Dr Korb 2016 video: recommends Blephasteam, squeeze lids etc

[SirDryEye]

MGD1701 - with the blephasteam, is it better if you open or close your eyes.

[MGD1701]

Hi mbperso

Inflammation
Great question. I always wonder it too. How do your doctors detect it then? Since MMP-9 is only available in USA?? I even tried to do BlephEx but the dr said, ''You could save the money as your lids are so clean & no demodex''.

Blephastem
my booklet from the company indicates 42.5C.

[SirDryEye]

I can imagine that the steam from the blephasteam is very soothing, especially if your eyes are feeling very dry. Sometimes I like fill a plastic bowl with boiling water and put my face over the bowl into the steam. It feels very soothing however the effects is short lived. This is or probably similar to the effects the the blephasteam (probably not as effective though).

After a 10 min warm compress (EyeSoothe) my eyes feel very inflamed - especially after a message/lid squeeze. Has anyone ever felt this following the massage?

[mbperso]

Blephasteam:I have the feeling that temperature of 41C is not enough high. One Dr told me that too.
In order to get wet heat I prefer wet cotton and Meibopatch with microwave 1mn 10seconds (equivalent to bundle method ?)
However I think duration needed depends on the oil quality of everyone. It could be between 5mn and 15mn. I can feel oil after 8mn.

Inflammation: how to see inflammation just with the slit lamp ?

[dede29]

What did he say about "expression (done by doctor) - once a month"?

[SirDryEye]

Why is it that some people complain about the blephasteam? Also why would you close your eyes as oppose to opening them?

Since warm compress is so so important but hard to master, I would like to share this educational video (for doctors), found yesterday: Dr Korb, world MGD expert & inventor of LipiFlow etc, 2016 in Spain, published May 2018.

He considers wet heat is the most effective so Blephasteam is good, 12-15min. I have read/tried a lot and find Blephasem is the best - more importantly, safer. I close eyes as it is more effective.

If microwaved masks - he suggests to put a wet towel over it (part 3, 3:38) - to hold the heat longer. I have tried it and it works a bit better.

However, Bundle method (about 45C (113F), change wet towel every 2 min, is the most effective. The study (by his partner, Dr C Blackie and her team) proves it too. There is a video at YouTube.

sequeez lids NOT massage (to avoid damaging cornea)

He also mentioned pain, probing, LWE, lids seal, LLT, inflammation,
expression (done by doctor) - once a month
debridement - this is so interesting as it links to blink (part 3, 4:41)
(relations between blink/MGD &) scleral lens etc.

I can not thank Dr Korb enough for his great generosity to share his knowledge. I always look for his new videos/articles.There are a total of 4 videos. https://www.youtube.com/watch?v=vSShGZfxiFg

I spent/wasted 3 months to figure out all these as all doctors just told me 10 min which is useless as only 15-20 mins (& about 44C) helped for my thick oil.
See, even Dr Korb suggests 12-15 min - which really makes a big difference. Have read an article, posted earlier in the forum too, from Dr Korb team last year in relation to tempearture/duration to support this too - I like evidence-based stuff). I have noticed recommendations from most doctors are ranging from 4-20 min, microwave 10-20 seconds, tape (hot) water, without making any reference to temperature - how to achieve results with such vague information? No wonder one top American doctor says most people perform compress wrong.

My oil has been clear (can see oil drop from 20-zoom mirror) but still do about 12 min - I also use Blephastem to monitor oil status. Best indications, in my view, feel good afterwards & feel oil flowing.

Lipid layer thickness, LLT
one of my eyes has been improved double to 70 nm, per LipiView took in Feb. 2018. I believe now should be a bit higher.

My eyes have been pretty fit - good enough to work again.
Seems the main cause is incomplete blinking and no inflammation issue, confirmed by all +10 doctors in the last 2 years (slit lamp examination only). However, pure HOCL spray, NatraSan I have fouond (one year ago), helped me free from constant watery etc, just in a few days - very keen to know why. I wonder if MMP-9 test will detect better??

When you said 10 minutes is worthless you need 15-20, I agree 100%. I've watched a plugged gland go from milky and hard, to clear and hard, then finally melted. But that was after my 4th application of the compress after 15 mins.

last night for example, my compress was 25 minutes. I applied it 5 times because every time I removed it, my eyelashes were glued together. So last night I just went by feel. It's a very difficult thing to get right...but when you do, it helps so much.

[MGD1701]

Since warm compress is so so important but hard to master, I would like to share this educational video (for doctors), found yesterday: Dr Korb, world MGD expert & inventor of LipiFlow etc, 2016 in Spain, published May 2018.

Dr Korb considers wet heat is the best so Blephasteam is good. However, the very very very effective is, Bundle method (about 45C (113F), video https://www.youtube.com/watch?v=fpwA76xepa4
I have read/tried a lot and find Blephasem is the best - more importantly, safer.

Allow me to remind - when one has Rosacea/inflammation, be careful with the heat/temperature.
Cold compress or a combination of cold/warm might be better.

My own findings/research:
constant/wet heat, 43-45C, enough time & the best indications: feel oil flowing & feel good afterwards.

I wasted 3 months to figure out all these as all doctors just said10 min which is useless as only 15-20 mins (& about 44C) helped for my thick oil. Even Dr Korb suggests 12-15 min with Blephastem - which really makes a big difference.

Recommendations from doctors range from 4-20 min, microwave 10-20 seconds, hot water/shower, mostly NO reference on temperature/frequency - how we can achieve results with such vague information? No wonder one top American doctor says most people perform compress wrong.

Dr Korb recommends to sequeez lids NOT massage (to avoid damaging cornea)

There are a total of 4 videos (part 2,14:00 about wet heat, bundle menthod etc)
https://www.youtube.com/watch?v=mZyXyQi-5MQ

I can not thank Dr Korb enough for his great generosity to share his knowledge. I admire his result-driven approach.