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  • Any Help Greatly Appreciated

    Hello! I have been struggling with bad dry eye symptoms for the last year and a half or so. Back when this all started, I did some research online and found this forum and have been coming back to this site again and again for advice and help. I just became a member though and this is my first time posting. I have definitely been struggling/quite miserable over this and any help would be so greatly appreciated! I'll try not to make this too long, but figured I'd write what's going on and see if any of you have any advice.

    For the last year and a half, I have been dealing with incredibly sore, red, and bloodshot eyes, especially my right eye. Up until then, I was always told that my eyes were beautiful and clear and never had any problems like this. I went to my optometrist when this started and he didn't seem to know what was wrong, so I waited a couple months to see if it would get better and then went to an ophthalmologist to get a second opinion. He also didn't seem to think there was much of an issue and felt that my problem was more of a cosmetic issue than anything. Anyway, after no relief, I finally found a doctor a couple months ago who saw me and and confirmed that I have MGD. She did a mebiography and said that I have some atrophied glands, but she is hopeful that with hot compresses, omegas, and lid cleansing, I might be able to get the other glands functioning again and hopefully find some relief.

    At first, I felt somewhat hopeful. I bought a goggle/type beaded mask and have been doing warm wet compresses every day and at first those really seemed to help, even just for a little while. My eyes would become blurry, but they would actually feel good, even if it was just for an hour or so and they looked so much clearer than they had in such a long time. I also started using a lid cleansing oil that my doctor recommended and make sure to use a q-tip and wash my lids each night before bed. I started omega supplements (cold pressed flax-seed oil) and occasionally use refresh advanced or omega preservative free eye drops, although I don't use them every day as they really don't seem to help much. I have never once used visine or any type of vasoconstrictor eye drop and am so careful about using contacts etc. I haven't even been hardly wearing contacts this last year because of how miserable I've been over my eyes.

    Anyway, do any of you have any advice? Do I just need to be patient with the hot compresses and other treatment? The blood vessels, especially in my right eye, are so pronounced and thick and obvious and everyone is always commenting and noticing them. I'm only 24 and hate to think that I will have to deal with this the rest of my life. And the worst part is that it just seems to be getting worse. When I first wake up in the morning, my eyes are still red, but much, much, much less red than they are within 20 minutes and that's the one time of day that they are tolerable. I would be so happy if I could just keep my eyes like that! The fact that they can feel and look okay first thing in the morning or occasionally right after a warm compress (at least for 30 minutes or so following) is the only thing that gives me a little hope and makes me feel like this might be something that can get better. I just am so upset about it. I love doing things outdoors, backpacking, running, skiing etc. and can't hardly tolerate contacts anymore or even being outside in the cold air in glasses. I work at an office during the week and have been miserable on the computer. I'm just newly married and am seriously struggling with self-esteem issues now that my eyes are so red and horrible looking and I'm wearing glasses all the time. I'm so discouraged and just wish there was something I could do to help this. My doctor did mention lipiflow at my last appointment last week and I'm willing to try that. I can't imagine spending that much money on something like that and I don't know when I'll be able to do it, but at this point, am pretty much willing to give anything a chance. It just seems like there aren't too many hopeful stories on this site and I'd love some encouragement and advice if possible.

    Thanks in advance!

  • #2
    As some people on this forum have mentioned, your MGD is most likely due to computer use. When people are on the computer, they don't blink as often as they should. The reduced blinking rate leads to the meibomian glands getting clogged and/or atrophied, resulting in MGD.

    I was a similar age when I got dry eye - I was 25 then, now I'm 30. My dry eye started out mild, but gradually became worse over the course of two years while working in an office environment. Eventually it got so bad that I had to quit my office job. That was three years ago, and I haven't worked in an office job since then.

    I think there's still hope, but you might have to face some hard truths:
    • MGD cannot be cured, only managed. Whatever routine you develop now and in the coming years you will have to do indefinitely until something more effective comes along
    • Computer use can only make MGD worse. You may have to consider another career that involves less computer use if you want to save your vision in the long run.
    I think you're off to a good start in terms of managing your MGD - fish/flaxseed oils are great at reducing inflammation, and a compress will allow your oils to flow more freely. You'll probably need to take the omega-3 supplements at least for 1 month to figure out if they work or not.

    There are other more expensive options to manage MGD. Lipiflow is one of them, but is pretty expensive (at least it was when I had it done - $750 per eye). My doctor prefers something called Intense Pulsed Light, which he views as less expensive and more effective than Lipiflow. If neither of those are effective, you may have scar tissue over your glands (seen in meibography as dark spots at the lid margin) - in which case probing will be helpful. Unfortunately, IPL and probing are both kind of hard to find these days. The company that manufactures Lipiflow markets heavily to optometrists and ophthalmologists, so most eye doctors only know about Lipiflow.

    In the meantime, I would try to figure out if you also have aqueous deficiency (not enough tears). Did the doctor do something called a Schirmer test? It involves putting small strips of paper over your lower eyelids, closing your eyes for 5 minutes, and measuring the length of paper that has been soaked by your tears. Anything >10 mm is considered normal, and anything less is considered aqueous deficient.

    I think it's really important to try to get an accurate diagnosis as soon as possible. Personally, I received my MGD diagnosis 1 year after my initial symptoms, and my aqueous deficiency diagnosis 2 years after my initial symptoms. I wish I had known sooner, because I might have been able to significantly slow or stop the progression of my dry eye before it did further damage. Don't settle for a doctor that doesn't know a lot about dry eye.

    Anyway, hope I haven't been too discouraging - it is possible to get better, but you have to be aggressive in terms of getting an accurate diagnosis and getting the right treatment for your condition. And as I said, you might want to consider other careers that don't involve a lot of computer use.
    What you need to know about computer-induced dry eye
    Dry Eye Survey
    IPL Doctors
    Probing Doctors

    Comment


    • #3
      Hi Outdoorgirl
      I would say, being patient is not enough. You need to be proactive and educate yourself for new things.

      1st get accurate evaluations & identify causes so you know HOW to treat effectively.
      InflammaDry and Osmolarity tests seem to be pretty standard in USA.
      if untreated, only get worse and hard to treat too.

      omega 3: really helps - many paper prove it already. make sure get quality one.

      blinking exercise is important for computer users - suggest you do every hour.

      LipiFlow did help me to open all glands.

      Manual expression helps too, if you are lucky to find a doctor - cheap and effective.

      morning pain/red: maybe your eyes are closed but NOT sealed when sleep? good to ask someone to check.
      If so, swimming goggle should help. or ask dr to check if demodex presents?

      Think positively, you can manage it like I do.
      Last edited by MGD1701; 08-Dec-2017, 18:58.

      Comment


      • #4
        Hi,

        As you enjoy outdoors activity it might be worth investing in moisture chamber glasses like Ziena, 7Eye, WileyX etc. They have a shield around the frame to protect against wind etc. Contact lens wise you can look into scleral lenses which are able to be filled with artificial tears, they can be covered on insurance in some cases if deemed necessary. You can read an uplifting story from this person who eventually went on a wild adventure holiday with scleral lenses after previously experiencing a lot of dry eye pain:

        http://www.sarahartman.com/have-scleral-will-travel/

        For the computer there's various things you can do to make it easier on the eyes, I made a list here of tips gathered on forums / groups. Personally I use f.lux, a dark browser theme, an add-on that inverts webpage colors to be darker, Windows magnifier and increase text sizes wherever possible.

        https://www.evernote.com/shard/s539/...ccca48b4d019d4

        Eye drop wise it looks like you're trying the Refresh Mega 3 drops (omega / castor oil drops), but if you don't like those (I find they sting but everyone's different) there are other oil-based ones like Retaine MGD (aka Cationorm), Systane Balance, Emustil.

        For an eyelid wash, you could try pure hypochlorous which aims to remove bacteria. For example Heyedrate Lid Lash, Avenova, Ocusoft Hypochlor, Natrasan, Aquaint etc. I also found though that I needed to remove bacteria on the eye itself so a wide spectrum antibiotic eye ointment at night for awhile helped for me (chloramphenicol but there are others). Some people take a low-dose oral antibiotic for MGD (e.g. doxycycline, azithromycin etc.).

        Nutrition wise as well as Omega you can try adding antioxidants which some find helps their oil consistency / quality. Stuff like Vitamin C, lutein, zeaxanthin, astaxanthin, coenzyme Q10, Vitamin E etc.
        Sufferer due to Toxic Epidermal Necrolysis.
        Avatar art by corsariomarcio

        Comment


        • #5
          Hi Everyone,

          Thank you so very much for all of your responses. I can't tell you how much I appreciate the advice and support! You all have so much good advice and it helps knowing I'm not alone in this. I'll try to respond to each post so I don't miss anything.

          Originally posted by pythonidler View Post
          As some people on this forum have mentioned, your MGD is most likely due to computer use. When people are on the computer, they don't blink as often as they should. The reduced blinking rate leads to the meibomian glands getting clogged and/or atrophied, resulting in MGD.

          I was a similar age when I got dry eye - I was 25 then, now I'm 30. My dry eye started out mild, but gradually became worse over the course of two years while working in an office environment. Eventually it got so bad that I had to quit my office job. That was three years ago, and I haven't worked in an office job since then.

          I think there's still hope, but you might have to face some hard truths:
          • MGD cannot be cured, only managed. Whatever routine you develop now and in the coming years you will have to do indefinitely until something more effective comes along
          • Computer use can only make MGD worse. You may have to consider another career that involves less computer use if you want to save your vision in the long run.
          I think you're off to a good start in terms of managing your MGD - fish/flaxseed oils are great at reducing inflammation, and a compress will allow your oils to flow more freely. You'll probably need to take the omega-3 supplements at least for 1 month to figure out if they work or not.

          There are other more expensive options to manage MGD. Lipiflow is one of them, but is pretty expensive (at least it was when I had it done - $750 per eye). My doctor prefers something called Intense Pulsed Light, which he views as less expensive and more effective than Lipiflow. If neither of those are effective, you may have scar tissue over your glands (seen in meibography as dark spots at the lid margin) - in which case probing will be helpful. Unfortunately, IPL and probing are both kind of hard to find these days. The company that manufactures Lipiflow markets heavily to optometrists and ophthalmologists, so most eye doctors only know about Lipiflow.

          In the meantime, I would try to figure out if you also have aqueous deficiency (not enough tears). Did the doctor do something called a Schirmer test? It involves putting small strips of paper over your lower eyelids, closing your eyes for 5 minutes, and measuring the length of paper that has been soaked by your tears. Anything >10 mm is considered normal, and anything less is considered aqueous deficient.

          I think it's really important to try to get an accurate diagnosis as soon as possible. Personally, I received my MGD diagnosis 1 year after my initial symptoms, and my aqueous deficiency diagnosis 2 years after my initial symptoms. I wish I had known sooner, because I might have been able to significantly slow or stop the progression of my dry eye before it did further damage. Don't settle for a doctor that doesn't know a lot about dry eye.

          Anyway, hope I haven't been too discouraging - it is possible to get better, but you have to be aggressive in terms of getting an accurate diagnosis and getting the right treatment for your condition. And as I said, you might want to consider other careers that don't involve a lot of computer use.
          Yeah, I would have to agree that my computer use probably was the cause of this. I sure wish I could go back and change things. It honestly kills me knowing that this might've been preventable. My eyes have always been irritated using the computer for as long as I remember but I never thought it could have a lasting impact. My husband is currently finishing up his law enforcement academy and I am the one working right now, so I can't make any job changes at the moment, but I have been thinking about having to do something soon in the near future if this keeps up as bad as it's been. I absolutely love my job and have been there since I was 16, but I also know my eyes are miserable by the end of the work week and definitely do feel better on my days. I've been trying to do lots of blinking exercises during work and I think that does help a little. Has staying away from computer work helped your eyes at all?

          I was tested for aqueous deficiency and was told that I don't have any troubles with that, so it does just appear to be an issue with my lids and the oils. How did the lipiflow work for you? Would you recommend it? My eye doctor's office does offer lipiflow and I found another office in the area that does do IPL treatments. The office that does the IPL treatments seems to deal with cosmetics more than anything and the receptionist I talked to there didn't know what lipiflow even was, so I'm a little hesitant to go there, but maybe they know what they are doing. The new doctor I am seeing who diagnosed me with MGD is a specific dry eye specialist, so that helps and makes me feel like I'm hopefully in good hands. How did you like the IPL treatment? Thank you again for all your help and advice!

          Comment


          • #6
            Originally posted by MGD1701 View Post
            Hi Outdoorgirl
            I would say, being patient is not enough. You need to be proactive and educate yourself for new things.

            1st get accurate evaluations & identify causes so you know HOW to treat effectively.
            InflammaDry and Osmolarity tests seem to be pretty standard in USA.
            if untreated, only get worse and hard to treat too.

            omega 3: really helps - many paper prove it already. make sure get quality one.

            blinking exercise is important for computer users - suggest you do every hour.

            LipiFlow did help me to open all glands.

            Manual expression helps too, if you are lucky to find a doctor - cheap and effective.

            morning pain/red: maybe your eyes are closed but NOT sealed when sleep? good to ask someone to check.
            If so, swimming goggle should help. or ask dr to check if demodex presents?

            Think positively, you can manage it like I do.
            Thanks for your advice! What omega 3 supplements do you like? I'm on a flaxseed supplement now and have been for a little over a month and haven't noticed any improvement, but I have heard that it can take time, so I'll definitely keep up with it. I'm glad LipiFlow worked for you! I keep reading about a lot of people who didn't seem to have much success with it and it's nice to hear someone who did. Did you notice any improvement in your symptoms afterwards? How about the manual expression? Did your doctor do that for you?

            Thankfully, my eyes are actually okay first thing in the morning. It doesn't last long at all, but they stay somewhat clear for about 10 minutes or so and actually feel pretty good. I feel like everyone else has it the other way around and I'm not sure why mine are better in the morning, but I haven't had to sleep with goggles yet . Are your eyes better in the morning or at night? Thanks so much for taking the time to respond.

            Comment


            • #7
              Originally posted by PhoenixEyes View Post
              Hi,

              As you enjoy outdoors activity it might be worth investing in moisture chamber glasses like Ziena, 7Eye, WileyX etc. They have a shield around the frame to protect against wind etc. Contact lens wise you can look into scleral lenses which are able to be filled with artificial tears, they can be covered on insurance in some cases if deemed necessary. You can read an uplifting story from this person who eventually went on a wild adventure holiday with scleral lenses after previously experiencing a lot of dry eye pain:

              http://www.sarahartman.com/have-scleral-will-travel/

              For the computer there's various things you can do to make it easier on the eyes, I made a list here of tips gathered on forums / groups. Personally I use f.lux, a dark browser theme, an add-on that inverts webpage colors to be darker, Windows magnifier and increase text sizes wherever possible.

              https://www.evernote.com/shard/s539/...ccca48b4d019d4

              Eye drop wise it looks like you're trying the Refresh Mega 3 drops (omega / castor oil drops), but if you don't like those (I find they sting but everyone's different) there are other oil-based ones like Retaine MGD (aka Cationorm), Systane Balance, Emustil.

              For an eyelid wash, you could try pure hypochlorous which aims to remove bacteria. For example Heyedrate Lid Lash, Avenova, Ocusoft Hypochlor, Natrasan, Aquaint etc. I also found though that I needed to remove bacteria on the eye itself so a wide spectrum antibiotic eye ointment at night for awhile helped for me (chloramphenicol but there are others). Some people take a low-dose oral antibiotic for MGD (e.g. doxycycline, azithromycin etc.).

              Nutrition wise as well as Omega you can try adding antioxidants which some find helps their oil consistency / quality. Stuff like Vitamin C, lutein, zeaxanthin, astaxanthin, coenzyme Q10, Vitamin E etc.
              Hi Phoenix Eyes, thanks for those links and for all the tips. I have looked into the moisture chamber glasses and might decide to do that. From a purely vain/cosmetic standpoint, I sort of hate to get them, but definitely won't let that get in the way of my eye health and comfort. Up until about a year ago, I wore contacts most of the time and have already been struggling so much with just wearing glasses. It's probably good for me to get over it though haha.

              I have heard of scleral lenses, but didn't know that they could retain moisture like that. I do a lot of backpacking and search and rescue and they seem to be somewhat difficult to take care of, but maybe they are something I could use at some point when I'm at home or work? I'm pretty new to the site, but will look around and see what other people say about those too.

              Maybe I should try some other drops. I've just used the refresh and maybe a different brand will help. Do you have a favorite?

              My bottom eyelids, especially my right eye eyelid definitely feels inflamed and the margins are red, so I have a feeling that eyelid washes are probably one of the more important things I can do. All the washes that I see (I've just started Ocusoft now), say to rub the top and bottom of the lids, but not near the eye. Is there any kind of wash that you can use next to the gland? Or am I just being too careful and can I do that with all the washes?

              Thank you all again. I'm so glad that there is a site like this.

              Comment


              • #8
                Originally posted by outdoorgirl View Post
                Yeah, I would have to agree that my computer use probably was the cause of this. I sure wish I could go back and change things. It honestly kills me knowing that this might've been preventable. My eyes have always been irritated using the computer for as long as I remember but I never thought it could have a lasting impact. My husband is currently finishing up his law enforcement academy and I am the one working right now, so I can't make any job changes at the moment, but I have been thinking about having to do something soon in the near future if this keeps up as bad as it's been. I absolutely love my job and have been there since I was 16, but I also know my eyes are miserable by the end of the work week and definitely do feel better on my days. I've been trying to do lots of blinking exercises during work and I think that does help a little. Has staying away from computer work helped your eyes at all?

                I was tested for aqueous deficiency and was told that I don't have any troubles with that, so it does just appear to be an issue with my lids and the oils. How did the lipiflow work for you? Would you recommend it? My eye doctor's office does offer lipiflow and I found another office in the area that does do IPL treatments. The office that does the IPL treatments seems to deal with cosmetics more than anything and the receptionist I talked to there didn't know what lipiflow even was, so I'm a little hesitant to go there, but maybe they know what they are doing. The new doctor I am seeing who diagnosed me with MGD is a specific dry eye specialist, so that helps and makes me feel like I'm hopefully in good hands. How did you like the IPL treatment? Thank you again for all your help and advice!
                I'll tell you a quick story about my last office job:
                I was an engineer at a solar company in Arizona, spending probably 95% of my time in an office building and in front of a computer. But for the remaining 5%, I would go out to our solar projects in the hot, dry desert. As strange as this may sound, my eyes actually felt better in the dry desert, away from the air-conditioned office. One thing you may or may not have realized is that air conditioning and heating both tend to dry out your environment (as does being in front of a computer screen all day).

                About Lipiflow:
                I first had Lipflow done probably 1.5 years after my initial symptoms. I didn't know it at the time (and to this day I'm not sure if the doctor knew either), but scar tissue had developed over my meibomian glands and blocked a lot of the oils from being expressed. Thus, Lipiflow for me wasn't very effective at the time I had it done. Since that time, I have had meibomian gland probing done, which will break up a lot of the scar tissue and allow things like Lipiflow and IPL to be effective. That being said, I still think Lipiflow is kind of a waste of money, especially since my doctor believes that IPL is more effective (and cheaper).

                About IPL:
                I don't know how much you've read about IPL, but originally it was NOT designed to treat MGD. Originally, it was a sort of skin rejuvenation procedure. But Dr. Toyos out of Memphis noticed that some of his patients reported improved dry eye after having it done. Dr. Toyos perfected the procedure for dry eye. Today IPL is performed initially once per months for the first four months, then once every [x] number of months thereafter. [x] can be any number of months - it all depends on the individual. When I first had IPL, I had three treatments, but again since I had scar tissue at the time, they were not effective. After having probing done in December 2016, I started getting IPL done this year. I noticed an improvement after the 2nd treatment.

                The one concern with IPL right now is safety. You can google "the dangers of IPL", and it'll direct you to a post a user made on this forum about that subject. That being said, I've had IPL done about 7 times this year, and have had none of the issues described by that post. As long as your doctor is taking precautions (he should put a disposable eye patch over your lids, or else use a corneal shield that sits underneath the eyelid), you should be fine.


                So at this point you're kind of in a tough situation, right? You can't really give up your job because right now that's your family's only source of income. However, IMO, your health is much more important in the long-term. I made a good amount of money living in Arizona and working as an engineer, but now all of that money is going to go towards my medical expenses in the first 5-8 years after I quit my job. And as a bonus, I won't be able to make the same amount of money and won't be able to get very good insurance unless I marry into it. Dry Eye is a cruel disease.

                My advice to you going forward would be this:
                1. Find out if you have scar tissue over your meibomian glands. First, ask your doctor how he identifies scar tissue from meibography (it will appear as dark spots near your lid margin). If he doesn't know, that's not a good sign, and you might want to find another doctor. If you do have scar tissue, then no amount of Lipiflow or IPL will do you any good - you'll have to find someone who can do probing for you, and unfortunately there's not a whole lot of people who do that right now, and it's also very expensive. If you don't have scar tissue - that's great. But keep in mind if you're not good about using the warm compress daily, it will allow scar tissue to develop. It's also possible scar tissue could develop EVEN IF you use the compress.
                2. Find a doctor who can do IPL for dry eye. I wouldn't trust anyone but an eye doctor to do this. You can find a doctor by contacting the manufacturer of an IPL device designed specifically for dry eye.- Lumenis. The name of the IPL device is the M22. If you live in the Seattle area, I can give you a couple of doctors who do it.
                3. If you can afford it, go to your doctor for monthly or bimonthly checkups until you are sure that your condition won't get any worse. Make sure to have meibography done every visit to check for scar tissue.
                4. To manage your office environment temporarily, consider doing blinking exercises (as you're doing now), as well as moisture chamber goggles. Popular brands of goggles include 7eye and WileyX. If you visit their websites, they can tell you which optometrists sell them. You'll have to visit an optometrist in person to find out which model fits your face the best. They are all very different, and some will fit better than others.
                5. Start thinking about other careers you might want to pursue that don't involve a lot of screen time. If you're passionate about the outdoors, consider doing something related to that.
                What you need to know about computer-induced dry eye
                Dry Eye Survey
                IPL Doctors
                Probing Doctors

                Comment


                • #9
                  One other thing I wanted to add about IPL:
                  Originally, the doctor who did IPL for me at the Mayo Clinic said the cost would be 100% out of pocket. But somehow, that charge got submitted to my insurance, and they ended up covering it! And now, even though I get IPL done at a different doctor's office, I can still get the insurance company to pay for most of it. After I meet my deductible, I pay only $70 for each treatment. That is a factor of 10 cheaper than Lipiflow.
                  What you need to know about computer-induced dry eye
                  Dry Eye Survey
                  IPL Doctors
                  Probing Doctors

                  Comment


                  • #10
                    Outdoor girl, keep working on it but make sure you do have a really good doctor. I have been at this for a good 65 years now. I do not hesitate to change doctors as that is what held me up from good help. The good part for you compared to some of us is that so much more is known and some doctors are specializing in dry eye these days. I will say Rebeca is wonderful for making this site and when I see a doctor I have so much info that I can compare it to wheat the doc says to determine if it is one who really knows. I have seen so called top cornea docs who cost me tons of money and were worthless. I like to be trusting but these are my eyes and I want the best I can get for them. But it sounds like you are getting a good start on it. Hopefully research will come out with something to help us. The drops may not seem to help but you really need the lubrication. My corneas are scarred as I thought the same thing. So I set my phone as an alarm and just do them anyway and I think it may be helpful, although one never knows. But if something comes out on mgd I am sure Rebeca will be posting as fast as she can find out. BTW, I am changing docs again as the one I have now I have reached the top of his expertise. I can tell as he is not sure what to do anymore and he is not keeping up with things. So stay strong.

                    Comment


                    • #11
                      Originally posted by woodart View Post
                      Outdoor girl, keep working on it but make sure you do have a really good doctor. I have been at this for a good 65 years now. I do not hesitate to change doctors as that is what held me up from good help
                      I second this. Nothing's worse than sticking with a bad doctor for too long - it makes your condition irreversibly worse and thus more costly in the long-term. The good news is that the collective knowledge of this forum can help you filter out the bad doctors.
                      What you need to know about computer-induced dry eye
                      Dry Eye Survey
                      IPL Doctors
                      Probing Doctors

                      Comment


                      • #12
                        Hi outdoorgirl


                        LipiFlow: many studies show it is (the most) effective, mianly its heat can reach inner lids + massae but it is NOT a magic.
                        If you do in right order, combination and timing, you should gain better result.
                        For example, if you have scar tissue, probing should be done prior to LipiFlow.

                        lid cleanser oil recommended by your doctor, sounds interesting. Which brand? purpose: bacteria, demodex?
                        Last edited by MGD1701; 08-Apr-2018, 08:15.

                        Comment


                        • #13
                          Originally posted by pythonidler View Post

                          My advice to you going forward would be this:
                          1. Find out if you have scar tissue over your meibomian glands. First, ask your doctor how he identifies scar tissue from meibography (it will appear as dark spots near your lid margin). If he doesn't know, that's not a good sign, and you might want to find another doctor. If you do have scar tissue, then no amount of Lipiflow or IPL will do you any good - you'll have to find someone who can do probing for you, and unfortunately there's not a whole lot of people who do that right now, and it's also very expensive. If you don't have scar tissue - that's great. But keep in mind if you're not good about using the warm compress daily, it will allow scar tissue to develop. It's also possible scar tissue could develop EVEN IF you use the compress.
                          2. Find a doctor who can do IPL for dry eye. I wouldn't trust anyone but an eye doctor to do this. You can find a doctor by contacting the manufacturer of an IPL device designed specifically for dry eye.- Lumenis. The name of the IPL device is the M22. If you live in the Seattle area, I can give you a couple of doctors who do it.
                          That would be so awesome if you know of some eye doctors in the Seattle area who do the IPL treatments. I'm currently living about an hour north of Seattle and would love to get started if possible. I have my next follow up with my dry eye doctor early January and know that their office doesn't offer IPL, but would love to mention it to her and go to someone else for that treatment if needed. I'll definitely ask about the scar tissue too. Do you know of anyone in the Seattle area who does probing? I'm currently going here: http://www.eanw.net/center-for-eye-comfort/. Thanks again everyone for all of your help!

                          Comment


                          • #14
                            Hi outdoorgirl

                            I happen to know
                            IPL - Seattle, Dr Laura Periman performs IPL (& LipiFlow, not sure about probing)

                            http://www.dryeyezone.com/talk/forum...ra-periman-usa

                            Comment


                            • #15
                              Originally posted by outdoorgirl View Post

                              That would be so awesome if you know of some eye doctors in the Seattle area who do the IPL treatments. I'm currently living about an hour north of Seattle and would love to get started if possible. I have my next follow up with my dry eye doctor early January and know that their office doesn't offer IPL, but would love to mention it to her and go to someone else for that treatment if needed. I'll definitely ask about the scar tissue too. Do you know of anyone in the Seattle area who does probing? I'm currently going here: http://www.eanw.net/center-for-eye-comfort/. Thanks again everyone for all of your help!
                              Regarding IPL:
                              MGD1701 is right about Dr. Periman performing IPL, but unfortunately I've called several times this year to schedule an appointment with her, and she is very difficult to schedule with. The last time I called (November 2017), they said she is not accepting new patients at this time. Additionally, she requires a referral and only goes to the clinic twice per month. When I called to ask about the cost, they said it ranges from $350 to $500, depending on how much of your face they have to "zap".

                              I see another doctor for my IPL. Her name is Dr. Silvia McKevitt, and she works out of Eye Plastics Northwest in Renton. She charges either $250 for IPL if billed as a cosmetic procedure (in which case you pay the $250 out of pocket), or $500 if billed medically (in which case they will bill to insurance). This year I've had insurance cover all of my IPLs, and once my deductibles were met, I paid only $70 for each one. Dr. McKevitt has both the disposable eye patches and corneal shields, if you prefer one or the other as protection.

                              Regarding probing:
                              Unfortunately, I don't know of anyone in the Seattle area who does probing. I called Rhein Medical (the manufacturer of the probes), and they said the closest person who does it is located in Northern California, Dr. James Tearse out of Redwood City. I called his office and he charges $1000 per lid to do probing, so 4 lids = $4000 total. My doctor in Boston charged less than half of that for probing.
                              What you need to know about computer-induced dry eye
                              Dry Eye Survey
                              IPL Doctors
                              Probing Doctors

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