If they REALLY believed it would work, they'd tell the whole world.
Actually not. They have to worry about a lawsuit following if it doesn't work out well, which is why they stick to treatments widely accepted in the field.
This, in spades. We treat many diseases successfully with drugs approved for other conditions.
One of my fears with respect to O care is that drs will be reigned in and only allowed to treat with "approved" drugs.
For instance, bacterial corneal infections (bacterial keratitis) are typically treated with the best topical ocular antibiotics which have only been cleared for bacterial CONJUNCTIVITIS (not clear, thumbnail, 0.7 mm thick cornea) , which is a very uncomfortable debilitating ocular condition which is not typically blinding and which is typically self limiting- meaning, if you have an intact immune system you will develop an adequate immune response to defeat the infection and recover on your own.
Otoh, bacterial keratitis can be a blinding infection of the cornea which can perforate an eye and cause it to be lost. Btw, it can be interesting to goog 'bacterial corneal ulcers'.
A corneal infection with Pseudomonas Aeruginosa can blind an eye in 24 hours. All meds "approved" for TX of corneal ulcers are old meds and not the best antibiotics of choice to fight such infections. Getting FDA approval for treating those ulcers is much more rigorous and much more expensive so drug companies forgo the formalities and we risk our necks treating such infections with the best, newest, most drug resistant antibiotics which have only been ok'd for bacterial CONJUNCTIVITIS, not KERATITIS.
Now, what happens when despite your best efforts and use of the best ABs an eye is still lost becsuse treatment is started late? (Because the patient waited around).
How would you like to go to court and the lawyer suing your ass shows the jury you were not using a drug FDA freaking approved for bacterial corneal ulcers and you were ONLY treating with a drug approved for bacterial conjunctivitis?
I'll tell you what you do. You evaluate the ulcer size, depth, and location (central ulcers leave corneal scars which results in permanent vision loss to some degree or other).
You decide if you want to gamble for $150 that you can treat and cure the condition with no resultant visual loss (small, peripheral ulcer). Then you can start treatment to try and help the pt. We used to also have pharmacies with a compounding lab make up concentrated (strong) AB eye gtts that are not available commercially. I like ordering concentrated tobramycin (it is quite effective in killing P. Aeruginosa which can destroy an eye before you can get culture and sensitivity results- which, btw are a big patient expense required to protect drs from lawyers in court- if you dont stop the disease before the culture comes back the eye is lost anyway kind of deal, but dont go to court without being able to show you took a culture, sent the patient to the hospital with it and ordered a sensitivity a for a few hundred measley bucks) along with commercial Vigamox rotating gtts every 15 min for three hours to start.
Now, because of .gov and lawyers there are essentially no pharmacies taking the risk of formulating especially strong ABs for drs, which increases the risk for me in not being able to intervene and prevent vision loss.
With respect to dealing with advanced disease, is it best to start treatment or just get the patient an appt in a few weeks (post Ocare) at Texas Tech medical school in Lubbock?
Well, the jury is still out on that one.
