to keep people from rejecting transplanted organs. The eye drops are modestly effective at increasing tear production.

How Effective is Restasis for Dry Eyes?

The FDA reports the following results from clinical trials:

“Four multicenter, randomized, adequate and well-controlled clinical studies were performed in approximately 1,200 patients with moderate to severe keratoconjunctivitis sicca. RESTASIS® demonstrated statistically significant increases in Schirmer wetting of 10 mm versus vehicle at six months in patients whose tear production was presumed to be suppressed due to ocular inflammation. This effect was seen in approximately 15% of RESTASIS® ophthalmic emulsion-treated patients versus approximately 5% of vehicle-treated patients.”

We often find that such language is not terribly helpful. In trying to interpret the FDA’s summary, we conclude that in patients with chronic dry eye brought on by inflammation, six months of Restasis helped about 15% of them. That was 10% better than placebo (“vehicle-treated patients” got no active drug). How good is that? We leave it up to you to decide.

Restasis Side Effects:

According to the FDA, the most common complaint is a burning sensation (17%). Other adverse reactions include blurred vision, stinging, itching, pain, discharge and a feeling that something is stuck in the eye.

Your eye doctor needs to know that you are having difficulty with Restasis. There are other approaches to dry eye syndrome.

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  1. laura b

    There are tiny oil ducts at base of our eyelashes, which serve to spread a thin layer of oil over the eyeball when we blink. When we are not consuming enough good fats, those ducts don’t work well and that accounts for “dry eye”.

    We need to be eating coconut oil, omega 3, meat fats, nut oils, etc. (but not veg. oils). I (66 yrs old) started on krill oil, use Restasis and also apply castor oil to base of eyelashes with a q-tip every morning after shower. My eyes feel much better after 2 months of this; no more itching.

  2. Ronnie

    I was using those artificial tears products and no matter how many times a day I was putting the drops in my eyes, they burned and were tired. It was hard to even get through reading a newspaper daily. I saw your column about Restasis and was finally going to call my eye doctor (with my symptoms now going on weeks with no let up), until I spoke to someone.

    He told me that his eye doctor told him that when you are in the shower, wet your closed eyelids. Then take a small amount of baby shampoo (no conditioner formula) and massage it onto your eyelashes (again eyes closed!). Rinse. That should take care of the problem. Just before bed last night, I tried this.

    Since I wasn’t in the shower, I wet a wash cloth (which I was told was another way to apply the baby shampoo), and once my eyelids were wet, massaged the baby shampoo on my eyelids and then rinsed. I can’t believe I didn’t wake up with my eyes burning, and blurred vision (I would often artificial tears my eyes before sleep too). My dry eyes felt so much better. I’m going to try this again since I had success.

  3. Jim Jr
    Hendersonville, NC

    I used Restasis for several months as directed by our optometrist for dry eyes. Then I read about another solution for dry eyes. When I get up in the morning I put a wet, warm, clean wash cloth on my eyes for about half a minute. That seems to rest my eyes for the day. Now, I do the same for my wife each morning. She has stronger complaints for dry eyes and will remind me if I forget her. She is age 90 and I’m 85 and more mobile.

  4. Melanie

    Punctual Plugs are working for me! However, the docs tried to push the drugs on my first. I had to specifically ask for the plugs myself, they never offered them to me over the years. They are working, I try not to heap more drugs in my system!

  5. Mari

    There is disease related dry eye syndrome. Rheumatoid arthritis and Sjogren’s syndrome are two I am aware of. It depends on the cause of the dry eye. Is it age related or prescription related? Then this drug may not be for you. There are natural things to be done and can be searched for on the internet. To me it is a poor eye care specialist who would write out a prescription for dry eye without knowing the cause.

  6. Judy
    Winston Salem NC

    Many years ago, when I was young and vain, I was trying desperately to wear contact lenses but my eyes tended to be too dry. The doctor told me to start doing these exercises multiple times a day, whenever I thought about it — he had me blink rapidly, look up (10 blinks), to the side, look down and look to the other side (blinking rapidly ten times on each). This really made a difference in how dry my eyes were. Even today, if my eyes feel very dry, I look up, blinking rapidly, look to the side, down and to the other side. I have found this “exercise” always helps my eyes to moisturize themselves.

  7. JBG

    Back in the 1990s, I started having trouble with dry eyes. The eye doc said to use artificial tears. I bought some, but after contemplating putting drops in my eyes several times a day for the rest of my life, I looked around for a better solution.

    I don’t recall where I found the clue, but I started taking a borage oil supplement, 3 softgels/day. That pretty well fixed the problem.

    Not sure I’m allowed to tout a specific product here, but this info will help you find something like what I use:

    = = = =
    Borage Oil is an excellent plant source of the Omega-6 fatty acid Gamma Linolenic Acid (GLA). Borage Oil assists in the production of prostaglandins and supports cellular and metabolic health. Our 1000 mg softgels typically contain 190 mg of GLA and 350 mg of Linoleic Acid.
    = = = =

  8. Cathy
    Berlin CT

    I’m presently on Restasis for dry eye. I hope the statistics are better than 15% improvement. It’s very expensive and not the most pleasant feeling; like I have something in my eye. I still need lubricating eye drops as well. In addition, it may take up to 3 months before it works. Has anyone seen improvement on this drug?

  9. Cindy M. Black
    Seattle, WA

    I used to have dry eyes, and I tried using various forms/brands of “artificial tears” to alleviate that. What I found was that the more I used them, the drier my eyes became and so the more I HAD to use. That was DEFINITELY the end of my adventure with those products. And my eyes are just fine, many years later.

    I might add that my use of hyaluronic acid might well have had something to do with that. It’s a supplement that adds moisture to the body in general… it helps your skin stay supple, helps “lubricate” the joints from within, etc. I know I certainly have no more dry eyes and (as an added benefit), even though I’m post-menopausal, I find that sex is a lot easier now, as the hyaluronic acid also helps “down south” as well. Check it out! (PS, it’s a tad expensive, but not terribly so).

  10. marie

    If you are subject to migraines, Restasis can make them much worse. I used these drops for 2 days, and had migraines for a week. The drops were also not effective at all. Similason homeopathic drops for dry eyes is much better for me, as is plain old sterile saline solution.

  11. Jo

    What do I think? I think dry eye is not a disease but a symptom. To clear up the dry eye, diagnose the real condition or disease and clear it. Restaisis is merely a bandaid that , if it even worked, could prevent the search for and discovery of what is really wrong…..something that could be dangerous and destructive if not diagnosed and treated.

  12. Marie
    South Carolina

    This says that there are other approaches to dry eye syndrome, but does not say what they are or where to find them. That would be helpful here!

  13. Linda

    I find these ads insulting. Chronic dry eye is a condition, not a disease. To frighten people into asking their doctors for prescriptions is a new low for the pharmaceutical companies. Chronic dry eye is often a part of the aging process and should not be lumped in with diseases which are caused by invading pathogens or cancers.

  14. Sherry
    Waxhaw, NC

    I have very bad dry eyes and I am allergic to EVERY type of OTC drop and ointment so I definitely decided Restasis was not for me. I have eye plugs in to help with the dry eye ( doesn’t help) and caught the part of the commercial for Restasis stating that if you have eye plugs NOT to use the drug. I called the company for an explanation because my doctor who wanted me to use Restasis never said it is contraindicated with eye plugs. The woman told me ” we don’t have any data how it works with eye plugs so therefore they have to advertise that you shouldn’t use it”.

  15. Margaret
    Houston, TX

    I’ve discovered that if I yawn, my eyes will water. I can start a yawn by stretching my mouth open and, after a few stretches, I start to yawn automatically and my eyes start watering naturally. Works great for me but be sure to pull off the road and stop driving before attempting this remedy for dry eyes.

  16. M C

    My doctor “strongly” recommended Restasis. I really tried to use it, but stinging and red eyes were just too much to endure. I have had dry eyes for years. Lasix and cataract surgery aggravated it. I went back to OTC eye drops, warm compresses, and saline rinses. I read that people were having good results with Occusoft Plus lid scrub. It is a leave-on scrub, rinsing not required. I tried it and it definitely improved the dryness. I started additional lid scrubs made with warm saline using Neil Med packets for nasal rinsing. I make it up in a small bowl of warm distilled water, wet out a paper towel or gauze, and gently scrub my lids. This has made an even greater difference. I rarely use OTC drops anymore. I think the scrubs remove debris and mucus so that oil glands can work and tear ducts are clean so tears are produced. I recommend trying this method. It feels great, can be used anytime and provides much needed relief.

  17. Nancy de Vos

    Are these side effects also caused by use of Systane, Refresh, Optive etc. for dry eyes? Seems I have a bit more blurriness since using Refresh—-is the problem of dry eyes cause by not blinking enough or not drinking enough water to hydrate your whole body/system? Curious….

  18. Connie Smalls

    When I saw the very first commercial on this product I knew it was a sham. “Dry eyes” is not a disease in the true sense of the word. We do not need yet another prescription drug that causes more side effects than the actual ailment. Don’t be so gullible that you jump for everything that’s offered in commercials. They are there to SELL a product. The first course of action regarding dry eyes is to see your eye doctor. Once he or she ensures that the problem could be tired, strained eyes, go over your daily routine and see if you can reduce this problem in a common-sense manner. He will offer you a prescription because that keeps him in business. You will have to come back for follow-up appointments and prescription refills. I think you should not fill the prescription. Take vitamins and minerals, and use-over-the counter eye drops for relief a few times a day. Go to your health food store and get fish oil. Ask for their recommendations. Drink a lot of water and other liquids. Get sleep. When your health improves your eyes will too. Stop straining them. Use your reading glasses as necessary. Use sunglasses. Take care of your eyes.

  19. Gloria

    Why would anyone opt to take an immunosuppressing drug for a condition that could be treated less radically and far safer? I have dry eyes and have for years. I used Restasis one time and knew it wasn’t for me. Every morning, I clean my eyes with warm wet cotton rounds and then apply clean cotton pads with hot water, a quick compress. I’ve removed the night’s detritus and am controlling inflammation (chronic blepheritis, a concomitant of dry eyes). I moisturize with innocuous tear facsimiles morning and night. I take Omega 3 capsules and things are OK. I wear sunglasses outdoors to be sure I don’t get foreign bodies in my eyes. They’re good without using dangerous drugs.


  20. Beth
    San Diego, Ca

    I tried this drug and had all of those things so I stopped. I just got a prescription for the new drug for dry eye, Xiidra. It is very expense, and my insurance doesn’t, cover it. It seems to work better as it relates to the blurriness. Can you tel us the difference from the other dry eye drug and why is the cost so high?

  21. Susan

    I’ve had trouble with dry eyes for several years. My eye doctor suggested fish oil supplements. I use the TheraTears Eye Nutrition Supplement. It has really made a difference. I used to have severe pain in my eyes when I tried to open them in the morning. My eyes were so dry they were stuck to my eyelids. No more!

  22. Jeanne

    I have dry eye so bad some days I could not leave the house to go to work. The pain from the sun and artificial lights was unbearable. Restasis solved most of the problems I have with dry eye, but it does cause some blurring of vision. Most medications have trade offs and if your eyes are as bad as mine this may be acceptable to you also.

  23. Jan

    I would suggest punctal plugs for dry eyes on the lower lid only. I got them last fall and my tear production has improved dramatically. It is a fast painless procedure that plugs the drainage holes for tears. The holes are located in the corner (by your nose) of the lower eyelid. I cannot believe what a difference it has made in keeping my eyes “wet” throughout the day and I am not taking any drugs. You can easily have them removed at any time if they don’t work out for you.

  24. Laura
    Cleveland, Ohio

    I have used Restasis for three years. I went from no tears to some tears. Some is better than none. I use preservative-free artificial tears (the small phials) to augment the Restasis. It did take almost six months for the Restasis to show results. My doctor told me this in the beginning. It was worth it. Imagine crying and not being able to produce a teardrop, or getting something in your eye and no amount of blinking could dislodge it. Or even worse, your eye surface is so dry that your eyelids stick to it. The general use artificial tears can only be used a few times a day, they are not made for constant use. I use the preservative-free artificial tears to flush my eyes when I do get something in them. I do get the side effects when I use Restasis: the eye pricking feeling, the burning, the redness. But, it is temporary and passes within about 20 minutes. For me, it is worth putting up with. Some days I don’t feel the effects at all. while others I can’t wait to flush my eyes to soothe them. Until something better comes along, I’ll stick with the Restasis as long as it continues to work.

  25. Brooke

    I was told by three different eye doctors that Restasis would empty my wallet before it ever did anything for my dry eyes.The last Dr. I saw put in plugs and that worked well.

  26. Tina L.

    I, too, experienced chronic dry eye for several years. I was using over the counter eye drops, but they were not helping. So, my doctor prescribed Restasis. I used it for several months. Gradually, I noticed some improvement in the dry eye issue. But, eventually my vision started blurring. It continued to get worse. My doctor and I agreed that I needed to stop using Restasis and go back to over the counter eye drops. I have done that and no longer have the blurred vision.

  27. Karen N.
    New York

    It has been 6 weeks for me using Restasis faithfully. I was warned that it might sting and burn, but thankfully, that has not happened. I’m willing to give the full prescription a chance to work (2 months), but I don’t see much relief yet. I have had no side effects using it. Before trying Restasis, I had punctal plugs. The benefits of plugs should last about 8 to 9 months I was told, but they seemed to only help for about a month.

  28. Judy

    People that are tempted to try Restasis should be warned that it is VERY expensive! I had to stop it after only 3 days due to extreme photosensitivity and burning. Ask the pharmacist for a week’s supply to make sure it works.

  29. Tam

    I tried it twice, months in between trying . My vision would become more blurred than it already was from the dry eye. Caused red irritated eyes.

  30. Nora

    I am doing well with tear duct blockers. Restasis is very expensive.

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