LipiFlow device - what the????

[ltree]

no. u need to get prescription from US dr AND fill it in the US. canadian pharmacy wont have xiidra. u can fill it in costco usa, if u have canadian costco membership, itll also work in the us.

I see. It makes more sense what you said - thanks.

[deep_dry_eye]

Wow, I really hope the price will be reduced soon.

Just to be sure I got it right - if I can get a prescription from a Dr in the States, I can have it filled at a Costco in Canada?

uptowneye.ca has IPL -- you might wanna give that a try as well. First IPL clinic that I know of in Toronto.

[deep_dry_eye]

Wow, I really hope the price will be reduced soon.

Just to be sure I got it right - if I can get a prescription from a Dr in the States, I can have it filled at a Costco in Canada?

no. u need to get prescription from US dr AND fill it in the US. canadian pharmacy wont have xiidra. u can fill it in costco usa, if u have canadian costco membership, itll also work in the us.

[ltree]

At Costco, Xiidra costs $545.53 for 60 vials (1 month supply). An optometrist visit costs around $60? I was in California so I can't help you for close to Toronto... sorry.

Wow, I really hope the price will be reduced soon.

Just to be sure I got it right - if I can get a prescription from a Dr in the States, I can have it filled at a Costco in Canada?

[deep_dry_eye]

I see.. So, is there any optometrist that you'd recommend in the States for this purpose then? I am hoping to find someone who can be reasonably close to Toronto, in Buffalo etc.

Do you mind if I ask how much it cost you? Thanks again!

At Costco, Xiidra costs $545.53 for 60 vials (1 month supply). An optometrist visit costs around $60? I was in California so I can't help you for close to Toronto... sorry.

[ltree]

You are right, it is not approved yet in Canada. You might be able to get access to it for free via Health Canada, but I am not sure of the procedure (i.e., I am guessing since some Canadians can get Azasite; Xiidra must be similiar).
As for myself getting Xiidra, basically what you have to do is see an optometrist in the USA and ask for a Xiidra prescription. Then goto say Costco to get it filled. It is not cheap.

I see.. So, is there any optometrist that you'd recommend in the States for this purpose then? I am hoping to find someone who can be reasonably close to Toronto, in Buffalo etc.

Do you mind if I ask how much it cost you? Thanks again!

[deep_dry_eye]

Hello DDE, I hope you find something useful in my other post.

Could you tell me where you got Xiidra prescribed? I am told it is not approved yet in Canada and who knows how long it would take. After reading some comments at DEZ, I really want to give it a try as I have barely any tears right now, even with punctal plugs (lower). Is it possible, for example, to travel to the States and get a prescription filled?

Thanks in advance.

You are right, it is not approved yet in Canada. You might be able to get access to it for free via Health Canada, but I am not sure of the procedure (i.e., I am guessing since some Canadians can get Azasite; Xiidra must be similiar).
As for myself getting Xiidra, basically what you have to do is see an optometrist in the USA and ask for a Xiidra prescription. Then goto say Costco to get it filled. It is not cheap.

[ltree]

Hello DDE, I hope you find something useful in my other post.

Could you tell me where you got Xiidra prescribed? I am told it is not approved yet in Canada and who knows how long it would take. After reading some comments at DEZ, I really want to give it a try as I have barely any tears right now, even with punctal plugs (lower). Is it possible, for example, to travel to the States and get a prescription filled?

Thanks in advance.

[MGD1701]

Hi LHeston

InfammaDry Test:
Woo, seems the test is great. Do you think it is more accurate than the examindation by slit lamp?
Did your dr dectect sources of infammation?

[LHeston2]

You might want to also try Restasis as well. I have MGD and Xiidra didn't help me (but I was only on 2 month trial). You can go on both Restasis and Xiidra, esp if your insurance covers it. Restasis (while only works on some 15% of the population) has slightly more literature behind improving MGD if there is an inflammatory cause. You might also want to go on doxy to thin out the oil as well, even if there is no visible inflammation.

Thanks, I am considering Restasis, but I worry about how long it might take to start working. I did not think of doxy, so I could try that.

[LHeston2]

Hi
aqueous deficiency
Have you taken Sjö Diagnostic (blood) Test (Bausch + Lomb)? to detect biomarkers for Sjörgen’s syndrome/SS?
The test is a valuable diagnostic tool & the advantage is it can detect SS 4.5 years early than the traditional test.

effective Lidhygiene is important for MGD.

LipiFlow helped me opened ALL glands and 3 doctors said I did not need probing.
if your glands are blocked and nothing come out - good to find out WHY? inflammation or scar tissue (probing helps this).
If you have inflammation - very important to put it under control as it makes glands worsening.

recent study shows a combination of Omega 3 + 6/GLA are more effective. I am trying this now and seems that is the case.

Inflammation: did dr do InflammaDry test to make sure you do not have (or low) inflammation before putting plugs?
''The test has been shown to significantly and positively correlate with corneal fluorescein staining scores and abnormal superficial corneal epithelia as seen with confocal microscopy.'' ......By Mark Schaeffer, OD January 1, 2017'', for your info.

Thanks so much. My doctor recommended the Sjo blood test, so I actually just did it yesterday and am waiting on results. (My doctor herself has Sjorgen's Syndrome.) I am doing occusoft hypchlor spray 2x a day for lids. I am taking Omega 3 oil. Inflammadry test was strong positive in my right eye and positive in left. I had Schirmer's 5mm and 6mm and then grade 2 MG atrophy in right and grade 1 MG atrophy in left.

[deep_dry_eye]

Hi deep_dry_eye. As I mentioned earlier, I am now focusing on addressing another unrelated eye problem, since my dry eyes have become very manageable and are no longer uncomfortable. So I have been seeing retina specialists for this other problem, who are not focused on dry eye measurements like taking TBUT, Schirmers, and evaluating glands. And I don't feel the need to get these checked, because my eyes feel good now, plus I have my own more practical measurements which are better indicators for me to monitor my dry eye status.

Thanks -- I really wish you the best of luck. I'm already suffering so much from my dry eyes, and I can't imagine what you must be going through with your retinal problems as well. I am happy to hear that your eyes have improved so much (at least in terms of dryness). I hope your retinal issues will be fixed too. I am at high risk of retinal problems as well (i.e., high myopia and already lots of floaters and occasional flashes). I will pray for all of us that God will deliver us from these eye hardship.

[deep_dry_eye]

In office expression: did you feel better after expression?

When I do get it, no I don't really notice a difference.

[Hokucat]

Hi deep_dry_eye. As I mentioned earlier, I am now focusing on addressing another unrelated eye problem, since my dry eyes have become very manageable and are no longer uncomfortable. So I have been seeing retina specialists for this other problem, who are not focused on dry eye measurements like taking TBUT, Schirmers, and evaluating glands. And I don't feel the need to get these checked, because my eyes feel good now, plus I have my own more practical measurements which are better indicators for me to monitor my dry eye status.

I was home bound for several years because the extreme dryness was so debilitating. I couldn't do anything except sleep or sit around with my eyes closed all day, it hurt so much. I had severe photophobia, couldn't drive, read, use electronic devices, watch tv or go to the movies, go outside, go shopping, wear my sclerals anymore, be in a room with a fan or air conditioning, etc. It was like being in prison with my eyes being tortured all day long.

Now I can do all these things again, with increasing comfort and number of hours since the last probing plus starting the lemon/tea. I've been able to work my way up to wearing sclerals 12+ hours a day comfortably, can use electronic devices throughout the day, have increased the distance I can drive without discomfort, go shopping all day without a problem, go outside for a walk for several hours, etc. Being able to do these things with continued improvement is how I measure how well I'm doing.

When I recently saw my scleral specialist, she did her own usual observations and tests to evaluate the dryness, and it's not Schirmers or TBUT. She noted I had some tear film now, whereas before I got better I did not. She said the surface of my eyes are smooth now, before they were like sandpaper. She also did the fluorescein staining and said there was only a tiny dry spot on one eye, whereas before I had many dry spots on both eyes. For me, these were sufficient enough clinical signs showing improvement.

I know you really want to get pre/post probing statistics for Schirmers, TBUT, # of functioning glands, and meibum quality. ****** and other doctors have studies published online that have some of this info and more. Or you can also try asking others in this forum who have had success with probing, to see if they have any of this data. Here's an example of one study on the effect of probing on Schirmers and TBUT:

https://www.ncbi.nlm.nih.gov/m/pubmed/27032021/

[MGD1701]

Hi linguininess

Thanks for sharing. Good luck with IPL.

Do you feel better after stopping lid scrubs?
All I have read is, proper lidhygiene is a good way to prevent inflammation. Maybe you are a special case.