Kami, you're absolutely right. There are pros and cons to every procedure, and ultimately each person is responsible to determine what's best for themselves. Unfortunately probing is more invasive than IPL, LipiView, expression, etc., but it appears it is the one, if not the only procedure, that currently can get through scar tissue inside the glands. I guess if you feel confident that's not your situation, then the other options might be all you need. It's just that often one does not know they have scar tissue in there, like me, until the probing was actually done.
It will be interesting to see how many doctors in the UK and outside USA are on Rhein's list.
That link you posted was terrific detail from a doctor explaining MGD and what to expect from the LipiView consult, thanks for sharing it. When I had LipiFlow several years ago, my specialist did not provide all that info on what my glands looked like, issues with my blinking, etc. If he did, I may not have done Lipiflow and be out $1,200. Maybe over time information has increased. Also, there was not much info online available at the time on what I should have expect at the consult. But it can also show the depth of the consultation and communication between specialist and patient can make a huge difference in the success of the procedure. And sometimes despite this, it still may not work as our conditions are not all exactly the same and this is a complicated disease.
MGD1701:
If you end up doing the probe, you might consider having someone ride the train home with you. After one of my five procedures, my eyes were pretty sore that afternoon, so my husband had to help me get around. The other four times was fine, but you never know.
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Interesting read I found elsewhere on the forum. Partial blinking has alot to answer for! Good breakdown of lipiflow.
http://www.dryeyezone.com/talk/forum...nd-Evaluation=
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Wow. Very interesting from all, thank you. Seems like there are pros and cons for all treatments, lipiflow, Ipl, probing and so on. I guess we've all got to go what we feel is best. Interesting point re poor quality oil. I've been told my oil is ok but would be interesting to know how bad quality oil is defined. -
Hi
I plan to do probing/BlephEx etc shortly which takes 3.5 hours one way.
I hope my eyes will be fit enough afterwards so I can return home ALONE by train at night.
I visited 10 doctors and have learnt enough lesson.
Sometimes I feel I am a victim. Why? Because years of inadequately treated by these doctors
who just gave me wrong drops/ointments and incorrect/vague home regimen - only 2 doctors checked glands.
(no surprise some glands are gone for good and are short etc.)
Unfortunately, I just realize these NOW. Bad luck or being naive to trust doctors?
Only one doctor was 'honest & brave' enough telling me, ''Sorry, I can NOT help you'', on the second visit though.
Since then I start my own research/experinments each day!Last edited by MGD1701; 25-Apr-2017, 14:44. -
Here are some previous threads, unfortunately almost every person was recommended against probing or found it didn't help them, so it gives the idea that it's not often practiced or advised here in the UK, it's rather skewed to the negative side. Hopefully the list from Rhein Medical will show a different more positive picture.perhaps try reaching out in this forum by starting a new thread entitled something like "Recommendations for probing doctor in UK?".
May-2012 IPL/****** probing doctor in the uk or europe yet?
Apr-2014 Mgd probing in the uk also this other postirish eyes
Try Teifi James in Halifax West Yorkshire.
Sorry I have no details but I spoke to his secretary some time ago regarding suitability, costs etc.
My consultant has misgivings about it as a treatment so I have gone along with his views. My consultant (private) is not convinced that probing is safe and fears that damage might be done when the probe is inserted. He knows the man who performs the procedure and has a lot of respect for him but cannot accept it is the route to take. That's not to say I wouldn't give it a go at some stage. I was shocked at how much it cost.
Apr-2012 dry eye and accutanelizlou29
David O'Brart at Guy's at St. Thomas' in London does it. I went for a consultation with him and he didn't recommend it for me. [...] He said he could express the oils when applying pressure, the oil is just of bad quality so I need to work on that. [...] He felt 10 days of Azithroymycin antibiotics would improve it even though I'd been on Doxy before with no benefit. I emailed him with an update as to how I'd got on at his request with no response. Appointment was £200 and I was there for 20 mins incl. 5 mins Schirmers test. I don't know anyone locally to you that does it. Someone else on the forum had seen David O'Brart with good results and had the procedure but I can't remember who it was, sorry. Hopefully they will chime in. [...] I know others have had great treatment from him and he lectures at conferences etc so I assume he was having an off day!
Oct-2016 MGD probing expression in the UKApr-2012 macio1981
Firstly I found a new ophthalmologist based in London called Mr David O'Brart. He is a very experienced and qualified surgeon and he performed Meibomian Gland Probing on my glands to try and free them up and get the oil moving better. Again...this did not help noticeably. He also prescribed Azithromycin orally (have tried Doxycycline but no good and terrible in the summer) tea tree oil face wash and prednisolone eye drops but again I still could not get proper relief.
No response:Angela810
Has anyone had experience with MGD probing/expression in the UK. Was the experience good or bad? Is there a doctor that you can reccommend? I'm quite worried to take the risk with this. Although I'm guessing that if done by an expert the results could be good.
dnivara
I m not from the UK. I got probed by Dr ****** who is supposed to have invented the technique. My eyes felt worse within a day. The progress that I had made with my eyes over a year got wiped out, which was quite depressing. I dont know if I have scars or what exactly happened that made my eyes worse - Dr ****** wouldn't tell. There are people in this forum for whom probing has helped.
Angela810
So sorry to hear that it made you worse I hope it's back to normal now.
I seem to only read major success stories about probing. My doc also is a bit cautious about probing because he feels it would cause inflammation that would make the MGD worse.
Maybe that's what happened with you? Hmm I think I may try expression for a while longer to see if that improves things. If that doesn't work, probing will be my VERY last option.
Sep-2013 Has anyone in the uk been probed?
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Thanks Pythonidler. I recall you did something similar to identify IPL doctors several months ago.
Next week I'll give Rhein Medical a call or send them an email requesting the list. Once I get it, can make it available in this forum. -
Hokucat, that's a great idea about contacting Rhein Medical. If I need probing again in the far future and I can't do it with my current doctor, I'll make sure to contact them. -
Kami, perhaps try reaching out in this forum by starting a new thread entitled something like "Recommendations for probing doctor in UK?". You could also check if your current doctors know someone who does it.
We could also contact Rhein Medical, who manufactures and sells the ****** Probe, to get a list by location of all the doctors offices they sold to, the contact info, and how much they sold each doctor to-date. I got a list like this from them four years ago, when I was looking for a probe doctor. Using this, I identified several doctors relatively close to my area who purchased the most, surmising those who bought more likely had more experience doing the probes. Then I'd call those doctor offices to ask approximately how many probe procedures they performed so far, looked at any reviews they had online, and that's how I ended up going to my two probe doctors. There's others in this forum considering probing, so the list could benefit them too.
If you could go to Florida to see Dr. ****** who created the probe and the procedure, that would be the ultimate! Plus he has a great reputation as a dry eye specialist in general.
When I called to make my first appointments with each of my two probe doctors. I told them I was coming from far away, so wanted to have both the consult on probing and the probing procedure done that same day, if I was a good candidate. Both accommodated me, so just a thought if you end up going somewhere far. -
Yes, I think MGD1701, Pythonidler, and I all agree probing could be a good first option, especially given all three of us had LipiFlow, it didn't work for us, and it was very expensive and not covered by insurance. As I wrote earlier, doing probing first would clear any scar tissue and other blockage you may have in one procedure, and then you could maintain it with periodic LipiFlows, expressions, diet changes, etc. The downsides are probing is more invasive, and is not yet practiced by as many doctors as LipiFlow and IPL, so it may be difficult to find a doctor near you. The up side besides clearing everything up front is it might be covered by your insurance...mines covered all but 10% of the probing costs.
Of course we are not your doctor, and your situation might be that you don't have any stubborn blockage or scar tissue inside the glands that LipiFlow cannot address. I think we all just would hate to see you spend all that money up front and it not work, like we did! -
Kami,
Have you ever had manual expression before? This is a really cheap alternative to Lipiflow. Probably not as effective since it doesn't involve heat, but something that's probably worth trying before Lipiflow.
I understand about probing not being widely available - as far as I know only a few doctors in the States do it as well. I live in Seattle and had to fly all the way to Boston to get it done. Were there other doctors closer than that? Probably, but I still would've had to take a plane to get there.
Cost and distance traveled aside, probing was a big help for me. None of the IPL treatments I'm currently on would've been effective without probing. -
Hi
The usual lid scrubs and heat compress twice a day. I'm in the UK and probing is very difficult to find. Very few do it!
The strange thing is I can express oil without heat quite alot of the time by applying a little pressure ( more than a blink). I've tried this with the anterior nasal glands and seems to work but not much comes out with just a blink! It's all very confusing! -
Hi Dryeyekami
Just curious what treatment recommendations your doctor made, their order and home theraphy?
If I were you, my order would be: 1) probing 2) LipiFlow for better results, based on my experiece/learnt/read. -
Oh and my oil is normal not thickened apparently so all I can think it is is blockages! -
Hi
capped means (I think) that there's blockages where the glands open up into the eyelids. Maybe thickened oil that's accumulated and is now building up. I'm hoping lipiflow will melt the accumulated oil and break it out so to speak before the glands become even more dilated and get to a point to where they start to scar over
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Yes Kami, the sooner you address it the better. Thanks for summarizing your LipiView findings. Maybe ask what the "slightly capped appearance" might indicate.
It sounds like you are planning to do the LipiFlow since IPL is not an option. I do hope it works for you, let us know how it goes!
