Restasis works best in the long-term treatment of meibomian gland dysfunction (“MGD”). We find that when people are given Restasis while their eyes are still inflamed, this medicine causes ocular irritation and burning. Just as gasoline works great in the gas tank of car, but you cannot use gasoline to put out a car fire, Restasis does not work when the eye is “on fire” or having active inflammation. We pre-treat with topical steroids first and we find that this makes the Restasis well tolerated.
Restasis is excellent for long-term suppression of the inflammation causing dry eye and we normally start it 4-12 weeks after starting MGD therapy.