Thanks hoku. Makes sense! Just had a note through from the lipiview test..... Suggesting blockages are starting.... Might be useful to try hit the glands early before they get worse?
To summarise my findings the lipiview found that your Lipid layer thickness was reduced and you are a partial blinker. Looks like your glands are starting to become blocked resulting in less oil being produced. Although you still have most of your glands functioning there was some evidence of blockage and mild dilation. They did have a slightly capped appearance. Nothing too bad.
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Hey Kami. Warm compresses help thin or liquefy the oils. Likely your oils are a little thick, that's why compresses help you. But unless you find a way to improve the flow of your oil, it will probably keep getting blocked up.
Here's a link to an article that might be of some interest to you on this website that discusses compresses and some warnings about self expressing glands:
http://dryeyezone.com/encyclopedia/mgcare.html -
I'm doing the vit b,c,d, zinc, Omega etc so trying to stock up there! Also doing the green tea with lemon.... Compresses definitely help. I can see pools of oil after. Even now if I press hard enough (without compress) I can sometimes get a little oil from a few glands. Leads me to believe there's a small blockage somewhere given the pressure I'm having to use?
i don't understand compresses .... They release oil but the fact that mgd persists suggests that the glands just block again? -
Hi Kami. Ok, so IPL is not an option. When I did LipiFlow, it reminded me of a high tech warm compress for $1,200. If warm compresses help you, perhaps LipiFlow will help. It didn't help me, but I might have had some scar tissue at the time.
Some people find gland expression helpful to unblock their glands. You might also look into diet changes, which for me was the game changer to help my meibum flow and not block up my glands any more, after first unblocking my glands with the probe. -
Thank you! Ipl would be a no go for me as I've a darker skin type so can't have it done. My confusion is that the glands present fine with no. Obvious deep blockage etc. Yet they don't produce oil.... So is the blockage small and more at the surface? -
Hi Kami. Glad they thought your glands looked fine, with no obvious scarring. If your glands are blocked with thick oil or producing little oil, I've read about more success in this forum with IPL than LipiFlow, but it might also be cause LipiFlow is so expensive, not that many people try it. I recall Pythonidler who has done both said IPL cost less and may work just as well, if not better. I've never had IPL, I went directly to probing (which worked for me), so am not the best person to compare LipiFlow vs IPL. I'm sure Pythonidler can give you lots of advice on this.
BTW, probing would clear both scar tissue and blockage from thick oil build up in one procedure, if you're concerned you might have some scar tissue inside the glands that could not be seen from your exam yesterday. So another option is to do probing first, and then maintain it with periodic IPLs, 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 is it might be covered by your insurance...mines covered all but 10% of the probing costs, but covered nothing when I did LipiFlow.
Ok, good luck with whichever route you take, and remember to do your blinking exercises too! Below is a link to blink reminders from this website you can install on your computer. I recently set up an hourly blink reminder on my iPhone, because it's so easy to forget to blink and I'm not usually at my computer!
http://www.dryeyezone.com/reminders/Last edited by Hokucat; 18-Apr-2017, 18:44. -
Hi hoku,
Yes indeed lots of blinking exercises. She was surprised that all my glands were fine as was I. I'm going to try them over the next few days. She simply told me the glands weren't producing oil but not scarred or blocked over the top so yes potential scarring/ blockage internally but it hasn't caused duct swelling so maybe blocked right at the top of the glands openings?
I'm guessing lipiflow may help here as there are no major obstructions or atrophy?
Thoughts?
Kami -
Hi Kami. Your glands not producing oil and/or being blocked can definitely be the result of incomplete blinking or not blinking enough. So what did they advise for treatment? Did they tell you to at least do blinking exercises every hour? If not taken care of at some point, they can atrophy and permanently be gone.
How did they confirm there's no scar tissue? Sometimes the scar tissue is inside the glands and not evident from outside. -
So... Had my lipiview assessment.... Very bad incomplete blinking (almost all blinks were incomplete), scores of 42 and 28 but....All the glands look fine and normal just not producing oil. Maybe called due to all my incomplete blinking? No scarring and only 5 glands expressing oil.
So looks like lots of blocked glands.... -
Hey MGD1701. All good questions!
1) I'm not sure if I had scar tissue at the time I had LipiFlow, since my LipiView showed my tear film in low normal range and that was several years ago, so for me it's hard to say. But it makes sense if one does have scar tissue to resolve it first, otherwise LipiFlow, IPL, warm compress, diet changes, etc. likely will have little or no impact.
2) Since I've gotten better, I don't know if the scar tissue is still present or active, because it was only the doctors who did the probing who told me I had scar tissue. They were the only doctors who really examined my glands closely. I probably should go back to one of them to check this at some point. It hasn't been a priority since I've been doing so well relative to before, and my other eye doctors tell me the surface of my cornea and sclera looks good and I have some tear film now. As far as what causes scar tissue, I've read different theories, there does not appear to be only one cause.
Thank you for the Sjogren's video! I will take a look later today.
To start a new post, you can select the Forum you want it to be in, then select New Topic, then it will show Create New Topic where you write something, then Post. I think you will have a lot of good info to start your own posts!Last edited by Hokucat; 17-Apr-2017, 09:10. -
Hi Hokucat
Thanks so much for sharing as always. Curious to know
1) Do you think you could gain more relief/success if you did probing or took care of scar tissues issues before LipiFlow?
2) Scar tissues - Since you now feel much better, do these scar tissues still present?
Any ideas where these scar tissues come from?
Lastly, I found this viedo which you might be interested. I dont know how to post a new post. Could you be so kind to tell me how?
Sjogren's Syndrome: Beyond Dry Eyes and Mouth by Frederick Vivino, MD, 2016.Dec.
https://www.youtube.com/watch?v=COnBpgmNU6kLast edited by MGD1701; 17-Apr-2017, 06:16. -
Hi Kami. Your glands secreting oil from you self expressing is indeed a good sign like MGD1701 said, sounds like at least some of them are still open. Perhaps you have dry eyes because some of them are blocked with scar tissue or have thick oil like Pythonidler indicated, and other possibilities are some could be atrophied or the oil being secreted is flowing but of poor quality. Ultimately I had three of these...some with scar tissue, some with thick oil blocking the glands, and some atrophied.
The day I had the LipiView evaluation done about five years ago, it showed my tear film was on the low normal side. So the doctor said LipiFlow may or may not help me, and left it to me whether I wanted to proceed. I opted to do it, cause like all of us I was desperate for something to help me. Well for me it didn't work, I didn't notice any improvement at all. And when I had my follow-up LipiView, it showed my tear film was in the poor range. I do not recall the doctor taking any images of my glands, but maybe the process is different now.
Later I turned to probing. I had the procedure five times over two and a half years. Prior to each procedure, the doctor would do some gland expression. Those that secreted oil, the oil was very thick like Crisco oil, and were easy to probe. There were some that appeared to have thick crusted oil, which were a little more diffucult to probe. Several the doctor said had scar tissue, which were really difficult to probe, some of these could not be probed at all. Some glands I was told atrophied or too tiny to probe.
When they probe, they put a probe in one gland at a time. They have different size probes, for me many of my glands were on the smaller side, so the doctor needed to switch to smaller probes. Typically when the doctor successfully probed a gland, I felt a "pop". The doctor said this is because probing was like popping a balloon, so this was a good sign.
After each probe procedure, my eyes felt a little better, but they would soon start feeling dry again. I was constantly trying different things in my diet to help my eyes over the last several years, and happened to try fresh lemon juice in green tea daily, shortly after my fifth probe. After less than a week of the lemon/tea, my eyes started feeling less dry. That was in October 2015. I have continued the lemon/tea since then and my dryness has continued to get better, so have not needed another probe. I still have moderate dry eyes and probably always will due to those permanently blocked and atrophied glands, but it's more manageable now, mainly by wearing sclerals lenses 12+ hours a day.
So the trick after probing or any procedure like LipiFlow, IPL, expression, etc. that helps one open up the glands, is to also find something that helps improve the on-going quality and flow of the oil, and ideally try it soon after you get the procedure. That could be diet, medication, compresses, and/or other treatments. Otherwise if you get blocked up again, likely no diet changes or other treatments will work. I realize that's easier said than done!
Good luck on your appointment tomorrow!Last edited by Hokucat; 17-Apr-2017, 00:22. -
Hi mgd. I used lots of lighting and a 20x zoom mirror. Could only see the bottom lid glands. Many seemed to be secreting a clear oil although my lower lid margin did not necessarily look 'wet'. Not tried the uppers yet....
Compresses leave my eyes wet after expression. Not sure if that's oil however or just moisture? So compresses clear blockages but then the glands get blocked again and we compress again and so on.... Does the cycle ever end?? -
Hi pythonidler
Your doctor - Yes, please pm me the details. Wont hurt to have it, capable dr is hard to find. Thanks!
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Hi Dryeyekami
Congratulations on your clear oil - good sign. How can you see the oil coming out from glands, by mirror?
I can only see upper glands' with 20-zoom mirror - I am keen to know others approach.
I hope there is a way to we can 'monitor' if we perform warm compress & massage correctly since they are so important but I could not find anything.
Doctor instructions are either vague or different - sometimes even incorrect - so frustrating!!
Why you felt pain if you use 'gentle' pressure?? Did you do warm compress before massage?
PS - do NOT use oil-based drop 24 hours prior to the LipiFlow assessment or dr visit, if your dr has NOT told you so.Last edited by MGD1701; 16-Apr-2017, 02:08.