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Is this your first LACRISERT® prescription? Yes No
If yes, how many times a day do you use artificial tear products? Never 1-2 times 3-4 times More than 4 times
If no, how long have you been using LACRISERT®? 1-5 months 6 months-1 year More than 1 year
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LACRISERT^® is indicated in patients with moderate to severe Dry Eye syndromes, including keratoconjunctivitis sicca. LACRISERT^® is indicated especially in patients who remain symptomatic after an adequate trial of therapy with artificial tear solutions. LACRISERT^® is also indicated for patients with exposure keratitis, decreased corneal sensitivity, and recurrent corneal erosions.

Important Safety Information
Do not use LACRISERT^® if you are allergic to hydroxypropyl cellulose. Instructions for inserting and removing LACRISERT^® should be carefully followed. If improperly placed, LACRISERT^® may result in a scratch to the cornea of your eye. Because LACRISERT^® may cause temporary blurred vision, please use caution when driving or operating machinery. Rubbing the eye(s) containing LACRISERT^® should be avoided. You should always discuss this safety information with your doctor. The following adverse reactions have been reported but were in most instances mild and temporary: temporary blurring of vision, eye discomfort or irritation, matting or stickiness of eyelashes, increased sensitivity to light, eyelid swelling, and eye redness. Talk to your doctor if you have side effects that bother you or that do not go away. You are encouraged to report side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.