"I HAVE A SCRIBE!" As an Assyriologist I now have this mental image of you being followed around by a robed youth with a clay tablet and a reed stylus, struggling to remember the right medicine logograms in cuneiform.
I maintain that it's not Ophthalmologists, Dermatologists and the like working little (compared to none-medical professions), but rather that most other specialties are just that overloaded that any normal, survivable workload feels like a luxury in comparison.
in any other business working 4-5 days a week would be perfectly normal but medicine has become a nonstop slog where people kinda resent the lowered workload of fields whose workload isn't so horrifyingly unsurvivable
Medicine self-selects for people who are extremely intelligent but that also have a desire to compete for being “the best.” The competition to be the most dedicated, the most stressed out, the most willing to work 6-7 days a week. It’s honestly shameful, because it results in the patient load per person is so high and there aren’t enough people to bring in to make it easier. I wonder how much better medicine would be if the workload was better for all drs and healthcare workers.
As someone who legit makes the Systane drops (along with a bunch of others), I joked with my boss last time you mentioned it in a video that our company isn't even paying for the free advertising. If anyone is curious, Systane Ultra is the easiest to make (we make it so much I could probably make it in my sleep) and Systane Complete is the hardest.
I have dry eye & was told to use Systane Complete. I see why people buy Visine or no name brands $17.50 for 2/3 an ounce is alot for some of us. At least now ;) I see who gets it.
the reason people ask if you do it yourself is most ophthalmologists (especially married ones!!) do not have time to edit a popular series of youtube videos LOL
Thank you for scaring me into finally throwing away the bottle of allergy eye drops that I've had open since the summer and which is probably host to an excitingly diverse selection of bacterial colonies by now.
I am a telephone advice nurse in Northern California for the large healthcare provider and I have started telling anyone who calls about eyedrops and stuff because I get everybody no Visine thanks to you thanks for your work. It makes me laugh. I’ve been a nurse for 25 years and you’re the best.
@@Citiesinmotionplayer I was doing this by voice. That’s the reason the punctuation may not be so great sorry I was busy taking care of my severely autistic child in between watching this video and enjoying it.
I got an eye infection from Target brand eye drops. Called them to report it and to their credit, they’ve called to check that I am ok and pulled the product like 2 days later (presumably after other similar reports). Thankfully I didn’t keep using them or lose my sight!
Btw, it was my FIRST TIME using eye drops because I recently switched to wearing contacts in the lab. I hate things touching my eyes because of how vulnerable the eye is. I ended up buying Systane but now I mostly just wear glasses unless I have to wear goggles that day. 🥲
I read a study that eye drop bottles are deliberately made to have a bigger opening than is necessary, so that more of the liquid flows out than required and that way the bottle runs out faster. If they made the hole smaller it would actually make it easier to apply eye drops since the drop would be of a smaller size, splash less and perhaps actually go in to the eye rather than overflow and create a mess, not to mention overdose (more liquid per drop = more medicine per dose) and chances of infection (you dab your face to clean the overflow and it can bring germs from your cheeks or whatever to your recently wet eye)
i research herbal medicines and one of the things that makes me sad is when people confuse homeopathy with actual science based on the chemical content of the plant. yes, chamomile might make the puffiness in your eyes go down (if you don't have an allergy to ragweed.) no, chamomile diluted to a ratio of 1:1000 will not do that. please stop putting whimsical tap water on your face.
I appreciate your making the "generic" avoidance understandable for us. I was taken aback when I saw the price I would have to pay on the one you recommended. You convinced me before you did a lens replacement on me, and I am so pleased that I listened to you. I still use the brand you told us to this day.
With so many of the same issues showing up across multiple brands it sounds like everyone is getting their eye drops from a blank label factory. For those who don’t know, some factories make products and do not put any labels on it. The idea is that a large retailer will buy this product and put their own label on it and sell it as if they made it. It’s called blank label and it’s more common than you think.
I used to work in pharma manufacturing. So this is how it works in our country, and I think in most countries. Pharma companies have generic and branded for every medicines. The branded ones are being made in the main manufacturing facilities of the company and they are very strict in sanitation and processing of the products. The generic ones are made by another manufacturer (usually owned by the same company) and the facilities and manufacturing process of that company isn't always monitored by the mother company. And most of the time (based from what I've heard from friends who worked there) those generic meds manufacturing aren't up to the standards. Some of them are lax in terms of sanitation and handling. That's why there are more recalls for generic medicines than branded ones.
Sometimes I chop onions and just deal with the burning because that’s the only time my eyes are fully as moist as they’re supposed to be. Once the burning stops my eyes get a break from how they normally feel. I hadn’t really thought about artificial tears before this video. I’m going to buy some.
Optical medicine is in the same regulatory class as sterile injectables. Things like morphine and IV drips that go directly into your bloodstream. Medicines that bypass your digestive system have to be made in a much higher level of sterile environment, from compounding through fill/finish. I’m a Pharma consultant and this is what I do every day.
That's concerning that there's an eye drop called "Rugby", because rugby and the eyes do *not* mix well, and if you attempt to mix them anyway you get into a lot of trouble for it.
I was really sick in the neuro ICU a week ago and I was unable to speak. I thought I recognized you and called out Glaucomflecken from my bed. All the nurses who were following my speech were like 'Glaucomflecken ?' 'Did she just say that ?' 'Is that a real word ?'. I was so disappointed. I was sure it was you
Fun fact: tetrahydrozoline (in Visine; also called 'tetryzoline') and brimonidine (in Lumify) are both imidazoline derivatives. Various other imidazoline derivatives are used in other eye drops and in nasal sprays. All of them could be harmful if misused. Both tetrahydrozoline and brimonidine are apparently toward the lower end of potential toxicity (I can't quickly find a resource directly comparing brimonidine to other members of the class, though; there are reports of adverse effects from brimonidine, but they all seem to result from the much higher concentrations used in treating glaucoma). One of the imidazoline derivatives that's readily available OTC is dramatically more hazardous than the others: oxymetazoline, used in Afrin and several other nasal sprays (and much more prevalent on the market in the US than in other countries, for whatever reason). So, within the particular scope of 'readily available imidazoline derivatives we should worry about', Visine is probably not the worst offender; more likely the title belongs to Afrin.
The other day my wife and I were in Target and she casually commented that she needed eye drops. We sauntered over to the pharmacy section a stood there looking at what appeared to be a couple thousand brands of eye drops. My wife was like how can there be so many? Which one do I pick? I remembered seeing this video and told my wife to hold on for a second. We needed to consult Dr Glaucomflecken. Shes like Who! I said Dr Glaucomflecken. I searched and pulled up you You Tube video in Target and there was my wife and myself watching this video. It truly was a sight to behold and yes she got preservative free name brand. Not sure which brand now but it was one you recommended. Thanks for your advice and I really enjoy the vids.
It’s interesting to hear you talk about Visine. I used Visine allergy drops for a short time and my most of my eyelashes fell out, upper and lower, both eyes. That was lots of fun because then they were all on the same “loss cycle” and they’d all fall out together. I looked like a weirdo with lashes just in the corners of my eyes. It took almost 10 years later to finally get them fully back. Now I just use Refresh tears when my eyes are dry.
As far as "losing" a big proportion of the drops you put into your eyes, when I was prescribed medicated eyedrops, the ophthalmologists at the hospital instructed me to pull the lower eyelid out, put the appropriate number of drops inside the lid (not directly on eyeball), then close the eye and apply gentle pressure with a finger to the inside corner of the eye to prevent the medication from draining out for several minutes. The manufacturer instructions said the same thing. You can only do 1 eye at a time so of course it takes longer but I guess it was to ensure sufficient contact time of the eye surface with the med.
Bottle of Lies by Katherine Eban goes into the problems of the generic drug industry, a lot of it comes down to lack of proper inspections at the factories.
I occasionally sleep with my eyes open and wake up with the driest stinging eyes. I've tried so many eye drops and yet never knew there were gel versions of eye drops and have now ordered some.
@@nikkih8690 parents when I was younger mainly but friends during sleepovers also mentioned it. It's pretty obvious for myself now since a strip of each eye will be super irritated and dry in the morning.
@@nikkih8690My optometrist tells me I probably sleep with my eyes not completely closed. There is a horizontal line of redness across my eyeballs. She recommended sleeping with an eye mask and using the gel eye drops at night.
Is this a thing like the baby food shortage where it was like only a few factories make a disproportionate amount of all drops so once there's any issue at the factory it has a huge impact?
It's not unusual to have a single manufacturing company make the exact same ingredient or product (sometimes with different shapes/stamps/impressions) for a plethora of generic distributors who just attach their label and ship it. You'll sometimes see the same pill markings on multiple generic brands.
You can... But you need to know your prescription... I used to buy at zenni optical, you enter in your prescription information and pick out frames, ect. Distance between pupils showed what frames worked for me.
Listening to the first few minutes of describing the morning and I’m at the part he has already arrived at work, but no mention of pants being worn yet.
Thoroughly enjoyed this episode. I actually liked how you talked about “a day in the life”better than putting a video with it. Those videos sometimes have the tendency to lose my attention if too long. Because of you, I learned somethings today. You are a good teacher and the humor helps! Keep doing you! ❤
just yesterday I was at the pharmacy asking them what I can do about running out of one of my Rx scrips for glaucoma because I miss the eyeball on a fairly regular basis. The insurance company said basically sorry Charlie...My ophthalmologist is adamant that I never miss a single day. It's very frustrating! thanks for all you do!
I know it's been a while since this comment was made, but (if you're in the US) maybe check and see if your insurance allows for a "lost medication" override. This isn't technically allowed as it wasn’t misplaced, but I've had patients drop medication in pet water dishes that insurances replaced without fuss. I think that spilling of eye drops would constitute med loss and they might allow for an early fill if you're in a difficult spot. I would also recommend discussing the issue with your doctor. They can possibly write for a larger quantity (over the same days supply) to try and give you a buffer (if insurance will cover it), or help show you a better technique. I've had some older patients that have shaky hands have to administer eye drops, and I've always felt badly because they always complained about missing their eye when applying so they ran out way too soon. I would recommend trying to work with your doctor and pharmacy to try and come up with a plan that insurance will (begrudgingly) accept.
Oh yeah!! That would be so cool to learn about. I'm helping a friend write her birth plan, and there are way more eye drops topics on the plan template than I ever would have anticipated!
There seems to be some confusion here. Vitamin K injections are given to newborns in the thigh to prevent them from hemorrhaging. Erythromycin eye ointment is given to newborns to prevent infections that they might acquire from the birth canal. No one puts vitamin K eye drops on newborns, or anyone else. That is not a thing. Both of these treatments are done to protect newborns. They are not harmful in any way. Please take the advice of educated medical professionals (like Dr. Flanary.)
They eye treatment at birth is not vitamin K…whole separate treatment. Vitamin K does not cross the placenta to the developing baby, and the gut does not have any bacteria to make vitamin K before birth. After birth, there is little vitamin K in breast milk and breastfed babies can be low in vitamin K for several weeks until the normal gut bacteria start making it. Giving it has cut the rate of neonatal brain bleeding and other hemorrhage (say, excessive bleeding with circumcision). Without it, there is an 81x more likely risk of bleeding. The eye ointment is erythromycin antibiotic. Neonatal eye infection is a common cause of congenital blindness. Many hospitals give these treatments in the delivery room to make sure they don’t get forgotten, but there is some concern that it can be disruptive in the “golden hour” of bonding and initiating breast feeding, so ask to defer these interventions for a few hours to allow for some initial bonding, which is reasonable.
You Sir. Are the man. I have never before been as interested when watching this type of content. You have somehow found a way to not only make me learn something but also care about what I'm learning. You should be a teacher. Knock knock eye is my new favorite thing. Thank you for what you do.
Thanks so much for these videos ❤😂🎉 Really enjoyed getting a funny perspective of the US Healthcare system south of the border. Actually helped me personally a whole bunch 🎉 Kind regards from Canada 🇨🇦
Have you heard of Nano Droppers? My Mom has glaucoma and when she started paying $300 per bottle for Ropressa, her Dr suggested it. Now it doesn't dribble down her face And she's had several appointments since then and apparently she's getting enough medicine because no worsening. P.S. Thank you for all you do ❤
Haha, I have Sjogrens and I also like to peruse the eye drop section looking for new drops and ointments 😂. Thankfully I stick to the name brand drops because I have quite the collection.
@elainelise, also a (recently diagnosed) SS patient, plus learned at my new ophthalmologist appt that “Oh, and besides classic SS dry eye, you also have glaucoma” 😮 And walked out of the appt with new Rxs for 4 eye drops. 😳 It was then I learned how many types of drops there are. I also stick to name brand and thanks to @drglaucomflecken, got my husband to stop using his generic drops (which we learned were a generic Visine). It’s a whole marketplace out there, isn’t it?!
I was listening to this as I fell asleep and I’ve only taken one microbio class but i heard “drug-resistant Pseudomonas aeruginosa” and that panicked me enough to wake me up 😂 edit: my parents always called it ibuprofen so i was today years old when i realized that advil is the same thing edit edit: even if the same eyedrops are being exposed to the same manufacturing equipment and thusly the same contamination from that source, the differing formulas in the products themselves could be responsible for accumulating contamination.
A couple ideas for future episodes: Atropine eye drops and contacts for kids with quickly worsening myopia When to/who should see an ophthalmologist vs. optometrist
Great video! 🎉I enjoyed every part of it. Thanks for your time! Also, appreciated the part about homeopathic eyedrops… Living in Europe, pharmacists here push that stuff hard. I find it dangerous and irresponsible. Either it’s water, alcohol or sugar. No room for useless remedies, we need proper medication!
Honestly I would love to see you go deeper on any subject, but I have a deep dark love of hearing experts go as deep as they want on subjects they care about. Deep discussions of the minutia of the eye? Sounds great to me.
A friend, who wore contacts, got a bit of diatomaceous earth in his eyes while working on his pool. It resulted in a Pseudomonas infection for which he had to stay up 48 hours putting in eye drops every 15 minutes, then 48 hours of eye drops every half hour, etc., until he was cured. This was after the ophthalmologist injected his eye with antibiotics two days in a row. This infection is serious stuff.
If your doctor recommends a brand name OTC medication, call the company’s customer service line & ask for coupons. I’ve saved hundreds by doing that & saying, “I really love your product but it’s not quite in my budget. Is there anything you can do to help?”
Thank you for this info! I just found out I have Sjogren’s and need to use lots of eye drops. But I was very worried about safety. I will stick to brand names now.
I have dry-eye every now and then, having had eye surgery a couple of years ago. I tried Systane once, but it pissed off my eyes. Used Equate once, and had to go to a shitty clinic, but I might have been using the wrong type of fluid. I definitely prefer Refresh Lubricant Eye Drops, but I often go with CVS Health if it's on sale, so this news sucks, lmao. I would definitely recommend putting a news source in your description when talking about a topic like this, though.
Your videos about US drug companies and FDA made me very grateful for being in a country with EU oversight. They keep the big corporations in check at least to a degree.
Systane is the brand they gave me a sample of after my cataract surgery. The nurse said the lubricating drops work better if you keep them in the refrigerator.
I have used many many MANY bottles of visine that have sat in, drawers, my car, and EVEN MY community eye drops that all my stoner CO-WORKERS use (I usually disanfetic and a tissue to clean it) *im aware that this is also a terrible idea* I don’t even want to talk about my terrible terrible terrible life decisions
Dr. G - you are great! I always learn so much from your videos. Presenting complicated information with humor is a great way to teach. Thank you! One thing I am always curious about - how can Lasik help if your eyes have two different prescriptions?
I have adie syndrome in my left eye. When my doc first told me, I heard, "you have a dystonic pupil." It was years before I knew what he said. Adie's tonic pupil. I would love to hear you discuss this condition.
Thanks much for these videos! Although it’s not the eyeball, I’ve had 2 basal cell surgeries on my lower eyelid. Was told it’s a common spot as sunlight comes over top of sunglass frame and reaches unprotected lower lid. First time I became aware of an ophthalmologist plastic surgeon and she was amazingly skilled! You would never know a hexagonal chunk of cancer was removed other than a resulting crooked eyelash.
Please do an episode on visual snow! I was so excited when you mentioned it in a previous episode and I'm still looking forward to a video from you about it!
I have RCE. After a horrific series of events that started with an optometrist missing an infection and placing a BCL, and ended with a crater in my ocular surface... My corneal specialist has insisted nothing but Systane PF ointment and prescription drops touch my eyeball.
When I'm in my opthalmologist's office, I'm always amazed by the way he quickly approaches and magically dispenses eye drops into my eyes. He uses one hand, holding the bottle with a finger and thumb while retracting my lower eye lid with another finger in one swift motion. This is a task that takes about one second to complete, you don't even realize what just happened. Before you have time to blink, he's back with another drop! A common misconception is that regular people know how to put eye drops in their eyes! They've been told to never touch their eyes with the bottle, contamination and such. They're so scared of making contact with the eye and end up with drops all over their face, but not one in the eye! Some people try holding the bottle above their face a few inches and systematically maneuver a drop into their eye. But instead of hitting the eye, their eyebrow is sufficiently hydrated. Then they try to approach the canthus but blink when the drop hits the eye. I've even been told to close my eyes with my head back and put the drop in the corner of the eye, next to the nose. Once the drop has landed, you're supposed to open the eye and turn your head to allow the drop to roll into the eye. This is really a hit or miss technique and might work half of the time. We've been taught all our lives to avoid getting anything in our eyes. So the thought of purposely introducing something into our eyes goes against everything we've been told. What is second nature to all opthalmologists is a frightful experience for many people. The greatest thing you could teach us is how to properly and easily get the drops into our eyes, in one try! This may sound trivial or even silly but it's a much needed lesson! Imagine someone who has had three eye surgeries and thousands of drops in their eyes but still can't get one drop successfully in the eye without sacrificing many more.😢 There's been no traumatic event that has caused this aversion to using eye drops. It makes no sense to have such problems with achieving this task of getting drops into the eyes but the struggle is real! A simple way of dealing with getting one drop in the eye without losing half the bottle, would be much appreciated! Especially since you just explained how one drop is usually sufficient! I'd love to be able to stand in front of the mirror and actually feel the drop get into the eye! I have to believe more people struggle with this and it's not just me. You would be doing a great service as a board certified opthalmologist to enlighten us of the proper procedure.😉 Frankly I enjoy your eye talk and have learned a number of things! But the next lesson I would love to see is a very simple one! I'll even have a bottle of eye drops at the ready to practice while you demonstrate!(I have two eyes!😋) Thanks for your wonderful videos and your wealth of knowledge, all is greatly appreciated!
Thanks for this video. I had Stevens Johnson Syndrome with ocular involvement triggered by an antibiotic in 2015 and my eyes have never recovered 100%. I have had to use drops everyday since then because my eyes are always dry now.
Eye drop question - you stated 1 drop per eye, but the preservative free Refresh tubes are enough for like 8 drops per eye. Is it safe to keep the opened dropper for multiple uses throughout the day, even though there's no preservatives in it? I've always assumed we should use the whole thing immediately
Clicked on this specifically to find out about Visine. Im about one week post my first cataract surgery & in addition to the 3 drops the dr has me using they also recommended buying artificial tears but strongly advised against Visine without saying why. I bought Blink but I'm already putting so many drops in my eyes- & down my face, lol- that I havent even opened them.
Is it possible that we don't see as big of problem with the big brands because there was that MASSIVE B&L contact solution recall scandal like a decade and a half ago?
Update: after watching this I got night time eye gel (which i had never heard of before) and better day time eye drops. Holy cow what a difference. I still sleep with my eyes slightly open but I don't have horrible scratchy eyes every morning. What I thought was "eye strain" was just my eyes being dry as a desert and the comfort level of just existing is so much better. Winter is always bad here since the indoor humidity is so low but now, my eyes are wet and feeling good!
I enjoy your show very much. I didnt know how low my eyeball information titer was; its getting better. Id like to hear more about infections, but you know stuff I never heard of.
Unrelated but at a construction company I worked for we had to ban energy drinks like it was high school. People were over drinking them in hot weather and getting sent to the hospital because they would knock back a 4 pack or more in like 20 minutes. Every single one was under age 25 and a new or young worker. I asked around and everyone over a certain age thought the drinks were disgusting bad for your health and worse than alcohol. I like them but I am not about to drink more than one or two over a day. And not every day! Anyways we could not just ban them by age so we just flat out banned them period. I was the first aid attendant at the site and explaining to management that education was not working and the general response is it is not against the rules resulted in said management deciding not to allow them on any of their sites at all.
Welll.... after listening to this -- think I will be tossing out the multiple bottles of drops in my med cabinet that are way way way way expired, lol.
The fact that most of your content is made after your kids are put to bed explains a lot about the vibes 😂
Yassss... Those late night vibes 🙌🏻
To be honest, I don't know how his kids don't hear him 😂😂
"I HAVE A SCRIBE!"
As an Assyriologist I now have this mental image of you being followed around by a robed youth with a clay tablet and a reed stylus, struggling to remember the right medicine logograms in cuneiform.
LOVE this image! 🤣🤣🤣
As a history enthusiast myself, I have the same image in my head. I thought "I feel bad for the guy who has to write this all down."
😊
I maintain that it's not Ophthalmologists, Dermatologists and the like working little (compared to none-medical professions), but rather that most other specialties are just that overloaded that any normal, survivable workload feels like a luxury in comparison.
in any other business working 4-5 days a week would be perfectly normal but medicine has become a nonstop slog where people kinda resent the lowered workload of fields whose workload isn't so horrifyingly unsurvivable
Medicine self-selects for people who are extremely intelligent but that also have a desire to compete for being “the best.” The competition to be the most dedicated, the most stressed out, the most willing to work 6-7 days a week. It’s honestly shameful, because it results in the patient load per person is so high and there aren’t enough people to bring in to make it easier. I wonder how much better medicine would be if the workload was better for all drs and healthcare workers.
As someone who legit makes the Systane drops (along with a bunch of others), I joked with my boss last time you mentioned it in a video that our company isn't even paying for the free advertising.
If anyone is curious, Systane Ultra is the easiest to make (we make it so much I could probably make it in my sleep) and Systane Complete is the hardest.
I have dry eye & was told to use Systane Complete.
I see why people buy Visine or no name brands $17.50 for 2/3 an ounce is alot for some of us.
At least now ;) I see who gets it.
My eye doctor recommended systane because I have dry eye disease
Tell ya bois those little twist tubes are sharp and need a redesign
I had LASIK surgery and my ophthalmologist told me to use Systane, when needed. I’ve used nothing else. I love the product.
I'm a big fan of stystane hydration
the reason people ask if you do it yourself is most ophthalmologists (especially married ones!!) do not have time to edit a popular series of youtube videos LOL
Thank you for scaring me into finally throwing away the bottle of allergy eye drops that I've had open since the summer and which is probably host to an excitingly diverse selection of bacterial colonies by now.
I am a telephone advice nurse in Northern California for the large healthcare provider and I have started telling anyone who calls about eyedrops and stuff because I get everybody no Visine thanks to you thanks for your work. It makes me laugh. I’ve been a nurse for 25 years and you’re the best.
here, have some commas ,,,,,,
@@Citiesinmotionplayer I was doing this by voice. That’s the reason the punctuation may not be so great sorry I was busy taking care of my severely autistic child in between watching this video and enjoying it.
Dr. G.. can you demonstrate "actually" getting the eyedrop "in" the eye.. I miss too often! Thanks for all you do.
I’m almost definitely a member of that provider and thank you for doing the work you do 💖
I got an eye infection from Target brand eye drops. Called them to report it and to their credit, they’ve called to check that I am ok and pulled the product like 2 days later (presumably after other similar reports).
Thankfully I didn’t keep using them or lose my sight!
Btw, it was my FIRST TIME using eye drops because I recently switched to wearing contacts in the lab. I hate things touching my eyes because of how vulnerable the eye is. I ended up buying Systane but now I mostly just wear glasses unless I have to wear goggles that day. 🥲
I read a study that eye drop bottles are deliberately made to have a bigger opening than is necessary, so that more of the liquid flows out than required and that way the bottle runs out faster.
If they made the hole smaller it would actually make it easier to apply eye drops since the drop would be of a smaller size, splash less and perhaps actually go in to the eye rather than overflow and create a mess, not to mention overdose (more liquid per drop = more medicine per dose) and chances of infection (you dab your face to clean the overflow and it can bring germs from your cheeks or whatever to your recently wet eye)
i research herbal medicines and one of the things that makes me sad is when people confuse homeopathy with actual science based on the chemical content of the plant. yes, chamomile might make the puffiness in your eyes go down (if you don't have an allergy to ragweed.) no, chamomile diluted to a ratio of 1:1000 will not do that. please stop putting whimsical tap water on your face.
I will, from this day onward, exclusively refer to homeopathic solutions as "whimsical tap water." Brilliant 😂❤
I appreciate your making the "generic" avoidance understandable for us. I was taken aback when I saw the price I would have to pay on the one you recommended. You convinced me before you did a lens replacement on me, and I am so pleased that I listened to you. I still use the brand you told us to this day.
With so many of the same issues showing up across multiple brands it sounds like everyone is getting their eye drops from a blank label factory.
For those who don’t know, some factories make products and do not put any labels on it. The idea is that a large retailer will buy this product and put their own label on it and sell it as if they made it. It’s called blank label and it’s more common than you think.
I used to work in pharma manufacturing. So this is how it works in our country, and I think in most countries. Pharma companies have generic and branded for every medicines. The branded ones are being made in the main manufacturing facilities of the company and they are very strict in sanitation and processing of the products. The generic ones are made by another manufacturer (usually owned by the same company) and the facilities and manufacturing process of that company isn't always monitored by the mother company. And most of the time (based from what I've heard from friends who worked there) those generic meds manufacturing aren't up to the standards. Some of them are lax in terms of sanitation and handling. That's why there are more recalls for generic medicines than branded ones.
Sometimes I chop onions and just deal with the burning because that’s the only time my eyes are fully as moist as they’re supposed to be. Once the burning stops my eyes get a break from how they normally feel. I hadn’t really thought about artificial tears before this video. I’m going to buy some.
Optical medicine is in the same regulatory class as sterile injectables. Things like morphine and IV drips that go directly into your bloodstream. Medicines that bypass your digestive system have to be made in a much higher level of sterile environment, from compounding through fill/finish. I’m a Pharma consultant and this is what I do every day.
I would love to hear more about blepharitis! And also dry eye syndrome. Thank you! Loved this episode!
So would I, having had both!
That's concerning that there's an eye drop called "Rugby", because rugby and the eyes do *not* mix well, and if you attempt to mix them anyway you get into a lot of trouble for it.
Rugby is a generic drugs manufacturer. They make lots of medications, not just eye drops
I was really sick in the neuro ICU a week ago and I was unable to speak. I thought I recognized you and called out Glaucomflecken from my bed. All the nurses who were following my speech were like 'Glaucomflecken ?' 'Did she just say that ?' 'Is that a real word ?'. I was so disappointed. I was sure it was you
Fun fact: tetrahydrozoline (in Visine; also called 'tetryzoline') and brimonidine (in Lumify) are both imidazoline derivatives. Various other imidazoline derivatives are used in other eye drops and in nasal sprays. All of them could be harmful if misused. Both tetrahydrozoline and brimonidine are apparently toward the lower end of potential toxicity (I can't quickly find a resource directly comparing brimonidine to other members of the class, though; there are reports of adverse effects from brimonidine, but they all seem to result from the much higher concentrations used in treating glaucoma).
One of the imidazoline derivatives that's readily available OTC is dramatically more hazardous than the others: oxymetazoline, used in Afrin and several other nasal sprays (and much more prevalent on the market in the US than in other countries, for whatever reason).
So, within the particular scope of 'readily available imidazoline derivatives we should worry about', Visine is probably not the worst offender; more likely the title belongs to Afrin.
I tell my patients to avoid Afrin like the plague lol it shouldn't be on the market
I read your posting, looked at the bottle of nasal spray the ENT gave me, saw oxymetazoline on the label, and tossed it in the trash. Thank you!
The other day my wife and I were in Target and she casually commented that she needed eye drops. We sauntered over to the pharmacy section a stood there looking at what appeared to be a couple thousand brands of eye drops. My wife was like how can there be so many? Which one do I pick? I remembered seeing this video and told my wife to hold on for a second. We needed to consult Dr Glaucomflecken. Shes like Who! I said Dr Glaucomflecken. I searched and pulled up you You Tube video in Target and there was my wife and myself watching this video. It truly was a sight to behold and yes she got preservative free name brand. Not sure which brand now but it was one you recommended. Thanks for your advice and I really enjoy the vids.
It’s interesting to hear you talk about Visine. I used Visine allergy drops for a short time and my most of my eyelashes fell out, upper and lower, both eyes. That was lots of fun because then they were all on the same “loss cycle” and they’d all fall out together. I looked like a weirdo with lashes just in the corners of my eyes. It took almost 10 years later to finally get them fully back. Now I just use Refresh tears when my eyes are dry.
Im a nerd about cars and computers and i can appciate other nerds nerding out
As far as "losing" a big proportion of the drops you put into your eyes, when I was prescribed medicated eyedrops, the ophthalmologists at the hospital instructed me to pull the lower eyelid out, put the appropriate number of drops inside the lid (not directly on eyeball), then close the eye and apply gentle pressure with a finger to the inside corner of the eye to prevent the medication from draining out for several minutes.
The manufacturer instructions said the same thing. You can only do 1 eye at a time so of course it takes longer but I guess it was to ensure sufficient contact time of the eye surface with the med.
I can barely manage to get the drops in my eye at all, much less muck with my eyelid at the same time.
Bottle of Lies by Katherine Eban goes into the problems of the generic drug industry, a lot of it comes down to lack of proper inspections at the factories.
I occasionally sleep with my eyes open and wake up with the driest stinging eyes. I've tried so many eye drops and yet never knew there were gel versions of eye drops and have now ordered some.
Silly question but I have to ask. How do you know you sleep with your eyes open? Your partner perhaps?
@@nikkih8690 parents when I was younger mainly but friends during sleepovers also mentioned it. It's pretty obvious for myself now since a strip of each eye will be super irritated and dry in the morning.
@@nikkih8690My optometrist tells me I probably sleep with my eyes not completely closed. There is a horizontal line of redness across my eyeballs. She recommended sleeping with an eye mask and using the gel eye drops at night.
@@nikkih8690 Sometime it's not open all the way, but just enough to dry them up.
"I'm not unique. I just have a weird thing that I do." I'm going to have to use that line.
A whole half hour? Let’s glaucomflecken gooooo!!!
An episode about blepharitis or how migraines cause auras would be interesting!
Ooh yes. Retinal/optical migraine. Been getting those since I had a baby.
As a person who has eye issues, I think it's good when my specialist is passionate about their field, I want my opthalmologist to be an eye drop geek.
How do people manage to actually get even 20% of a drop in the eyeball? I always blink and end up dosing my eyelids.
Yes, bring back the infection tree! Lab rats want to see it.
Systane is expensive but blindness is infinitely worse! Thank you for sharing your very knowledgeable opinion!
Is this a thing like the baby food shortage where it was like only a few factories make a disproportionate amount of all drops so once there's any issue at the factory it has a huge impact?
It's not unusual to have a single manufacturing company make the exact same ingredient or product (sometimes with different shapes/stamps/impressions) for a plethora of generic distributors who just attach their label and ship it. You'll sometimes see the same pill markings on multiple generic brands.
This question came up with my family last week: why can you buy reading glasses OTC but not glasses for nearsightedness?
You can... But you need to know your prescription... I used to buy at zenni optical, you enter in your prescription information and pick out frames, ect. Distance between pupils showed what frames worked for me.
Listening to the first few minutes of describing the morning and I’m at the part he has already arrived at work, but no mention of pants being worn yet.
Thoroughly enjoyed this episode. I actually liked how you talked about “a day in the life”better than putting a video with it. Those videos sometimes have the tendency to lose my attention if too long.
Because of you, I learned somethings today. You are a good teacher and the humor helps!
Keep doing you! ❤
just yesterday I was at the pharmacy asking them what I can do about running out of one of my Rx scrips for glaucoma because I miss the eyeball on a fairly regular basis. The insurance company said basically sorry Charlie...My ophthalmologist is adamant that I never miss a single day. It's very frustrating! thanks for all you do!
there are some devices such as the "auto drop" that can help you with aiming
there are some devices such as the "auto drop" that can help you with aiming
someone else on this thread said that Nanodropper works very well for them.
I know it's been a while since this comment was made, but (if you're in the US) maybe check and see if your insurance allows for a "lost medication" override. This isn't technically allowed as it wasn’t misplaced, but I've had patients drop medication in pet water dishes that insurances replaced without fuss. I think that spilling of eye drops would constitute med loss and they might allow for an early fill if you're in a difficult spot.
I would also recommend discussing the issue with your doctor. They can possibly write for a larger quantity (over the same days supply) to try and give you a buffer (if insurance will cover it), or help show you a better technique. I've had some older patients that have shaky hands have to administer eye drops, and I've always felt badly because they always complained about missing their eye when applying so they ran out way too soon. I would recommend trying to work with your doctor and pharmacy to try and come up with a plan that insurance will (begrudgingly) accept.
Oh! Could you do an episode on vitamin K eye drops for infants at birth? It's a topic I don't think a lot of people are aware of and why it's done
Oh yeah!! That would be so cool to learn about. I'm helping a friend write her birth plan, and there are way more eye drops topics on the plan template than I ever would have anticipated!
The ointment on the eyes is an antibiotic. Vitamin k is an injection
There seems to be some confusion here. Vitamin K injections are given to newborns in the thigh to prevent them from hemorrhaging. Erythromycin eye ointment is given to newborns to prevent infections that they might acquire from the birth canal. No one puts vitamin K eye drops on newborns, or anyone else. That is not a thing. Both of these treatments are done to protect newborns. They are not harmful in any way. Please take the advice of educated medical professionals (like Dr. Flanary.)
They eye treatment at birth is not vitamin K…whole separate treatment. Vitamin K does not cross the placenta to the developing baby, and the gut does not have any bacteria to make vitamin K before birth. After birth, there is little vitamin K in breast milk and breastfed babies can be low in vitamin K for several weeks until the normal gut bacteria start making it. Giving it has cut the rate of neonatal brain bleeding and other hemorrhage (say, excessive bleeding with circumcision). Without it, there is an 81x more likely risk of bleeding.
The eye ointment is erythromycin antibiotic. Neonatal eye infection is a common cause of congenital blindness. Many hospitals give these treatments in the delivery room to make sure they don’t get forgotten, but there is some concern that it can be disruptive in the “golden hour” of bonding and initiating breast feeding, so ask to defer these interventions for a few hours to allow for some initial bonding, which is reasonable.
@@fayej6591 I just know the hospital I gave birth at told me the eye drops were vitamin K. Perhaps things are different in different countries?
Visual snow! Yes, let's talk!
Please explain the connection between seasonal allergies and itchy eyes. I've always wondered.
Seasonal allergies can have a number of symptoms, one of which is itchy eyes
@@Beam3178 I know that, I was wondering about the behind the scenes of it. What chain reaction of systems causes it?
Thank you so much for discussing the eyedrop issue. I couldn't get any clear information about the recall.
You Sir. Are the man. I have never before been as interested when watching this type of content. You have somehow found a way to not only make me learn something but also care about what I'm learning. You should be a teacher. Knock knock eye is my new favorite thing. Thank you for what you do.
As an eye drop user I really appreciate this discussion.
Thanks so much for these videos ❤😂🎉 Really enjoyed getting a funny perspective of the US Healthcare system south of the border. Actually helped me personally a whole bunch 🎉
Kind regards from Canada 🇨🇦
Have you heard of Nano Droppers? My Mom has glaucoma and when she started paying $300 per bottle for Ropressa, her Dr suggested it. Now it doesn't dribble down her face And she's had several appointments since then and apparently she's getting enough medicine because no worsening. P.S. Thank you for all you do ❤
Thank you for the mention! We love hearing that our Nanodropper Adaptors are helping with your mom's medication
Would love to hear more information on visual snow! Feel like this isn't taken seriously.Thank you.
As a scribe, your content makes me feel so appreciated haha
Haha, I have Sjogrens and I also like to peruse the eye drop section looking for new drops and ointments 😂. Thankfully I stick to the name brand drops because I have quite the collection.
@elainelise, also a (recently diagnosed) SS patient, plus learned at my new ophthalmologist appt that “Oh, and besides classic SS dry eye, you also have glaucoma” 😮 And walked out of the appt with new Rxs for 4 eye drops. 😳 It was then I learned how many types of drops there are. I also stick to name brand and thanks to @drglaucomflecken, got my husband to stop using his generic drops (which we learned were a generic Visine). It’s a whole marketplace out there, isn’t it?!
I was listening to this as I fell asleep and I’ve only taken one microbio class but i heard “drug-resistant Pseudomonas aeruginosa” and that panicked me enough to wake me up 😂
edit: my parents always called it ibuprofen so i was today years old when i realized that advil is the same thing
edit edit: even if the same eyedrops are being exposed to the same manufacturing equipment and thusly the same contamination from that source, the differing formulas in the products themselves could be responsible for accumulating contamination.
The lesson I am taking away here is that I can get the generic eye drops, but only if I am taking them orally.
A couple ideas for future episodes:
Atropine eye drops and contacts for kids with quickly worsening myopia
When to/who should see an ophthalmologist vs. optometrist
Great video! 🎉I enjoyed every part of it. Thanks for your time! Also, appreciated the part about homeopathic eyedrops… Living in Europe, pharmacists here push that stuff hard. I find it dangerous and irresponsible. Either it’s water, alcohol or sugar. No room for useless remedies, we need proper medication!
I gotta say you are one of the biggest pushes I had to evaluate the very conservative perception of health care.
Honestly I would love to see you go deeper on any subject, but I have a deep dark love of hearing experts go as deep as they want on subjects they care about. Deep discussions of the minutia of the eye? Sounds great to me.
A friend, who wore contacts, got a bit of diatomaceous earth in his eyes while working on his pool. It resulted in a Pseudomonas infection for which he had to stay up 48 hours putting in eye drops every 15 minutes, then 48 hours of eye drops every half hour, etc., until he was cured. This was after the ophthalmologist injected his eye with antibiotics two days in a row. This infection is serious stuff.
If your doctor recommends a brand name OTC medication, call the company’s customer service line & ask for coupons. I’ve saved hundreds by doing that & saying, “I really love your product but it’s not quite in my budget. Is there anything you can do to help?”
Thank you for this info! I just found out I have Sjogren’s and need to use lots of eye drops. But I was very worried about safety. I will stick to brand names now.
I have dry-eye every now and then, having had eye surgery a couple of years ago. I tried Systane once, but it pissed off my eyes. Used Equate once, and had to go to a shitty clinic, but I might have been using the wrong type of fluid. I definitely prefer Refresh Lubricant Eye Drops, but I often go with CVS Health if it's on sale, so this news sucks, lmao.
I would definitely recommend putting a news source in your description when talking about a topic like this, though.
Your videos about US drug companies and FDA made me very grateful for being in a country with EU oversight. They keep the big corporations in check at least to a degree.
Where is Texaco Mike?
is he safe? is he alright?
I was at my ophthalmologist last week and they had scheduled 12 emergency visits on top of their already full schedule that day. I know you’re busy!
Systane is the brand they gave me a sample of after my cataract surgery. The nurse said the lubricating drops work better if you keep them in the refrigerator.
I have used many many MANY bottles of visine that have sat in, drawers, my car, and EVEN MY community eye drops that all my stoner CO-WORKERS use (I usually disanfetic and a tissue to clean it) *im aware that this is also a terrible idea*
I don’t even want to talk about my terrible terrible terrible life decisions
Dr. G - you are great! I always learn so much from your videos. Presenting complicated information with humor is a great way to teach. Thank you! One thing I am always curious about - how can Lasik help if your eyes have two different prescriptions?
Pharmacy technician here! I hate it when the sig on eye drops says "Apply to affected eye(s)." Just say left or right or both!
I have adie syndrome in my left eye. When my doc first told me, I heard, "you have a dystonic pupil." It was years before I knew what he said. Adie's tonic pupil. I would love to hear you discuss this condition.
Thanks much for these videos! Although it’s not the eyeball, I’ve had 2 basal cell surgeries on my lower eyelid. Was told it’s a common spot as sunlight comes over top of sunglass frame and reaches unprotected lower lid. First time I became aware of an ophthalmologist plastic surgeon and she was amazingly skilled! You would never know a hexagonal chunk of cancer was removed other than a resulting crooked eyelash.
Please do an episode on visual snow! I was so excited when you mentioned it in a previous episode and I'm still looking forward to a video from you about it!
As a family med doc who has next to no knowledge of eye drops, I am taking notes. 👀
I have RCE. After a horrific series of events that started with an optometrist missing an infection and placing a BCL, and ended with a crater in my ocular surface... My corneal specialist has insisted nothing but Systane PF ointment and prescription drops touch my eyeball.
I’m invested enough that I seriously wondered if Jonathan would be joining you.
When I'm in my opthalmologist's office, I'm always amazed by the way he quickly approaches and magically dispenses eye drops into my eyes.
He uses one hand, holding the bottle with a finger and thumb while retracting my lower eye lid with another finger in one swift motion.
This is a task that takes about one second to complete, you don't even realize what just happened.
Before you have time to blink, he's back with another drop!
A common misconception is that regular people know how to put eye drops in their eyes!
They've been told to never touch their eyes with the bottle, contamination and such. They're so scared of making contact with the eye and end up with drops all over their face, but not one in the eye!
Some people try holding the bottle above their face a few inches and systematically maneuver a drop into their eye. But instead of hitting the eye, their eyebrow is sufficiently hydrated.
Then they try to approach the canthus but blink when the drop hits the eye.
I've even been told to close my eyes with my head back and put the drop in the corner of the eye, next to the nose. Once the drop has landed, you're supposed to open the eye and turn your head to allow the drop to roll into the eye. This is really a hit or miss technique and might work half of the time.
We've been taught all our lives to avoid getting anything in our eyes. So the thought of purposely introducing something into our eyes goes against everything we've been told.
What is second nature to all opthalmologists is a frightful experience for many people.
The greatest thing you could teach us is how to properly and easily get the drops into our eyes, in one try!
This may sound trivial or even silly but it's a much needed lesson!
Imagine someone who has had three eye surgeries and thousands of drops in their eyes but still can't get one drop successfully in the eye without sacrificing many more.😢
There's been no traumatic event that has caused this aversion to using eye drops. It makes no sense to have such problems with achieving this task of getting drops into the eyes but the struggle is real!
A simple way of dealing with getting one drop in the eye without losing half the bottle, would be much appreciated! Especially since you just explained how one drop is usually sufficient!
I'd love to be able to stand in front of the mirror and actually feel the drop get into the eye!
I have to believe more people struggle with this and it's not just me.
You would be doing a great service as a board certified opthalmologist to enlighten us of the proper procedure.😉
Frankly I enjoy your eye talk and have learned a number of things! But the next lesson I would love to see is a very simple one! I'll even have a bottle of eye drops at the ready to practice while you demonstrate!(I have two eyes!😋)
Thanks for your wonderful videos and your wealth of knowledge, all is greatly appreciated!
Thanks for this video. I had Stevens Johnson Syndrome with ocular involvement triggered by an antibiotic in 2015 and my eyes have never recovered 100%. I have had to use drops everyday since then because my eyes are always dry now.
Eye drop question - you stated 1 drop per eye, but the preservative free Refresh tubes are enough for like 8 drops per eye. Is it safe to keep the opened dropper for multiple uses throughout the day, even though there's no preservatives in it? I've always assumed we should use the whole thing immediately
My doctor told me they are okay to use for 24 hours.
@@lisab5309 Great to know! My Christmas budget thanks you for the info 😂
Please do more of these! Especially the sti’s
This was helpful, thank you. My tear ducts don't work as well since my stroke.
Clicked on this specifically to find out about Visine. Im about one week post my first cataract surgery & in addition to the 3 drops the dr has me using they also recommended buying artificial tears but strongly advised against Visine without saying why. I bought Blink but I'm already putting so many drops in my eyes- & down my face, lol- that I havent even opened them.
I hate Visine because it burns the heck out of my eyes like no other eyedrop brand 😵
You answered all my eye drop questions. Thank you!
RPh here. Generic for Patanol is olopadine. I enjoy your videos, sir!
Is it possible that we don't see as big of problem with the big brands because there was that MASSIVE B&L contact solution recall scandal like a decade and a half ago?
Please cover blepharitis. 🙏🏻
I love this series. Just saw my eye doctor yesterday and now this shows up. Thanks for shining a light on eye care.
Update: after watching this I got night time eye gel (which i had never heard of before) and better day time eye drops. Holy cow what a difference. I still sleep with my eyes slightly open but I don't have horrible scratchy eyes every morning. What I thought was "eye strain" was just my eyes being dry as a desert and the comfort level of just existing is so much better. Winter is always bad here since the indoor humidity is so low but now, my eyes are wet and feeling good!
I enjoy your show very much. I didnt know how low my eyeball information titer was; its getting better. Id like to hear more about infections, but you know stuff I never heard of.
Only 20% of every eye drop is effective…sounds like I need to use 5 to 10 drops each time then so I get the full recommended dose.
Who knew eyedrops could be so interesting! lol Didnt know there was eyedrop drama.
I can't believe I'm the first. Love you Dr. G!
Unrelated but at a construction company I worked for we had to ban energy drinks like it was high school. People were over drinking them in hot weather and getting sent to the hospital because they would knock back a 4 pack or more in like 20 minutes. Every single one was under age 25 and a new or young worker. I asked around and everyone over a certain age thought the drinks were disgusting bad for your health and worse than alcohol. I like them but I am not about to drink more than one or two over a day. And not every day! Anyways we could not just ban them by age so we just flat out banned them period. I was the first aid attendant at the site and explaining to management that education was not working and the general response is it is not against the rules resulted in said management deciding not to allow them on any of their sites at all.
There were recalls of generic acetaminophen or ibuprofen... I forget so I kinda do buy Advil and Tylenol now because of that
Let’s talk aphasia. I was born before the advent of lens implants. Coke bottle glasses are my jam.
All I can think of is the movie 28 Days Later…😂
Yes! I’ve been waiting to find out what to do about gritty eyes when waking. Thanks!!
I use Refresh, they work great! I get them at Costco, bulk pack FTW!
Thanks for the eyedrop episode! I did enjoy the verbal day in the life as well
Thanks for the info about nighttime drops...I didn't know about those, and definitely need that.
yay! excited for the KC episode ❤STD episode should be fun, but have you seen or heard about parasites like roundworms and other types of worms? 😅
Welll.... after listening to this -- think I will be tossing out the multiple bottles of drops in my med cabinet that are way way way way expired, lol.
Hi, love your channel, can you please do more on cool infections?
I would love an episode on nearsightedness. Can you prevent it from further progressing and how to protect the eye even if you already have it