Dr. Korb - compromised lid seal found in majority of symptomatic dry eye patients who did not respond to regular treatments

[Guest]

No, I won't. It's not something I want to do right now.

[Topher3]

It's very interesting when you say my lower glands have more atrophy. I don't exactly know how atrophied acini look like in a meibography. I always though dark areas represent part of the glands that have atrophied. I might be wrong. Do you notice structural changes in the meibomian glands of my lower eyelids that indicate atrophy/damage?

Can you mark the areas of atrophy editing my pictures?

I am always trying to infer what the hell is wrong with my glands. The orifices do get blocked by cappings everyday and the volume of secretions is sometimes copious and sometimes low. Only thing I haven't paid much attention to yet is demodex infestation of my eyelashes and possibly meibomian glands. Waiting for the tea tree oil to arrive from US to commence my demodex protocol.

Maybe atrophy isn’t the correct word, however there are abnormalities. My glands are a lot worse than yours but a simple google images of normal lower lid meibomian glands you can notice the difference. One of your lower lids are a lot better than the other when it comes to longer glands with less tortuosity and breakage if the gland. You can see how it stops from becoming long lines to kind of a where you can’t really make out what’s happening.

[Milo007]

No, I won't. :-( I am not in Canada right now, for one thing, and won't be for several months. And when I do return, I'm still not sure if I'll get Lipiview, because it won't change my treatment choices... so that makes me not want to waste time driving to the appointment, waiting in the waiting for hours (the doc that offers it tends to always be behind and have very long waits... maybe that's changed in recent years, but I'm not holding my breath), go through whatever is involved in the procedure, fork out 45 bucks, and so on. I'm just not in the mood to do any of that given that it won't change anything in terms of my treatments or how my eyes feel.

My current thinking is that the next big spend on my eyes will be IPL because I think that's the treatment that's most likely (although certainly not guaranteed) to give me more bang for my buck. Also, it does not require me to refrain from using drops/ointment for 24 hours prior, it may help deal with the neovascularization of my lid margins (I have rosacea, which is a likely contributor to this issue), AND it can help soften any clogged secretions. However, It will require me to fly to another city to get it done by an ophthalmologist... and if I budget for a total of 4-6 treatments in the first year, that's going to cost thousands of dollars which I'll have to save up for (i.e. cost of treatment, flights, accommodations). If I'd been able to work this past year, things would be better... but no such luck, so I'll have to wait.

Anyhow, realistically, even the IPL thing will likely need to wait at least 1.5 - 2.5 years for me.

Sorry if I sound grumpy... it's not you or anyone here. :-(

No it's absolutely fine! You don't sound grumpy at all. Besides everything you do if you take my advice please try a thorough demodex protocol for at least three months since you have rosacea. Try including TTO and topical ivermectin cream in your daily routine twice a day. Most cases of MGD and specially rosacea are a result of demodex infestation. It might be worth trying once.

I strongly believe now demodex could be an overlooked cause of most forms of dry eyes.

[Milo007]

Maybe atrophy isn’t the correct word, however there are abnormalities. My glands are a lot worse than yours but a simple google images of normal lower lid meibomian glands you can notice the difference. One of your lower lids are a lot better than the other when it comes to longer glands with less tortuosity and breakage if the gland. You can see how it stops from becoming long lines to kind of a where you can’t really make out what’s happening.

My eyes are burning like crazy as I type. Why the hell am I not dead yet?

[Topher3]

My eyes are burning like crazy as I type. Why the hell am I not dead yet?

Have you got moisture chamber glasses on? My eyes burn like crazy without them they’re a must for me at all times.

[Milo007]

Have you got moisture chamber glasses on? My eyes burn like crazy without them they’re a must for me at all times.

Yes even with the MCGs on the inner surfaces of my eyelids are burning for the last few days.

[Topher3]

It's very interesting when you say my lower glands have more atrophy. I don't exactly know how atrophied acini look like in a meibography. I always though dark areas represent part of the glands that have atrophied. I might be wrong. Do you notice structural changes in the meibomian glands of my lower eyelids that indicate atrophy/damage?

Can you mark the areas of atrophy editing my pictures?

I am always trying to infer what the hell is wrong with my glands. The orifices do get blocked by cappings everyday and the volume of secretions is sometimes copious and sometimes low. Only thing I haven't paid much attention to yet is demodex infestation of my eyelashes and possibly meibomian glands. Waiting for the tea tree oil to arrive from US to commence my demodex protocol.

[Milo007]

Yes you are right. Those part of the glands seem to lack anatomical details. I am afraid if the demodex mites are eating out my glands. I have developed demodex phobia recently. All I think and dream about is demodex at the moment.

[Topher3]

What have you done differently to have very bad burning these last few days? Something must have changed in that time.

[Milo007]

What have you done differently to have very bad burning these last few days? Something must have changed in that time.

Stopped using TTO. And didn't use steroids after 23rd of January. Things were really good until 1st of February while the residual effect of TTO was there I think.

[Topher3]

Stopped using TTO. And didn't use steroids after 23rd of January. Things were really good until 1st of February while the residual effect of TTO was there I think.

Sounds like it could be demodex if the tea tree oil is the reason why you’ve got these issues currently. Why did you stop using? Did you run out of it ?

[Milo007]

Sounds like it could be demodex if the tea tree oil is the reason why you’ve got these issues currently. Why did you stop using? Did you run out of it ?

I have had such burning for the last one year or more (ever since my dry eyes became severe dramatically). It's not that it has occured recently. I kept the thing under control with intermittent use of ocular steroids. The symptoms aggravate and subside following an irregular pattern. When the symptoms are unbearable I use steroids for a day or two. This means I never got rid of the problem without the steroids. Also it could be that steroids actually helped the demodex come back stronger each time I used them even though they gave me temporary remission of symptoms. I read somewhere steroids help demodex multiply faster as it weakens the local immunity around eyes.

I stopped it because I feel it's not 100% pure TTO and could be adulterated with harmful chemicals or other cheap essential oils. It smells more like eucalyptus oil and there are tons of synthetic oils or adulterated ones out there in the market which can actually damage my eyes. Don't want to put something near my eyes that has no guarantee of authenticity. So I have ordered TTO and jojoba oil from Edens Garden. Waiting for the stuff to arrive.