LipiFlow device - what the????

[MGD30]

For me, when I went to see a specialist; manual expression was done as a way to gauge how blocked my glands were and how thickened my oil was. It was not a substitute for Lipiflow or IPL. I have never had IPL performed but I have heard that manual expression is done in conjunction with the IPL in order to remove the old oil from inside your glands (the Lipiview machine does this by itself).

[Minni]

Uh, you know more than me, since I just perfunctorily researched MGP, but not yet "expression". You're lucky you're in Florida. When I contacted the main office in Florida for a referral, as well as asking the cost of MGP, he just suggested I come down there, and phone his office re: costs. I'm not in a position to do so. So that'sthe end of that. I keep learning that genuine help, either surgical or stem-cells, is mostly within the grasp of those who still have lots of energy, support & means left. As for me, I've long been drained by life, society & weather. I need to weigh the odds in the balance. A non-guarantee is just not worth for me the expense & travel-hassle.

P.S. There's so many parallel type experiences all over the web. For example, debates between MS patients "should I get the CCSVI procedure for stenosis" or opt for the real thing (stem cells)?
With dry eye patients its "should I get the MGP procedure for XXX" or opt for...whatever...
That's why I sorta laugh-in-a-tragic-way that everyone remains so compartmentalized in their cubby-hole hidey-holes - not knowing that other patient-groups have parallel type issues.
common denominator culprit = our lovely non-encompassing systems & mindsets

[JJdryeye]

Can anyone explain to me where Manual Lid Expression (by a doctor) falls in the grand scheme of things when comparing this procedure to some of the other meibomian gland treatments such as probing and Lipiflow? Would Lid Expression be a better first choice/first try when it comes to addressing blocked glands? Is it effective? I'd love to hear some of your experiences with this and whether or not it helped you. It's not as inexpensive as I thought, so I'm carefully weighing my options at this point and would much appreciate your input.

[Jelena Ristic]

You never know. If you have the insurance to cover testing for lymphoma...why not to get it off of you mind. Rare as it may be...it's scary. I know. I had a chalazion that turned really messy years ago and looked just like a cancerous one. It turned out to be nothing...but, it's hard to take it off of your mind unless you know for sure. As for food allergies...gluten and dairy are big ones, but it could be others too. I had no CLUE I was very allergic to pineapple, garlic and ginger for example. I used to use garlic and ginger in cooking a lot. It's really hard to get to the bottom of, but all you can do is keep trying which is a pain for sure.

[Leah]

Hi Jelena,

I'm sure you're right that I need to find the underlying cause of my blocked glands. I have considered food allergies and even went gluten-free, dairy-free, etc. for a period of time, to no real effect. I have not tried testosterone and I will bring that up at my next appointment. I have seen a number of dry eye specialists who haven't found the answer yet. In fact, my eyes got so bad during Xmas vacation in Miami (I'm from NYC) that I ended up in the ER of Bascom Palmer Eye Institute. They gave me a thorough examination, took a culture, and gave me a course of antibiotics both oral and eye ointment just in case. The culture turned out negative for all manner of things including chlamydia so of course the antibiotics had no effect. They mentioned that lymphoma was a low differential and I should have a biopsy done on my eye (without being specific about what kind of lymphoma or biopsy on which part of my eye -- but I assume conjunctiva?). However, other doctors I've consulted are all less alarmist, pointing out lymphoma of the eye is VERY rare. I have zero other symptoms and recent blood tests show nothing systemic, but I've read that lymphoma sometimes appears in the eye months or years before appearing elsewhere in the body, and that because it is so rare and masquerades as many different ailments, it often takes up to two years to diagnose. Needless to say, I'm approaching panic. I am seeing a top doctor in NYC this week, then go back to Miami for a follow up at Bascom Palmer, then come back to NY for a 3rd opinion. Hopefully, I'll get some answers. But thanks for your suggestions. I'll definitely check into the testosterone possibility. What a relief it would be if that were the problem!

[Jelena Ristic]

Hi Leah,

It seems to me that the blockages of your meibomian glands are your main problem if Lipiflow worked at all and well. The problem is finding out why your glands are getting blocked up in the first place. You mentioned menopause as a trigger. Have you considered bioidentical hormone replacement therapy? Your problem may actually be lowered TESTOSTERONE. It exists both in men and women and declines in both as we age. There is also diet. Food allergies... I had them without any clue I did. They were a major cause of inflammation in my body and my eyes. The thing with Lipiflow or MGP is that it can clear glands, but it doesn't address the underlying causes of why they are being blocked in the first place. Once you find the causes and then have the treatments, you have a much greater chance of prolonged success. Have you tried taking fish oil or flax oil to help improve the quality of the oil in your meibomian glands? Have you actually seen a DRY EYE SPECIALIST who might be able to help you isolate causes and tell you exactly what type of Dry Eye you have? I'd try all these routes to see if they might help.

[Leah]

Hi Jelena. The cause of my dry eye was never actually determined. Both the quantity and quality of my tears was poor. I had my tear ducts blocked and then unblocked. I was tested for Sjogren's and other auto-immune diseases but my blood work was completely normal. Before the lipiflow treatment I was using Restasis twice daily over a couple of years. I also used Alrex and Lotomax at various times. Since my dry eye seemed to have started after menopause, I even tried Estradiol in eye drop form. I also used over the counter sterile tears such as Bion and Retaine MSG as needed. Nothing really worked. After the lipiflow treatment, my eyes totally cleared up for several months. I used only Alrex and a Bruder mask for 5 minutes in the morning and at night. I also used Retaine MSG as needed and cleaned my lids with Ocusoft Plus lid scrubs or sterile eyewash on a q-tip. My eyes were no longer red or irritated. I felt great!! Then, I stopped using the Alrex and over the period of a week, my red eyes were back, but even worse than before. Over the last three weeks they have become increasingly painful and irritated. I tried going back on the Alrex, but it didn't help. Then I was prescribed a combination of Bepreve and Prolensa -- no reaction. I was looked at for uveitis but told my inner eye was healthy. I've just finished a course of Tobramycin in case it was bacterial -- but no effect. My eyes feel worse. I use Cetaphil to clean my face and Nia 24 face cream but since this last round of problems have not used anything near my eyes, including make up. To my knowledge, I have no illnesses and except for my eyes I feel healthy and energetic. I've begun to wonder about other diseases like scleritis, but if I have it, it's in isolation because again, my only physical problem is my eyes. So that's my history. If it gives you any insight, I'd love to hear it. Thanks.

[Jelena Ristic]

Leah, Can I ask what other treatments you've tried, what kind of dry eye you've been diagnosed with and the causes of your dry eye? Do you suffer from any illness, and are you taking any medication or using any kind of face products regularly for washing your face, treating wrinkles or acne? It's very important you know what's causing your dry eye before you choose a treatment. I've done loads of research and their are dozens of treatments available, so I'm curious to know which you've tried. I might be able to suggest something. I am a dry eye patient too and I've been doing years of research on it with the concept in mind that if you can't nip all the causes in the bud and tailor treatments to address causes and not just symptoms, you're not going to get very far. It's what helped me control my Dry Eye...this kind of focused approach. I do have minor flare ups, but I always know what's causing them, so I can address them right away before things get out of control.

[Leah]

Thanks for your input, Spoon. My doctor has manually expressed the glands and while the MG excretion isn't perfect, it's pretty clear. The doctor has also debrided my lid margins several times with a special tool. Plus I've been using a q-tip with sterile eye was on my lid margins as well. Nothing helps. I have no unusual secretions or stickiness. Just redness and pain/irritation. I'm starting to wonder if I might have scleritis??? Do you know anything about that?

[Spoon]

Hi Leah. If you're sure that the redness and irritation is not due to a return dryness then one possibility is that Lipiflow got your glands producing more oil, but the oil is not normal meibum - it could be altered and irritating your eye balls. Have you or your doctor manually expressed the glands to see what the MG excretion looks like? - it could be free flowing but yellow, opaque or foamy. If the MG secretion is clear then it is less likely that this is the problem. Being a steroid the Alrex would probably have masked any inflammatory pain and redness this causes so it may have been like this since Lipiflow. Although its strange how going back on the Alrex didn't help. It could be that the inflammation following removal of the steroid blocked up meibomian glands, though you say dryness isn't an issue now. As a first suggestions I would try heating a small amount of salt water, dipping a q tip in it and running it along the lid margins each evening (covering the the inner edge of the lid margin where the MG orifices are). I find this helps improve the quality of the oil I am producing (which is unfortunately not a lot for me at this stage) and also provides gentle debridement of the lid margin.

[Leah]

This was almost a success story... After several years of dry eye syndrome with no relief from any treatment (and I tried them all!) I learned about Lipiflow in this forum. I found a doctor in my area who had the equipment and after ascertaining that I was, indeed, a candidate, I had the lipiflow treatment. The results were almost instantaneous and miraculous. Within a week, the redness, which had been a constant for years, was almost entirely gone and so was the constant irritation. With daily compresses using a Bruder mask, Alrex drops once a day, and Retaine MGD as needed, I was able to maintain my eyes in excellent condition for many months. Then, because of a spike in the pressure in my eyes, my doctor advised me to try to stop using the Alrex. Within a week, my eyes became red and irritated again. I went back on the Alrex but to no avail. I tried a combination of Bepreve and Prolensa -- also didn't work. I've been checked for uveitis and been told my inner eye is healthy. My ocular surface is also moist and shows no damage. I don't have herpes or rosacea. I've been on Tobramycin but it's made no difference, so obviously, I don't have a bacterial infection. My eyes keep getting redder and more painful but none of the doctors I've seen can seem to figure out what's wrong or what to do about it. Has anyone else had a similar experience? Does anyone have any suggestions about what it might be? Any and all advice would be greatly appreciated. Thanks!

[Nightbird]

It helped me a lot. I had it done at the beginning of April. For the first few weeks I felt no improvement, but by the beginning of May I was 90% better. At the beginning of this month I started to feel some symptoms again. Nothing like the way it was before the first treatment, but I decided not to wait until it got really bad again, so I had a second treatment. The first time I paid $1500, the second $1000. So the cost is coming down, at least in areas like mine where there are many sites and therefore a lot of competition. For me Lipiflow is cheaper than not being able to work. I could not do so before the first treatment, and wearing MCs at work is not an option, I have to meet with clients often and my boss would tell me to go home rather than alarm them. Nor is wearing sclerals all day. I can do it when I have to but I know it’s unwise to wear them every day for more than 6 hours. I also believe Lipiflow will be covered by insurance, although not for anther 3 years or so. I would have posted about this sooner, but felt I couldn't really say it worked unless i got at least 6 months out of it, b/c of the cost.

[Lacrima]

I had it done when my MGs were very blocked.

Unfortunately no improvement for me- short or longterm.

I agree with above comments and would try it again if my symptoms were mild.

[Murphy321]

This is very discouraging

[Max52]

I had no success with either. I did lipiflow 3 times and nothing. The doxy I did for about 5 months and it didn't help at all.

Did you have lipiview all three times as well? Did those results show any improvement?