LipiFlow device - what the????

[Dryeyekami]

Hi mgd

I guess my home routine is pretty much the same as everyone else's. Eyelid cleaning using blephasol and heat compress for 10-15 mins using the eye doctor mask. Hylo forte drops with Vita ointment on a night.

My oil seems ok when I use compresses, reasonable consistency. It just stops flowing once the heat wears off!

In terms of diet I take Omega 3,6 flaxseed oil, vit b and d to improve oil quality

[MGD1701]

Hi Dryeyekami
I would love to know details too including home regimen, if possible, so we all could learn something (purpose of this forum??).I am sure it is ok since many others share such info here too - if you have concerns, no need to mention name of the dr.

Gland open has nothing to do with production of oil, I guess. My problem is thick oil - when I do Blephasteam/42.5C, no/hardly secretion feeling - I told dr who had no solutions nor told my oil is thick. Later I found out, I need about 44C (but bad for conera). Now I do 15 min. (instead of 10 min as instructed by doctors).

You mentioned your glands do not produce oil, possible reasons: inefficient omeg 3, hormon, etc?? I think it is wise to sort this out first, otherwise LipiFlow still is not helpful??? What did your dr recommend??

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Hi Hokucat
I requested probing/BlephEx and the nurse said first consulation. I assume they will combine it, like they did to my friend who highly recommended the dr. I hope the (11th) doctor will do properly (expression first etc). Lastly, I can not tell you how much I admire you to find a doctor who cherishes her reputation and is serious about her profession. Thanks again for your help/info!

[Hokucat]

Hey MGD1701. Whether the doctor probes all or only the problem glands depends on you doctor, and probably if they have a preliminary procedure to determine which glands they probe.

Right before doing probing, my doctor first does gland expression, which I think you refer to as lid margin debridement using a golf club spud? She said she does this not only to initially clear glands of oil blockage and check oil quality, but also to see which glands have nothing excreted. The ones with nothing excreted are the priorities for probing cause they likely have scar tissue, stubborn oil blockage, or could be permanently closed/atrophied. I think she still did probe some glands that had oil excreted, but for me these were few. Plus all those tiny glands all in a row, not sure how she could keep straight exactly which ones excreted nothing!

Do you plan to go for the probing consult to see if you are a good candidate on a separate trip PRIOR to the procedure, or are you going to set it up for the consult and procedure on the same day, with the assumption you will be a good candidate? To save me a trip, I was able to do the latter for each of my two probe doctors the first time I went to them. If you tell them you're coming from far away, sometimes they will accommodate you.

Sounds like you and I had the "marginal" LipiView doctor consult :-(

[Dryeyekami]

Mgd- when you say glands are open do you mean that they are producing oil?

[Dryeyekami]

Hey Phoenix. Yes they check blink rate, lipid thickness, do a full meibography and check lipid secretion from glands. They're the cheapest I've found for lipiflow also. No pressure to buy the treatment either.

ill pm details as not sure u can post here.

Basically all my blinks were partial, lipid later was thin, no atrophy but slightly dilated capped glands so little oil was getting out

[PhoenixEyes]

Phoenix... You're in the UK also I assume? If so there's a place in Manchester that does free lipiview evaluation...That's where I went. I can give you the details.

Hi, Yes I'm in the UK too. I'd love the details, thank you. Do they also do meibography to check if any have atrophied?

[Dryeyekami]

Mgd I've been told I don't have much debris on my kids but yes you can have blephex done in the UK. I only have a little blephiritis

[Dryeyekami]

Phoenix... You're in the UK also I assume? If so there's a place in Manchester that does free lipiview evaluation...That's where I went. I can give you the details.

Compresses seem to work for an hour or so for me. After compress I see oil but then stops. I'm assuming compress loosens / softens the blockage but never actually removes it. It then hardens again limiting oil flow.

[MGD1701]

Hi, BlephEx is also an alternative, if probing is not possible. It is cheaper too. I think it is available in UK.
In USA, some doctors do Lid Margin Debridement (by gulf cub spud – to remove material enabling secretions from glands to spread across the ocular surface, for a smooth surface to distribute lipid/blinking, accordingly to Dr Korb). My Dr said BlephEx can deal this issue, if dr performs properly.

[PhoenixEyes]

I also found out how (from different sources): Warm compress (as often as possible) - it works for me.

This is what the NHS in the UK also suggests for MGD. Doxycycline may also be used in rare cases, but primarily warm compresses. Sadly probing isn't yet approved on the NHS here. I've tried warm compresses with a microwavable grapeseed bag 2x and 4x a day for some months but no luck yet. It's definitely a good idea to keep up with it though, no downsides to it.

[MGD1701]

Hi
My dr also did NOT provide info on glands details and detect incomplete blinking issues (even I spent money on LipiView) etc. when I did LipiFlow last year.

Scar Tissue - I have been curious and luckily found an article from Dr Sandra Lora Cremers, MD, FACS, under title, ''How to clean Eyelids/lid hygiene'': ''The hypothesis is that debris (ie, old cell, bacteria, mites, makeup) clog the meibomian gland orifices which then prevents the meibomian gland from pumping out its oil. This leads to a back up which can then lead to a *stye and eventually a chalazion in the eyelid: sometimes there are multiple ones of these. If not cleared quickly, this gland can scar permannently and never produce meibum (the precious oily part of tear film) again.!''

How to get ride of *stye (or watering eyes)?
I also found out how (from different sources): Warm compress (as often as possible) - it works for me. Dr Cremers has a demo in Youtube too.

Hokucat - thanks for the kind advice. My functional glands are about 66% and 75% and most glands are open, so I assume even I do probing, I dont need to do all??

[Hokucat]

Yes, one could analyze this to death and still make the wrong decision! But I see your reasoning that you have not had this for years like some of us so may not have scar tissue, and you do have some oil which many in this forum would love to have. Good luck with whichever route you take, and let us know how it goes.

[Dryeyekami]

I guess for us all the golden chalice is the reason why we have mgd!

[Dryeyekami]

I'm sure inflammation plays a role also.... But it's chicken and egg

[Dryeyekami]

Hey hoku. Agree completely re scar tissue. My thinking around my situation is.... Relatively recent mgd. Oil quality ok... No atrophy...Glands slightly dilated and capped. I can still squeeze oil out with a little pressure without heat suggesting (I think?) Small blockages which are resulting in not enough oil being released....

The blockages....As my glands appear capped I think these are hardened meibum. In terms of scar tissue....Again my thinking....As I've not atrophy and no obvious damage to glands other than dilation/ capping ....Scar tissue would not have had time to build up just yet.

I could of course be completely wrong!