Atrophied Glands 85% in one eye?!

[Katewest]

Is that possible? just got back from my lipiview. They just got it at my local opth office. He used a small light and lifted my lids. 75% in one and 85% in the other. I'm shocked that no other doc mentioned this. He said they never grow back. Is there any way he is off?

My other numbers are 34 and 52. He said normal was 100 plus.

[LaDiva]

Boy, I hope he is wrong. I don't know anything about this, nor how long it takes for glands to atrophy. Hoping that Lid-Man is way off base, Kate! Ouch!

[Katewest]

Ugh I know! I've heard some people on here saying their doc counted the exact number of atrophied glands. My doc looked at the bottom and top but not for very long with his light. And it was a %

Edit---they only have had lipiflow for a month or so and he was young....maybe he was wrong?!

[Rebecca Petris]

Personally - not meaning to cast doubt on YOUR doctor a bit - but generally speaking I think I might be reluctant to accept a doomsday prognosis on a meibomian gland unless it was coming from someone of pretty significant stature in the dry eye world. They don't all seem to come to their conclusions the same way. Also don't forget, no adult no matter how healthy has 100% of their meibomian gland function. Just sayin', don't let the numbers throw you too much.

[Katewest]

THANK YOU and I needed to hear that! I also called BFS because I was just their and they didnt mention this. Need a second and third opinion.

[DCRdryeye]

If they shined a torch into your glands that's a technique called "translumination" and takes LOTS of practice to get right. Dr. Korb said he had to practive thousands of times before he could make an accurate diagnosis. Did they use a meibomography machine on you too? if not, that's what you need to have done next as a back up diagnosis. 85% atrophied glands sounds a bit grim, I doubt that's correct.

I'm organizing a meibomography soon. Trouble is there is only 1 or 2 machines in our country and I always have to spend up to $400 in flights to see the top eye docs here. I have "partial cautery" booked in December, so that's another flight and accommodation and to travell "again" for meibomography is getting $$$$$$. Dry eye treatment and diagnosis is never cheap.

[Katewest]

I dont think I had a meibomography done. It was a test that had flashing lights which showed the tear film.

[kylix]

please read this article: http://www.revophth.com/content/c/44198/. There are some cutting-edge devices for detecting/measuring dry eye.
Here is what some doctors say about LipiView:

“The LipiView test is designed to measure the thickness of the lipid layer, but we have not found that to be very helpful,” he continues. “It doesn’t seem to correlate too well with people’s slit lamp exams or symptoms, or with what we think of as the severity of blepharitis. I’m not sure whether that’s a technological issue, or if the thickness of the lipid layer really isn’t a determinant of lipid layer function. It doesn’t really help us determine whether the patient is a good candidate for LipiFlow; instead, I determine that based on the slit lamp exam and the symptoms. Nor does it correlate with whether the patient is successful with LipiFlow.

“The most interesting part of the LipiView test, in fact, is the little video of the patient blinking that you record as part of the test,” he says. “The device gives you a printout that shows you who the partial blinkers are. This has nothing to do with the lipid layer thickness that the instrument is measuring, but for many patients, a partial blink is a big part of their problem. Unfortunately, there’s no easy way to eliminate partial blinking, but at least we can tell the patient, ‘This is why the 20 medications and treatments you’ve tried for this issue have not worked. You’re not completely blinking, so the lower half of your cornea is getting dried out as the day goes on.’ ”

Dr. Nichols also has used the LipiView device. “In practice, we’ve found patients with seemingly normal lipid layer thickness on the LipiView test; but you look at their secretions and their meibography and they’re not normal,” she says. “Maybe they just rubbed the eye and expressed some lipid. There’s a lot we don’t know yet, but it’s clear that you can’t use any one of these tests alone.”

Dr. O’Brien says the Ocular Surface Center clinic at Bascom Palmer Eye Institute has a LipiView device, but has only recently been gaining experience with screening dry-eye populations. “It produces very intriguing high-tech images, but the interpretation is still difficult,” he says. “I’m not sure we fully understand yet exactly what the patterns mean or how they correlate to clinical disease. However, it’s been useful for catching partial blinkers, and it’s been useful as a patient education tool, letting us show patients why they’re uncomfortable or having problems.”

Moreover a lot of people here underwent LipiFlow and their LipiView score increased significantelly but they didn't find any relief or improvement of their state, which correlates with what the doctors in that article say.
I also remember some member here who was told that all his glands artrofied by his doctor but meibography revealed something completely different, so until you are able to see it yourself, don't trust it completely, instead try to find someone who can show your glands to you, e.g. via meibography.

[Katewest]

Thanks for that info kylix. I decided to do another liliview and possible lipiflow at a different doctor. He has been doing it since Christmas and seems less salesy.

[DCRdryeye]

If anyone tells a dry eye patient they have 85% atrophied glands without a meibography just for sales is extremely painful for the client to hear, and very cruel and callous by the operator. There are a lot of charlatans out there to make money - be careful people.

[NotADryEye]

I dont think I had a meibomography done. It was a test that had flashing lights which showed the tear film.

What you describe is definitely not a meibography. During the meibography the lids are turned back. A light is shined and the meibomian glands are visible in the way bones are visible when you hold your hand up to a bright light.

I agree with DCRDryEye. Please proceed with caution.

[spmcc]

I dont think I had a meibomography done. It was a test that had flashing lights which showed the tear film.

That was LipiView.