After seeing the optho yesterday, here are some relevent tidbits to throw on here:
I refridgerated my open vials at first, then now I just cap them and leave them where they are.. no problems. Chill them if you want.
I started out at two doses a day, with little improvement. Three months ago, I upped it to three, and seemed to be getting better. I am now starting a 4 dose a day (that usually runs about a vial every 1 1/2 days) regimen, and think it's making a difference.
During the discussion about this with the doctor yesterday, he restated that he's no big fan of Restatsis in it's common form (the cyclosporine is in a very low concentration), but, said if I think it helps, then four doses are fine. Any harmful elements are very low, so I could take a bath in it if I wanted and it wouldn't hurt me (his words...hee hee).
Instructions for using the vial for four drops and throwing it away is a combination of liability issues (the very small chance of contamination) and fattening the bottom line by the company (IMHO). I think your expense would be no more by using the vial until it's gone compared to throwing it away two thirds full.
Perhaps this evidence will make them develop a higher concentration of cyclosporine doseage drops in the future.