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Newbie Here with Question about Lipiflow

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  • Newbie Here with Question about Lipiflow

    Hi! First time posting, although Iíve been browsing for quite awhile.

    Just had my annual eye exam today and my long time optometrist is going to contact an ophthalmologist group (that he refers his dry eye patients to) about scheduling me for a meibography and, most likely, Lipiflow.

    What can I expect from both of these procedures? Are they painful? How invasive is the Lipiflow? (I hate having anything put in my eyes, so of course I end up with eye problems.) Most importantly, will I be able to drive home after getting Lipiflow or will my vision be affected for a short time after?

    Briefly about me: I was diagnosed with EBMD two years ago (eyes felt dry and gritty and doctor could see the dots on my eyes in the slit lamp) and MGD one year ago (doctor had difficulty getting any oil to come out when he expressed my lower glands with his finger while viewing in the slit lamp). I found this forum in between those diagnoses and marvel over how well informed and educated you all are about your various conditions as well as how incredibly supportive everyone is of each other. Iíve found much comfort and many tips from reading all of your stories and am truly grateful to Rebecca for creating this site.


  • #2
    LipiFlow is considered to be relatively safe. They just warm up your eyelids and massage the lids (gently). There won't be any side effects or pain, it won't effect your vision at all and you can drive home for sure. The goal of LipiFlow is to remove any internal obstructions inside your glands. However, LipiFlow will not fundamentally fix the underlying issue (i.e., inflammation).

    You should definitely supplement LipiFlow with other procedures to tackle the fundamental inflammation behind MGD. You should consider IPL, which for reasons unknown, can reduce the inflammation in your glands and make your glands express better quality oil. Some doctors here in Canada, they recommend 2 sessions of IPL before evaluating LipiFlow is necessary. Additionally, you should consider drugs such as Xiidra and Restasis which can help reduce and control the inflammation behind the MGD.

    Comment


    • #3
      Welcome EBMD!

      I'm curious whether you know if you're experiencing more symptoms from the EBMD or the MGD, and if you are on treatment for EBMD. Also wondering if you're pursuing Lipiflow specifically because other treatments have not been enough? Lipiflow is good technology and all that, probably the worst that can be said of it is that it is overused in cases where not necessarily likely to be helpful.
      Rebecca Petris
      The Dry Eye Zone

      Comment


      • #4
        Thanks for the LipiFlow information, deep_dry_eye.

        My doctor didnít mention IPL, but I have read here that it will increase the quality of oil produced like you said. If the meibography shows that my glands are blocked, wouldnít it make sense for me to do LipiFlow first to hopefully get them unblocked and then follow up with IPL?

        Iíve been on Restasis for two years, but I donít know if itís done any good. I know my eyes feel worse now than they did two years ago. The only plus is that it no longer stings when I put it in.

        Iím curious to see what a meibography will show. Iíve read how people will do the warm compresses and afterward, theyíll feel the oil flowing or their eyes will feel a little moist. Iíve used the Bruder mask over the years and my eyes have always just felt disappointingly dry afterward. Maybe my glands are too blocked for the heat to have any effect.

        Comment


        • #5
          Hi Rebecca! I donít know which is causing my symptoms. Thankfully, Iíve never had any corneal erosions, just the dry, gritty eyes with occasional burning. Itís annoyingly inconsistent though Ė one day the right eye will feel worse, the next day itíll be the left eye. Thereís no rhyme or reason.

          Iím looking at LipiFlow because my doctor suggested it and he thinks that my glands are blocked, especially in the right eye.

          As for treatments, except for the two years of Restasis, everything else has been over-the-counter stuff:
          • Drops (preservative free only) provide true relief only for those first few minutes when the eye feels nice and wet. I keep them in the refrigerator so theyíre cold too. Iíve tried many different ones (as Iím sure we all have) and some have actually irritated my eyes.
          • Bruder mask hasnít had any effect. A cold mask actually seems to ease the burning somewhat, even though my eyes remain dry.
          • Lid hygiene every evening with Occusoft.
          • Humidifier in my bedroom and a small one by my desk at work.
          • Omega3 supplement daily.
          • I drink about 6 glasses of water every day, so Iím trying to keep myself hydrated that way too.
          • Moisture chamber glasses - I already wear prescription glasses so I tried the Global Vision Outfitter glasses to wear over them and there were gaps everywhere. I have safety goggles that I can wear at home over my glasses that seal pretty well with just a few slight gaps, but my eyes donít feel any different wearing them.
          • At night Iíve tried Tranquileyes and Onyix. I donít get a good seal with Onyix and itís uncomfortable - I feel like itís too close to my eyes if that makes sense. Tranquileyes is more comfortable, but Iím a side sleeper and it never stays on all night. I donít know if they slip off or if I unconsciously push them off while sleeping.

          Comment


          • #6
            I'm glad to have found this discussion, as I have similar symptoms EBMD.

            A bit of my story is that I also have EBMD, and Dry-Eye. I started having Recurring Erosions about 5 months ago, after my cataract surgeries. I just had a Lipiview and Lipiflow done about 4 and 3 weeks ago, respectively.
            I am still in the discovery stage with my DE, and have a follow-up appt. in about 5 weeks to see how my glands are doing, so I cannot speak to the success of the Lipiflow yet.

            I will say that I appreciated the Lipiview, which revealed some reasons that I have DE. I recommend discovery like that exam highly. I also recommend a doctor who listens, doesn't just assume and prescribe. I spent about 6 months dealing with symptoms that brought me to the cataract surgery (narrow-angle closures), and no one diagnosed my DE until afterwards, so it went untreated!
            I'm on Xiidra now for about 2 months, and I can't say that I notice a difference. I don't appreciate the cost unless I can see marked difference, but I'm giving it another 2 months.

            You seem to be aware of your symptoms and journey, EBMD, which is important.

            Rebecca, please explain what you know about EBMD treatments.

            Comment


            • #7
              Originally posted by Rebecca Petris View Post
              Welcome EBMD!

              I'm curious whether you know if you're experiencing more symptoms from the EBMD or the MGD, and if you are on treatment for EBMD. Also wondering if you're pursuing Lipiflow specifically because other treatments have not been enough? Lipiflow is good technology and all that, probably the worst that can be said of it is that it is overused in cases where not necessarily likely to be helpful.
              Please explain what you know about EBMD treatments, Rebecca--thanks.

              Comment


              • #8
                EBMD I have three lipflows done at this point. They have not really helped me at all. Objectively they have increased the lipid layer. I still feel and look awful unfortunately.
                Here are the results if you would like to see them.
                http://forum.dryeyezone.com/forum/dr...elping-someone

                Maybe it takes more than 3?

                Comment


                • #9
                  EBMD precludes you from lipiflow. If you go to the lipiflow site, EBMD is indicated as s contradiction. The cups that go into the eye could cause an abrasion.

                  Comment


                  • #10
                    Originally posted by Dowork123 View Post
                    EBMD precludes you from lipiflow. If you go to the lipiflow site, EBMD is indicated as s contradiction. The cups that go into the eye could cause an abrasion.
                    Shoot. My doctor hasn't followed up with me yet, but I will definitely let him know that. I'll still go forward with the meibography though and hopefully get more details about what's happening with my glands. And thanks for the PMs regarding my side sleeping and the inconsistency with my eyes burning. I hadn't thought of the possibility of that being related.

                    Comment


                    • #11
                      Originally posted by EBMD View Post

                      Shoot. My doctor hasn't followed up with me yet, but I will definitely let him know that. I'll still go forward with the meibography though and hopefully get more details about what's happening with my glands. And thanks for the PMs regarding my side sleeping and the inconsistency with my eyes burning. I hadn't thought of the possibility of that being related.
                      No worries, I didnít either. Once I started protecting my eyes with gel and tape, things got a lot better. Still looking for a good PF gel though. Iím allergic to everything. Good luck.

                      Comment


                      • #12
                        Originally posted by EyesOpen View Post

                        Please explain what you know about EBMD treatments, Rebecca--thanks.
                        There's quite a range of different ways doctors may choose to handle it depending especially on severity and whether you're having erosions. Common approaches for chronic ebmd include sodium chloride ointment (eg Muro 128) or if severe with frequent erosions, debridement, sometimes stromal puncture. But if it's mild often just lubricant drops are enough.
                        Rebecca Petris
                        The Dry Eye Zone

                        Comment

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