VERY interesting article about IPL for dry eye!

[sazy123]

Sorry i did post this in the thread about ipl for dry eye here http://www.dryeyezone.com/talk/showt...0416#post40416

But i thought more people would see it here and some of the info is to interesting to be avoided.

Article by Dr toyos

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

i found these bits V interesting:

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

This is interesting to me, because ive suspected vascular involvement in my DE for a while:

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.

When the light reaches the lower eyelid, we
have patients look up and then apply treatment right
below the eyelash margin. The upper meibomian glands
are not treated directly, but we have seen an improvement
in the upper glands from indirect therapy.

All patients report a subjective improvement in
their dry eye symptoms (no steroids were prescribed after
treatment). On examination, we find that patients with
telangiectasia at the lid margin will have less after only one
treatment. Glands will show more fluid secretions when
pressed.
We also find less capping of the meibomian glands.
The lid margins are less erythematous and clearer

Sounds promising for all MGD suffers As you dont need to have facial rosacea for the treatment to work.
Maybe its too good to be true, but it gives me hope

[LasikRelatedDES]

During the last year, fewer than 1% of our treated patients
have been nonresponders.

Some of our patients come in every 3 months,
whereas others will not return for 1 year. Most of our patients
no longer need eye drops after they have finished
their initial course of treatment. They usually return for a
maintenance treatment when they feel that their symptoms
are coming back.

Oh my heck. Sign me up.

[vman]

fitzgerald skin types

That is very interesting..it's nice to see something totally new sometimes!

It's too bad that it's restricted to fitzgerald skin types 1 and 2...that excludes all non-caucasians, who are all 4 and higher. hopefully there will be a reliable approach to using light therapy in darker skin tones in the not too distant future...it looks like something that's of broad interest to the dermatology field, not just us dry eye types...so I'm fairly optimistic.

[sazy123]

That is very interesting..it's nice to see something totally new sometimes!

It's too bad that it's restricted to fitzgerald skin types 1 and 2...that excludes all non-caucasians, who are all 4 and higher. hopefully there will be a reliable approach to using light therapy in darker skin tones in the not too distant future...it looks like something that's of broad interest to the dermatology field, not just us dry eye types...so I'm fairly optimistic.

Mmm yeah thats a shame. I think though the majority of mgd patients would be type 1,2,3, because of rosacea and that mgd is very common in fair skinned people. They do say they will consider type 3 and that patch testing will be done.

You can see what type you are here:
http://www.spa-medical.com/fitzpatri...yping_test.htm

im between 1-2.

[stella]

Great find Sazy !
are you going to go for it ?
Your signature is- " i want a cure" - well maybe this is IT for you
Do hope so
All the best
Stella
PS I've always thought of you as a trail-blazer ! This may prove it

[lboogie]

I wonder how someone would be able to try this? Aside from flying to Tenessee. My opth always seems pretty open to things, but I am part of Kaiser, and they pretty much never cover the cost of anything that is not super, super proven and tested. I would be willing to pay out of pocket though to give it a try.

[sazy123]

I wonder how someone would be able to try this? Aside from flying to Tenessee. My opth always seems pretty open to things, but I am part of Kaiser, and they pretty much never cover the cost of anything that is not super, super proven and tested. I would be willing to pay out of pocket though to give it a try.

You would have to fly to LA 4 times (he does it in LA), and it would cost $1500 for the whole treatment, insurance doesnt cover it, (mite do eventually?) it is fairly new. Im from the UK so it will be costly but i have to try anyway, i have saved some money. Im wondering whether i could get two treatments 3 weeks apart and stay for 3 weeks- but that might not be cheaper. I may just hire a car and sleep in that when im out there or take a tent, might be cheaper.. desperate lengths!

[lboogie]

I just visited his clinic site....lots of lasik..........grrrrrrrr. Well if he makes dry eye, at least he's helping to figure out how to fix it.

Please keep us posted if anyone can ever try this!

[autumnn]

I am schd to see Dr. Toyos a week from tomorrow. I'd like to compile questions from this forum so that I can be as much help as possible to everyone who is interested in this treatment. Lets try to put together a master list of what we would like to know before I go and hope that this is an answer- or at least some help- for many of us.

[Lucy]

Hi AUTUMNN,
I wish you luck in your visit(s) with Dr. Toyos. I thought about one question you could ask him. He may not have an answer, but I'm wondering if this will work for those with bad dry eye who have Sjogrens. Sjogrens usually gets worse as time goes by and I think the eyes dry up accordingly. (I also have Lasik damaged eyes prior to dx of Sjogrens.) Lucy

[stephgurl1986]

wow, this sounds VERY intersting. I would love to try this therapy...and to be honest I think it would work for me.

I'm skin type 2 I believe (but a lot closer to 3 than to 1)...So I think I would have to go there during winter.

1500$ seems okay to me - why do I have to live a 12hours flight away?

I'm interested in what Sazy said about having the treatments within a shorter time and make a holiday out of it, because obviously I couldn't fly to L.A. once a month (imagine the horror for your eyes to fly 12h once a month, aside from the costs).

So he says he has treated so many patients - where are they? Nobody from dryeyezone? It seems like these patients only had a mild form of dry eye...

[Philipp_from_Germany]

Ipl

Thanks for sharing this essay Sarah.

I have been observing Mr. Toyos' endeavours for a few years now. This might become standard treatment for the "regular" dry eye patient one day. (Which is a medium scale MGD patient btw. "Hello, long time contact lens users...")

It does sound a bit too optimistic though. Raises one biiiiig question:

"To my knowledge, no one besides myself is using this technique."

WHY?????????? Pure ignorance? I can tell that exists being a scleral lens user.The german medical community just blindly ignores this fine instrument as treatment for dry eyes (did save my life though..). So I strongly believe in "mechanical" approaches lie this (as opposed to drugs) to resolve our "condition".

Good luck autumn - keep us posted!

[sazy123]

Thanks for sharing this essay Sarah.

I have been observing Mr. Toyos' endeavours for a few years now. This might become standard treatment for the "regular" dry eye patient one day. (Which is a medium scale MGD patient btw. "Hello, long time contact lens users...")

It does sound a bit too optimistic though. Raises one biiiiig question:

"To my knowledge, no one besides myself is using this technique."

WHY?????????? Pure ignorance? I can tell that exists being a scleral lens user.The german medical community just blindly ignores this fine instrument as treatment for dry eyes (did save my life though..). So I strongly believe in "mechanical" approaches lie this (as opposed to drugs) to resolve our "condition".

Good luck autumn - keep us posted!

In an email to me he said that he was in the process of rolling out training of othmalogisits. I am still sceptical but if it actually does what he says for MGD i can see this becoming a standard treatment for MGD, for one thing there is money in it which will make othphs much more interested in treating dry eye and wanting to diagnose MGD. Currently treating dry eye takes up time and there isnt much money in diagnosing and treating MGD.

[sanna]

why canīt the red veins just go away

Atummn,

I have a few questions. Why is he the only one useing this ipl? Like Phillip in Germany said. (I do not think that the German Doctors just ignors this, or the Swedish, there must be a reason. But I wish thats why i did not know about this) That is what you are going to visit Dr Toyos for right?
What about your vision?, I mean when they do this ipl thing, and can the the white part of your eye melt? Maybe I am just beeing stupid.

I hope that the ipl thing works, I really do. Maybe it will come to europe one day, or maybe I will do this prygium surgery instead for my ugly veins...

[autumnn]

OKAY all I am going today at 2:30...please post any questions ASAP and I will try to get the scoop for us!
Autumnn