IPL for dry eye, spoke to Dr toyos

[sazy123]

Hi

If anyone is interested in IPL i have some more information.
over the past few years Dr toyos has been using IPL for dry eye success here are the studies:

http://www.eyeworld.org/article.php?sid=2698
http://www.osnsupersite.com/view.aspx?rid=28335

I got in contact with Dr toyos about the procedure, as i am interested in it. This was his reply

I have a 90 percent response rate whether you have rosacea or not. We are in the process of training physicians how to do the procedure. It takes 4 to 6 treatments a month apart. I don't know how realistic it would be to come to the united states to see me. I do perform the procedure in beverly hills, california if you come out to the los angeles area. What you could do is find out if there is someone in your area that performs ipl with the dermamed quadra q4. The latest edition works better than its predecessors. Just let me know.

[autumnn]

Hi Sazy- I live in Southern California and have a derm apt schd for next week for the "rosacea" type issues I am having with my skin (some docs think I have it some don't- still I have some bumps and reddness). Anyway, the guy I am seeing is an expert with lasers and I will print this out and take it to him and see if he is willing to do something on my eyelids too. Otherwise, I would consider being a guinea pig and checking out the guy out in Beverly Hills and would report back ($$ could be an issue though- any idea the cost?- I emailed the doctor and will let you know what I hear back).....do you have little veins (tangelesia? sp?) on the top of your eyelids? I do, and I wonder if this is a problem? My TBUT is not terrible (appx a 10) so I wonder if I would even need this tmt....plus, I have made gains with lacriserts which are making life easier. Still, this IPL sounds pretty darn promising and I remember hearing about it in the past too. Maybe there is someone in the UK who can do it for you?

[sazy123]

Hi Sazy- I live in Southern California and have a derm apt schd for next week for the "rosacea" type issues I am having with my skin (some docs think I have it some don't- still I have some bumps and reddness). Anyway, the guy I am seeing is an expert with lasers and I will print this out and take it to him and see if he is willing to do something on my eyelids too. Otherwise, I would consider being a guinea pig and checking out the guy out in Beverly Hills and would report back ($$ could be an issue though- any idea the cost?- I emailed the doctor and will let you know what I hear back).....do you have little veins (tangelesia? sp?) on the top of your eyelids? I do, and I wonder if this is a problem? My TBUT is not terrible (appx a 10) so I wonder if I would even need this tmt....plus, I have made gains with lacriserts which are making life easier. Still, this IPL sounds pretty darn promising and I remember hearing about it in the past too. Maybe there is someone in the UK who can do it for you?

I dont know about cost i emailed him back about instructions that i could give to a doctor here but he hasnt got back to me yet. He doesnt always reply, i expect hes very busy, but i phoned his clinic and got the receptionist to pass on the message so he got back to me in email.

As far as i know he only does the face in those areas showed (in link). You have to be careful with IPL near the eyes.

My main question was whether it works for those who dont have bad facial rosacea, so the reply was that you didnt need to.

If you find out the cost let me know, i dont know if i can find someone here because they may use different IPL machines for one thing.

I have slight purple appearance on eye lid along lash line, very slight tanglsia- but thats not enough to cause probs.
I have always thought vascular flow to eyelids could be causing the problem.

[odydnas]

wow, that's really interesting. I wonder what the side effects are?

[autumnn]

Wow, the office called me back quickly after I emailed them about this. I have a consult with this doc set up for the 23rd of March. The total price for 4 treatments is $1500- insurance will not cover any of the cost. I will get all the details during my visit and post them later. If anyone wants to list some questions for me please go ahead and I will bring them with me for my appointment.

[sazy123]

Wow, the office called me back quickly after I emailed them about this. I have a consult with this doc set up for the 23rd of March. The total price for 4 treatments is $1500- insurance will not cover any of the cost. I will get all the details during my visit and post them later. If anyone wants to list some questions for me please go ahead and I will bring them with me for my appointment.

Oo thats really encouraging autum im glad i caught you with this post before you saw the other doctor!

I was expecting it to cost much more, since where it is etc, so that isnt to bad.

I think its better you have the treatment with the guy who actualy does it rather than someone else, although it may be fine both ways. I think doing it with someone who knows what they are doing with dry eye is the only way you can ensure whether you would benefit.

The problem for me is the flight costs and hotels.

Could you please ask him:

How safe is it? what about sensitive skin?

What setting of IPL machine he uses?

Does he treat within the peri-orbital area (which is just above the cheek bone)?

What is the average symptomatic relief that a patient will get? i.e- moderate dry eye to mild dry eye?

Do some patient have more benefit that others? i.e bad rosacea.

Is that to many?

[autumnn]

Hi Sazy- Yes, I will ask him all of those questions (no, that is not too many!).....when he sees me he has to determine whether or not I am a candidate- so I guess we are both evaluating each other! I am most curious about whether or not this is a LONG TERM fix because many laser treatments for the skin need to be repeated every 6 months or so to maintain the benefits.....I wonder if this is the case with this treatment? I am going to ask the other derm that I see next week about it but I doubt that any good doctor would get near the eyes unless they know what they are doing- I'd rather leave it up to Dr. Toyos. $1500 is a lot, but, not if it works for the LONG TERM.....if anyone else knows about IPL and dry eyes please post!

[odydnas]

Hi autumn,

Can you ask these questions too:

1. How many patients have you done, and how many have been done world-wide (or country-wide)?
2. What are the risks and side effects??

Thank you so much!

[autumnn]

Odydnas- Yes, I will certainly ask those questions too.
Lets all hang in there guys, we are going to each find some solutions that will help us
Anyone else please feel free to post questions and when I see him I will be representing all of us!

[Meebo]

Hey everyone....i know most of you remember me talking about the toyos procedure.

I think it is importnant to tell everyone that i recently saw another Dr. and he diagnosed me with allergic conjunctivitis and said that ocular rosacea/blepharitis was very unlikely.

I have been responding well to pataday and acular (NSAID) and also taking alamast but not sure if it is doing anything.

To solidify this i got allergy tested; prick was 50/50 so Dr. went intradermal. 100% allergic to cats, dogs, and feathers. He thinks the cat dander from having cats for 10 year (no more) and dust is causing my problems coupled with possible hyper sensitivity to specific chemicals found in soaps and facial products. I am going to spend a week out of my house to see how i feel.

ADDITIONALLY, setting appointment with Vitreous-Retina-Macula Consultants of New York. I heard they are BEST practice on the East Coast. I am going to get testing to the hilt, conjunctiva scraping testing, blood testing, everything that can possibly be done.

I am LITERALLY sick of this. Please, everyone, do me one favor. Make sure you get tested for allergies. Remember, when I first saw the doc, i was so inflamed that my meibomian glands were not excreting oil. Now, i am doing much better but have not pinpointed the actual cause.

[pjcortes]

Update please!

Hi Autumn,

Just checking to see whatever happened with your dr's apprt with Dr Toyos

Jennie

[sazy123]

Hey everyone....i know most of you remember me talking about the toyos procedure.

I think it is importnant to tell everyone that i recently saw another Dr. and he diagnosed me with allergic conjunctivitis and said that ocular rosacea/blepharitis was very unlikely.

I have been responding well to pataday and acular (NSAID) and also taking alamast but not sure if it is doing anything.

To solidify this i got allergy tested; prick was 50/50 so Dr. went intradermal. 100% allergic to cats, dogs, and feathers. He thinks the cat dander from having cats for 10 year (no more) and dust is causing my problems coupled with possible hyper sensitivity to specific chemicals found in soaps and facial products. I am going to spend a week out of my house to see how i feel.

ADDITIONALLY, setting appointment with Vitreous-Retina-Macula Consultants of New York. I heard they are BEST practice on the East Coast. I am going to get testing to the hilt, conjunctiva scraping testing, blood testing, everything that can possibly be done.

I am LITERALLY sick of this. Please, everyone, do me one favor. Make sure you get tested for allergies. Remember, when I first saw the doc, i was so inflamed that my meibomian glands were not excreting oil. Now, i am doing much better but have not pinpointed the actual cause.

Meebo, its great that you have think allergies are the cause. I have a very similar sounding dry eye- whereby the inflammation is clearly preventing the secretion of oil (i.e glands are not blocked).

And have also been diagnosed with allergic conjunctivitis by several doctors in the past, however i believe this diagnosis to be a red herring and a convenient one because ocular rosacea isnt, i do not appear to be allergic to ANYTHING! - this is where i have had the opposite experience to you. I have not responded to pataday, patonal, acular or any allergy eye med.

After extensive allergy tests- 3 skin prick tests and one intradermal tests testing against dust/dust mites etc- nothing significant showed up. Still awaiting results from chemical sensitivities. Oh and avoidance of foods did nothing.

So im fed up of the same diagnosis from doctors- allergic conjunctivitis (although i havent had one in ages!), because they cant diagnoses ocular rosacea!

What do Vitreous-Retina-Macula Consultants of New York do?

I wish you luck getting to the actual cause! if it is allergies to dust or something, you will probably pin point it by staying out of the house for a while.

[sazy123]

Hi Autumn,

Just checking to see whatever happened with your dr's apprt with Dr Toyos

Jennie

Autumn didnt go in the end, i am still thinking of going at some point as i still have minimal help from anything else.

If anyone else is thinking of making an appointment, let me know?

[sazy123]

Just found an article about IPL for dry eye by Dr toyos.


http://www.bmctoday.net/crstoday/pdfs/CRST0409_14.pdf

The light acts as a warm compress that liquifies the meibomian gland’s
secretions and ultimately unplugs them.

this is encouraging, my glands arent blocked but this could be it

and i dont believe need to be liquefied, But this is interesting:

One reason
why intense, pulsed light may work is that the closed
blood vessels can no longer send inflammatory mediators
to the gland. These mediators may cause the gland’s dysfunction

The first thing we noticed in patients treated with intense,
pulsed light is that their telangiectasias disappeared, as did
the erythema and swelling in the gland. Consequently, the
eyelids themselves appeared cleaner. One month after treatment,
meibomian glands that had not functioned at all
began to operate. Instead of resembling toothpaste, the
secretion we observed was thinner and more normal.

But good news for most MGD suffers! Or is it too good to be true?....

[annamarg]

Just found an article about IPL for dry eye by Dr toyos.


http://www.bmctoday.net/crstoday/pdfs/CRST0409_14.pdf



this is encouraging, my glands arent blocked but this could be it

and i dont believe need to be liquefied, But this is interesting:





But good news for most MGD suffers! Or is it too good to be true?....

Hi! Yeah sounds really good. Have been thinking about this for a year or so. Live in Sweden but maybe I'll go to Memphis to try this this summer.
Just a question for you Sazy (who also seem to have as dry eyes as I do), do you have 'toothpaste resembling secretion'? I don't. But almost wish I did since then this IPL method would maybe be appropriate for me.
Anna