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  • So after a really miserable few months which have basically sucked all the enjoyment out of my life I'm left considering my options...

    I have seen six different NHS opthamologists and one private in the last few months. I'm not sure what has suddenly caused a flare up in this condition that was fairly mild (more of an inconvenience than life-changing) up until February this year but on my last visit to the eye clinic 4 days ago the consultant actually stated that the MGD is very severe. He showed a family member who came with me how the MG's look when he pressed them (obviously I couldn't see the screen myself) and it was described as a yellow glue like substance. I also have AD. At present I am on Doxycycline 100mg once a day (have been for 5 weeks), I take flaxseed oil and fish oil daily. I have a problem with warm compresses as I have ocular rosacea (red eyelids) and they seem to aggravate my eyelids. The consultant said if it's really an issue I should try a facial steamer then lid massage. I said that this will cause a flare of the rosacea on my face and he said yes but you may only be red for an hour or two after, he didn't seem to think this was a problem even though a flare is painful and my MGD is caused by rosacea (well I assume it is) and if the rosacea gets worse wouldn't the MGD? (who knows I guess). Anyway he wanted me to try cyclosporine again, I stopped it as it made my eyes more sore but he said that would go after a month or so, I'm still hesitant. He said no to Aztyer (I kept asking) as he hasn't seen enough evidence that it will help. As understanding and personable as he was he said I need to find an eye drop I get on with as then I can just drop every couple of hours and go about my day as normal, wow wouldn't that be nice. Sadly I'm in pain everyday no matter what drops I use, this has taken over my life and wakes me at night so I get no respite. My work is suffering as I keep taking time off. I have insomnia anyway but it's got worse because of worry over my eyes as well as the pain keeping me awake. I have no social life now, I used to love going to the cinema, for dinner, shopping but can't do any of those things now.

    So.....although it is eating into our savings I've booked an appointment for a Lipiflow consultation. I have changed my mind about 10 times as to whether I should go ahead with it or not. If it could provide me with 9 months of relief then I wouldn't have thought twice but reading reviews from others on this forum it seems that it is a bit hit and miss, i.e it helps for a few weeks, a few months, no difference and for one person actually caused damage. There are of course a couple of people who have joined the forum, said it's amazing and where they had it done and never posted again, I choose to ignore those ones as I am naturally skeptical! I fully expect to go to the consultation and they will say I am a perfect candidate as they will be wanting to recoup the money paid out to get the equipment into their clinic. I told the receptionist I have punctal plugs and rosacea to check if that is a problem and she said they will go through all that in the assessment. Well I don't want to pay for the consultation only to be told I am not suitable for the treatment because of something I could have told them about before they examine me.

    I guess my thinking is that if I have the treatment, carry on on the doxy and keep improving my diet then I'm doing all I can to help myself. If i don't then I will be left wondering. If anyone who has had the treatment could comment on whether they felt it was worth it I would be really grateful.


    • Almondiyz
      Almondiyz commented
      Editing a comment
      Lipiflow...What is it REALLY supposed to do!? Help pls!

      OTE=lizlou29;83467]I don't think anyone in the UK performs meibomian gland probing. I have asked two opths if they know of anyone who does manual expression and they said no, just do warm compresses.

      I have never been told that the glands are obstructed as such, just that the oil is thick. It comes out when pressure is applied to the lids.

      I'm really confused now as I thought the idea behind Lipiflow was to open and clear the glands?[/QUOTE]

      I thought that's what Lipiflow was supposed to do, too. So, what excuse me...what the hell is Lipiflow supposed to do anyway!? I'm sick of this suffering in pain. When I started considering Lipiflow, my heart had hope. Now, I'm back into the deep abyss of hopelessness & depression. My family is sick of me always in one form of pain or another. Sorry, I'm so very upset!

    • lizlou29
      lizlou29 commented
      Editing a comment
      Almondiyz - Do you have MGD alone or do you also have aqueous deficiency?

      My opthalmologist is now focusing on treatments for the AD though I am still on Doxycycline for the MGD and take a good quality omega 3. I don't want to keep on bashing Lipiflow as a few people on the forum have had success with it but the inventor himself said that TBUT does not seem to increase after treatment, so what exactly does the treatment do as clearly then it is not improving the quality of the tear film or the TBUT would increase, at least this is my assumption. There must be something I am missing as a few people on the forum feel it has been the turning point for them so clearly it works well for some people.

      Only after treatment was I told to keep doing warm compresses as often as possible as then I would likely see better results. Perhaps the difference in the results seen by patients is partly down to the aftercare instructions? I know some people have been given a steroid drop after and I wasn't given this. I was advised to take more Omega 3 as well. Unless the treatment is standardised how can they clearly interpret the results?

      This condition can be very hard to live with and I understand your frustration. I still feel down a lot of the time but now I have finally found a good opthalmologist I feel there is some hope. Try to take your time with the decision on Lipiflow and make sure you have a thorough assessment first if you do decide to go ahead with it.

    • Guest's Avatar
      Guest commented
      Editing a comment
      Someone posted that in Germany probing is typically done before Lipiflow. Maybe you can find better help there. You might need to search DEZ.

  • So many people on this site have such good advice, I'd really like your opinions on where best to have Lipiflow.

    My doctor, who is a corneal specialist and treats a lot of dry eye patients, just got a Lipiflow system and offered me a treatment, including the Lipiview test, for $1300 (both eyes). Also interest-free financing for a year. Still expensive but less than I've seen it offered anywhere else. I'm thinking of taking him up on it but I'm hesitant because he has no experience with the system and maybe that's important? Maybe better to spend a few hundred more and go to someone who's been doing it for years and knows what works best in terms of pre-treatment, post-treatment, etc.?

    Am I being too analytical or could that matter? I don't want to waste the money and not have it work because I didn't want to spend a little more.


    • lizzyk
      lizzyk commented
      Editing a comment
      Originally posted by BigNate View Post
      I'm confused as to why people are going with Lipiflow. IPL does the same thing in addition to absorbing the little blood vessels which are part of the inflammation associated with MGD. This is what I have been told by Dr. Toyos, which obviously he has a bias toward IPL. I have been unable to prove him wrong though, not to mention the fact that IPL is about 10-20% the cost of Lipiflow.
      Can you please tell me what IPL is? Thanks.

      I had Lipiflow back in Feb and have noticed no difference.

    • BigNate
      BigNate commented
      Editing a comment
      IPL stands for Intense Pulsed Light. It is supposed to treat the inflammation, open the glands, and help liquify the oil. It was created by someone named Dr. Toyos. If you have a Facebook account, you can search "Toyos Clinic" and ask him questions about it. Experts say that it truly starts working after about the 3rd or 4th treatment.

      LaDiva, were you told that one treatment would be enough?

    • LaDiva
      LaDiva commented
      Editing a comment
      No, I had the full course, which was four, I think. I cannot remember exactly. When I went the first time my TBUT was 3 before treatment, and 7 after the first treatment. It never improved beyond 7 seconds even with multiple treatments.

  • Hi Guys,
    I just did this procedure at UCI in CA...Does it gets worse before it gets better ? is 4 days gone but still eyes worse then they were before i did procedure !
    PLEASE any advice ??
    Thank you for your time !


    • patientpatrick
      patientpatrick commented
      Editing a comment
      Dog how are u doing? Did you talk to dr carver or dr Kwan about your lipiflow treatment?


    • Dog2012
      Dog2012 commented
      Editing a comment
      It took 2 days for me to get to talk with someone at that time my situation is improved on its own...I am very Thankfully to You for introducing me to New Pharmacy to do a serum eye drops..Very inexpensively
      Great Experience !! it is about 50% per m..for 100 % drops.

    • Dog2012
      Dog2012 commented
      Editing a comment
      Yep..those 2 thinks helps .. I boost my Testosterone drastically..and thanks god ..i now do my serum drops here locally in Newport Beach ...50 % redaction cost...It seems to me just those two thinks works best for me.

  • I had Lipiflow last November. Immediately after the painless procedure, the ophthalmologist proceeded to manually express each and every meibomian gland and it was extremely painful. However, until recently, I have had such relief that the exorbitant price and pain was worth it. I am contemplating going back for another session.

    I'm wondering if other doctors do the expressing of the glands afterwards and if that is why I had such a good result.


    • Peppermint
      Peppermint commented
      Editing a comment
      Dr Cohen was trained by Dr Korb on this. I had lipiflow performed by Dr Cohen in Oct. when he did the exfoliation on my left eye in particular, it was as if a dam had burst. I felt so much moisture all at once. I had so much buildup and the exfoliation really did it's job of clearing out the layers of dead skin.

    • Peppermint
      Peppermint commented
      Editing a comment
      I had lipiflow 6 & 7 weeks ago and I keep improving. This past week up until thurs was my best week yet. It can take some time.

      Originally posted by CrankyCanuck View Post
      I have been suffering with dry eyes for many years. This year the blinking and squinting was so severe I was desperate for relief. When I heard about Lipiflow I decided to give it a try. I had the treatment two weeks ago. I haven't really noticed much difference yet but I'm still hopeful. The procedure was quite expensive and not covered by any medical plan. Be interested to hear others' experience with Lipiflow.

    • CrankyCanuck
      CrankyCanuck commented
      Editing a comment
      Thanks Peppermint, I'm still hopeful.

  • I am getting lipiflow tomorrow in Provo Utah. I have MGD and ocular rosacea. Doc's have told me my eyes don't look that dry. I do have red veins and red lids though so they sure look red to me! I called ahead and requested a full mb expression after b/c the doc doesn't usually do that. Another user on here had it done and thinks it helped and plus I know my glands are blocked and/or thick meibomian. I'll post after but will give it some time before I say if it helped or not. 1700.00 is A LOT to spend. I'm also going to ask when insurance will start covering it. More and more docs are getting lipiflow and hopefully insurance kicks in soon.

    I had a lipiview done a couple weeks ago from a different doc who said 85% of my glands had atrophied! I am really hoping this is not the case but it will be interesting to compare numbers.


    • LaDiva
      LaDiva commented
      Editing a comment
      Does this mean you don't feel better?

    • Katewest
      Katewest commented
      Editing a comment
      Yea, no difference….yet. I'm still hopeful for something but I'm defiantly not counting on it. I still live in the desert so when we move in May I am really counting on THAT to help.

    • Katewest
      Katewest commented
      Editing a comment
      Lipiflow Update about 5 weeks later….BLAH! Waste of money and time! I see no difference!

  • I recently had a conversation via social media and further emails with an eye clinic in the US who were promoting Lipiflow on Twitter. Obviously they were keen to promote the treatment and said the only patients who had seen no improvement were those with a partial blink. Everyone else had some relief even if only temporary but they recognised it was a chronic condition. My issue is that they were promoting as complete relief for up to a year. I know I'm not the only one who hasn't been helped by Lipiflow and yes I have aqueous deficiency as well as moderate to severe MGD. Also, people who come to this site are likely to have dry eye on the more severe end. However I'd like a rough idea of how many people on here have been helped by Lipiflow so...

    After your Lipiflow treatment did you feel:

    1. Significant improvement
    2. Minor improvement
    3. No improvement

    Lipiflow caused more inflammation in my eyelids so I was actually worse for a week then went back to feeling exactly as I did before treatment but I gather that is quite rare.


    • Yoyobee
      Yoyobee commented
      Editing a comment
      I would also vote no on the Lipiflow. I don't seem to produce enough oil. What is IPL?

    • Yoyobee
      Yoyobee commented
      Editing a comment
      Ok, just looked up IPL. Is it done in the U.S. Anywhere that you know of? I'm in Northern California. Thanks!

    • redeyesat50
      redeyesat50 commented
      Editing a comment
      IPL for dry eyes - locations

      Originally posted by Yoyobee View Post
      Ok, just looked up IPL. Is it done in the U.S. Anywhere that you know of? I'm in Northern California. Thanks!
      Dr Toyos has trained doctors all over the country. You may can call or email the office to get a list of doctors in your area that he recommends. Dr. Toyos is also on Twitter.

      The following doctor's website has it listed. His office is in Sacramento.

      IPL has taken away all the bacterial infection and my eyes feel much better. I go back for my third treatment the first week in August. Good luck to you.

  • Hi all,

    I'm a 19 year old engineering student and a chronic dry eye sufferer from Belgium.
    I have been lurking around on this forum for some time without commenting much, but I had Lipiflow and probing done last week, so I thought I'd share my experience with you.

    My problems began with soft contact lenses about 3 years ago. After 1.5 years of wearing them very comfortably every day, my eyes began to feel dry.
    Eventually, I couldn't tolerate them anymore and I had to switch back to glasses. I thought that was were my problems would end, but after one year of almost no symptoms,
    my eyes felt dry even without the contacts. It worsened and worsened and I saw lots of different ophtalmologists from the local hospital and the university hospital alike.
    I tried steroids, vitamin A ointments, anti-allergetics etc... but nothing really worked. Frustrated and with drier eyes than ever, I went to prof. Baudouin's practice in Paris.
    They came to the conclusion that I have evaporative dry eyes because my schirmer is normal but my TBUT very low. That's when I realized I probably have some form of MGD.
    But they didn't even bother to look at the glands, even when I asked them to. But they found inflammation and allergy on my ocular surface though and send me away with, again,
    steroids and anti-allergetics and with the promise they would give me cyclosporine if it didn't help. And it didn't.
    I had already made a new appointment, but in the mean time, my eyes where still dry as hell. And after lots and lots of research I became more and more convinced that MGD was my problem.
    So I made an appointment with prof. Geerling in Duesseldorf, who does Lipiflow and MG probing. I had the procedure a week ago.The probing was very uncomfortable. It hurt like hell and it was very difficult to keep
    my eyes open under the very bright slid lamp. The Lipiflow was much better. I was surprised that it took such a short time though. And it didn't feel hot at all. After the procedure, my eyes were very inflamed though.
    But I have still no relief at the moment. I probably should give it some more time, because the doc said they evaluate the procedure after 3 months.

    From what the doctors said and from what I have read on the internet during all these years, I came to the following conclusions about MGD:

    - MGD is a big cause of dry eye. Some figures hint at 80% of the dry eye population has it in some form. It is a progressive disease and it needs to be treated as quickly as possible.

    - MGD can be caused by allergy/inflammation/hormones/rosacea... the list is endless. So getting yourself tested is always a good idea.

    - If MGD progresses, the gland orifices will close (because of scar tissue?). If you don't open them, the glands will eventually die off, so get yourself probed as often as needed!!
    (The doctor who did the probing said when they are blocked, the glands will atrophy. I guess because of the increased pressure building up inside of the glands)

    - If MGD progresses, your glands, which are relatively long tubes, will become shorter and shorter and will produce less and less, until they disappear.
    -> Warm compresses seem to halt this proces. Prof. Geerling believes they are essential to keep the already short glands from becoming shorter and disappearing.
    -> This is confirmed by studies. I read a study a week ago which concluded warm compresses can double the lipid layer thickness. The meibomian gland area remains unaltered.
    -> You can view the anatomy of your MGs with the new meibography technics. (I think this will become a major research tool in the future to research what medication can improve the MG anatomy.)
    So if you can, have a meibography done to see what remains of your glands. I haven't done this yet, because I don't know where to get this done where I live.
    But the doctor who did the probing said my glands are very short. He only used the 1mm needle to get through the plugs.

    - MGD causes the tear film to dry up, creating dry spots all over the cornea. This will reduce the amount of goblet cells on the surface of the cornea, thus leading to an even more unstable tear film.
    Also, your remaining tear film will become more salty and this hyperosmolarity will kill even more goblet cells/gland cells.
    -> Using artifical tears (I prefer systane balance or ultra) without preservatives could be a good way to reduce the damage on your goblet cells
    -> Dryness also leads to inflammation? But I'm not quite sure of that. My understanding of corneal health (staining, goblet cells, consistency) is not that good...

    - Inflammation is BAD. It could be on of the reasons your MG's stop working, it can reduce your aqueous tear layer and it has a negative impact on basically all the epithelial cells in all of your glands.
    -> inflammation is induced by hot compresses. I have this a lot. Then my eyes go from veeeery dry to just burning and tearing.
    -> Maybe cyclosporine could be an effective way to get rid of the inflammation and get on with your warm compresses. And there is always topical steroids, but perhaps you should keep those to a minimum.

    - Doxycycline could alter the consistency of the meibum and make it less thick. It's also good to reduce inflammation

    - Supplements may or may not help, but after trying all kinds of things, I don't think they are that essential for most people with serious MGD.

    The above is roughly my thinking process of the past years. The things listed above are imho essential to keep your MGD from worsening. But it's hard telling what is the cause of MGD.
    This disease is so complex and yet there is so little doctors know about it. I guess you guys can relate to this. Everything I learned about it is from my own research.
    That being said, I feel there is a lot of research going on, lots of hopeful studies and new understandings and I really think there is hope.
    As I see it now, there are 3 drops on the market that could prove to be helpful:
    - Cyclosporin: ideal to control the inflammation. This could also benefit MGD which is confirmed by a few studies.
    - Azithromycin: effective in controlling staph induced MGD/blepharitis. It also has an anti-inflammatory effect and penetrated the tissue with a high efficacy.
    - Diquafosol: Stimulates basically all the epithelial cells: goblet cells, cells of the MGs and cells of the tear glands alike. So it has a triple function!
    -> This is the only medication that has clinically been proven to increase meibomian gland area!
    I would love to try this and my next step is to ask my regular doc to have it ordered at an international pharmacy because it's only available in Asia.
    I'd like to check out cyclosprine and azithromycin too. Has anyone tried one of these for MGD?

    So an all around MG workout would consist of:
    - warm compresses 2x a day
    - intraductal gland probing 2x or 3x a year (or as often as needed)
    - doxycycline 50mg 2x day
    - cyclosporine chronically and/or azithromycin periodically to control the MGD
    - long term diquafosol treatment to cure the MGD (or at least increase your MG area)
    - supplements like high vitamin D, multivitamins, multiminerals, 1000-2000mg of fish oil a day, flaxseed oil... but I don't think this is the most important part
    - Scleral lenses to get you through the day..? I'm currently looking into this option as I don't expect to be cured from this disease anytime soon
    and my daily life is affected at such a level that I'm truly desperate for relief. But I've read articles that state that MGD patients experience only limited relief with sclerals.
    This could also be a good way to increase the overall health of your cornea and goblet cells and have a better tear film when you're not wearing them.

    Imho, all of the above is essential to control and improve this terrible condition.
    It's a pity that so few ophtalmologists are into this area of ocular medicine. It's really tough to get a good diagnosis, let alone prescriptions for medication, especially when it's knew stuff.
    And Restasis and Diquas aren't even officially available in Europe... But as I said, I'm confident that MG treatment will significantly improve in the next years so I keep on dreaming and researching.
    Thank you for taking the time to read all this. If you have any thoughts, remarks, questions... please comment and get the discussion going! I'm after all just a patient looking for answers, just like you.



    • cathy8889
      cathy8889 commented
      Editing a comment
      That's great news

    • Max52
      Max52 commented
      Editing a comment
      Originally posted by Santaklauzz View Post
      Quick update:

      For the first time in more than two years, I have the feeling that my eyes are improving a bit instead of getting worse.
      The difference is only minimal, but still. When I'm studying at home, I can have hours on end that my eyes don't bother me now.
      I also used to have very bad eyes in the morning. Like they were glued together. But that has improved as well.
      But the most striking thing happened this morning: Most days I have to go to class by bike (if I can go to class at all) and for the past years, that has meant hell.
      But the discomfort I had today was almost nothing compared to what it used to be. I almost enjoyed it!
      The sun on my face, the wind in my hair, the smell of spring... I pictured all the things that I'll be able to enjoy again if this mess ever heals.
      I can't describe how great it feels to have hope again. To remember how it was to be normal.

      It's very well possible that this 'good' period is just a fluctuation. Maybe my eyes are worse again next week.
      But I don't think this is a coincidence. My MG's are open and working thanks to doxy and MG probing.
      And now that I'm on Restasis + non-steroidal anti-inflammatory drops + anti-allergic drops, my eyes might be going back to normal slowly.
      I will certainly keep you guys updated. Hopefully, more positive news will follow...
      Hi...can you tell me what the non-steroidal anti-inflammatory drop is you're using?

    • Santaklauzz
      Santaklauzz commented
      Editing a comment
      Hi, Max

      The product is called Indocollyre 0.1%. Its active ingredient is indomethacin.
      (And the anti-allergic drop is N-acetyl-aspartyl)

  • There's a new study out of Germany on LipiFlow:

    It found that a single LipiFlow treatment is as least as effective as a 3-month, twice-daily lid margin hygiene regimen for MGD.

    However, I think the most interesting thing about the study is it was observer-masked. I can't think of another LipiFlow study that was blinded/masked.

    On another note... because I always compare LipiFlow and probing, I'm wondering if anyone knows of an observer-masked probing study.

    I know that asking for double-blinded would be next to impossible (Sham LipiFlow probably could be done. Sham probing probably not).

    Just curious and wondering about the future of these boutique treatments.


    • So...the adventure continues. I had Lipiflow done on 1/22. I went to the Southern Eye Center in Hattiesburg, MS. The dr's name is Dr. Cameron Griffith. They did the Lipiview first. My scores were miserable, 27 in the left eye and 37 in the right eye. Dr. Griffith said my meibomian glands were plugged (capped he called them). Also, I have mild to moderate atrophy. They expressed these (the lower ones) with the golf club instrument everyone talks about. It is painful but bearable. After that a large amount of money was extracted from my wallet ($1,700 total for everything). Then the Lipiflow procedure was done. It was not painful but my eyes were definitely freaked out for a few days (about 4). They knew something had been done to them and they were not happy about it. The only change I have noticed so far is that the fluid is much more liquid and not thick and goopy like it was. That being said, I can't say I have improved at all yet. Dr. Griffith said he is seeing best results at 3 months out so I guess I still have some hope. I wonder why none of the other (multiple) opthamologist's, cornea specialist's ectera that I have seen over the last 2 years never bothered to say that my glands were plugged up and needed to be expressed. I mean, they weren't going to work! They were completely plugged! I actually felt and heard them pop open. Another thing I wonder about...I know my eyes are way drier at night but why, when they are full of all kinds of drops and goop (Refresh Pm, artificial tears etc.) and I am lying down with them closed, why do they still hurt so bad that I am frequently in tears and can hardly get to sleep. Anyone?


      • EternalTears
        EternalTears commented
        Editing a comment
        I know as long as I am actively blinking my eyes feel relatively good but once im sleeping with them closed, I notice the dryness and discomfort. I believe the blinking increases the lipid flow from the glands and disperses over tear film which likely is increasing the evaporation time of tears. I had a lipiflow today for one eye as it was my first. I was told allow 2-4 weeks and come back for retest (lipiview) to see what improvement occurred. I went to for treatment under DR

      • indrep
        indrep commented
        Editing a comment
        When your eyes are closed they are in contact contact with the inflamed lids. Reducing the inflammation of the lids will help, unfortunately that is not an "overnight" process. Lowering the inflammation by reducing the osmolarity of the tear film is the best long term solution.

    • confidential
      Last edited by EternalTears; 06-Feb-2014, 19:35.


      • akmpt
        akmpt commented
        Editing a comment
        Originally posted by Chels23 View Post
        lol nice troll advertising "akmpt". It's pretty obvious you're not a patient. But thanks for sharing the advice about this new device. We get the point, no need to write on every thread, we're not idiots haha.
        I am not trolling, I've replied on like 2 threads then I figured out how to create my own, I am a patient and this is what works for me and I thought it could help others. I don't see how I'm hurting anyone, just figuring out how to navigate this site.

      • lizlou29
        lizlou29 commented
        Editing a comment
        Originally posted by akmpt View Post
        I am not trolling, I've replied on like 2 threads then I figured out how to create my own, I am a patient and this is what works for me and I thought it could help others. I don't see how I'm hurting anyone, just figuring out how to navigate this site.
        Akmpt, perhaps you could tell us more about the treatments you have tried before? I can see from your profile your symptoms and what you believe to be the cause of your dry eyes but not what meds or procedures you have tried before the Mibo Thermoflow.

      • Hazakman
        Hazakman commented
        Editing a comment
        for what it's worth.

        I had Lipiflow last year and felt great for (2) weeks and then it all came back. Has anyone with severe dry eyes actually had a complete recovery from this?

    • If you want to waste your money, donate to a lipiflow center and DR. 2 weeks and no difference. No wonder med ins. companies refuse to cover it. Its main use is for folks with mild MGD otherwise you would be better off giving it as a charitable contribution and write it off. I researched this lipiflow propaganda for a year and had 3 opinions and 2 lipiview tests and fell for the bait. There are No shortcuts. I have moderate MGD but mild symptoms that began 6 years ago. Some say to wait 4 weeks to see how effective the lipiflow is but I have doubts things are going to change.
      I went to Gavin Herbert UC Irvine Eye Center and had 1 eye done. I deserve the embarassment
      Last edited by EternalTears; 15-Feb-2014, 14:04.


      • EternalTears
        EternalTears commented
        Editing a comment
        its been 11 weeks and no improvement. I agree Bonedry60
        Last edited by EternalTears; 24-Apr-2014, 16:49.

      • EternalTears
        EternalTears commented
        Editing a comment
        Its been 11 weeks and no improvement. I rest my case. I tell others to try Azithromyacin BEFORE they play the lotto for $750 an eye. (if you need to learn it about, see following articles and links.)

        After a failed Lipiflow proc in 02/2014 & many other treatments, finally relief

        After a failed Lipiflow procedure in Feb 2014 & many other treatments since 2009, I actually listened to my mom who also had MGD and she had her DR prescribe Azithromycin 500mg about 9 months ago to use for 6 days and it worked so well for her that her dry eye symptoms improved significantly for about 9 months. When I heard this I had hard time believing it but on April 4 2014 I asked my ophthalmologist if I can try it and I have notice my eyes at night are not as dry and when I awake they open more easily and feel more moist. I have not added any other treatments recently and at least for my condition this antibiotic has been the most effective and all for $10.

        Below is the study of Azithromyacin

        PTI Dec 24, 2013, 03.43PM IST

        WASHINGTON: A common antibiotic may combat dry eye disease, a new study has found.

        Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease. Currently, there is no treatment for MGD that is approved by the US Food and Drug Administration (FDA).
        Researchers from the Schepens Eye Research Institute, Massachusetts Eye and Ear and Harvard Medical School have now identified a potential therapy to treat dry eye disease.

        "We discovered that azithromycin, an antibiotic, can directly stimulate the function of human meibomian gland epithelial cells," said first author Yang Liu, a postdoctoral fellow at Schepens Eye Research Institute and Harvard Medical School.
        This finding is very clinically significant, because topical azithromycin is the most commonly prescribed MGD treatment in the US, but its use is 'off-label,' which means the drug's efficacy has not yet been evaluated and approved by the FDA for patients with MGD, researchers said.
        This antibiotic has been presumed to be effective because of its anti-inflammatory and anti-bacterial actions, which may suppress the MGD-associated conjunctival inflammation (ie posterior blepharitis) and growth of lid bacteria.
        "We hypothesised that azithromycin could act directly on human meibomian gland epithelial cells to stimulate their differentiation, enhance the quality and quantity of their lipid production, and promote their holocrine secretion. Our results support this hypothesis," said senior author David A Sullivan, Senior Scientist and Margaret S Sinon Scholar in Ocular Surface Research, Schepens Eye Research Institute and Associate Professor of Ophthalmology, Harvard Medical School.
        The findings in this study may help lead to broader use of topical azithromycin as an FDA-approved, 'on-label' treatment to ameliorate the pathophysiology of MGD and its associated evaporative dry eye disease, researchers said.

        same findings are published from other sources below

        Common Antibiotic May Combat Dry Eye Disease

        Findings published Online First in JAMA Ophthalmology

        Contact: Mary Leach
        (617) 573-4170

        BOSTON (Dec. 23, 2013) -- Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease, which affects tens of millions of Americans. However, there is no FDA-approved treatment for MGD. Researchers from the Schepens Eye Research Institute/Massachusetts Eye and Ear and Harvard Medical School have just identified a potential therapy.

        “We discovered that azithromycin, an antibiotic, can directly stimulate the function of human meibomian gland epithelial cells,” said First Author Yang Liu, M.D., a postdoctoral fellow at Schepens Eye Research Institute and Harvard Medical School. Their finding is outlined in a Research Letter that was published Online First in JAMA Ophthalmology.

        This finding is very clinically significant, because topical azithromycin is the most commonly prescribed MGD treatment in the USA, but its use is ‘off-label,’ which means the drug’s efficacy has not yet been evaluated and approved by the Food and Drug Administration for patients with MGD. This antibiotic has been presumed to be effective because of its anti-inflammatory and anti-bacterial actions, which may suppress the MGD-associated conjunctival inflammation (i.e. posterior blepharitis) and growth of lid bacteria.

        “We hypothesized that azithromycin could act directly on human meibomian gland epithelial cells to stimulate their differentiation, enhance the quality and quantity of their lipid production, and promote their holocrine secretion. Our results support this hypothesis,” said Senior Author David A. Sullivan, Ph.D., Senior Scientist and Margaret S. Sinon Scholar in Ocular Surface Research, Schepens Eye Research Institute and Associate Professor of Ophthalmology, Harvard Medical School.

        The findings in this study may help lead to broader use of topical azithromycin as an FDA-approved, ‘on-label’ treatment to ameliorate the pathophysiology of MGD and its associated evaporative dry eye disease.

        Authors of the paper are: Yang Liu, M.D.; Wendy R. Kam, M.S.; Juan Ding, Ph.D.; and David A. Sullivan, Ph.D.

        This work was supported by grant EY05612 from the National Institutes of Health, the Margaret S. Sinon Scholar in Ocular Surface Research Fund, and the Guoxing Yao Research Fund.

      • EternalTears
        EternalTears commented
        Editing a comment
        let us know how effective it is when you do try it and how long it works.

        Originally posted by Max52 View Post
        Hi Liz...the testimonials are all over the internet and easy enough to google.. The most encouraging thing to me was the Pubmed, NCIB study. I can't copy and paste the entire thing, but google it. This is their conclusion:

        With such prolonged improvement in signs and symptoms of dry eye disease, the LipiFlow(®) Thermal Pulsation System offers a technological advancement for the treatment of dry eye disease secondary to meibomian gland dysfunction. A single 12-minute LipiFlow(®) treatment results in up to 9 months of sustained improvement of meibomian gland function, tear break-up time and dry eye symptoms that are unparalleled with current dry eye treatments.
        No, I haven't had it, but am considering it.

    • Hi all interested how the companies do promote their products:

      Please have a look at:

      DEEP module 6 and 7 - did not find the other modules.

      These are recommendations for ophthalmologists, how they should promote and sell the
      Lipiflow treatments to the patients etc.

      What they do not tell the ophthalmologists is, how they should treat their patients after
      getting Lipiflow. Like the eye masks and ointment for the nights to prevent
      the rapid reclosure of the MGS etc.

      For mild to moderate MGD Lipiflow may help very well. But these kind of marketing and promotion
      strategies are really strange!



      • Almondiyz
        Almondiyz commented
        Editing a comment
        lizlou, maybe Rebecca would allow you to copy the letter here on the open forum to educate us desperate sufferers?

      • Almondiyz
        Almondiyz commented
        Editing a comment
        Originally posted by Almondiyz View Post
        Max, no I didn’t get Lipiflow back in early 2013 with the first doctor I saw. The sales pitch turned me away from her solo practice. I initially went to her because I was able to be seen the next day after calling for an appointment as a new patient. Her office offered to do Lipiflow that first visit!

        Jan. 2014 I went to another doctor who said I WAS NOT a candidate because of contraindications. Active/Chronic blepharitis, ocular rosacea with severe telangiectasias that criss-crossed over my all my meibomian glands. That’s why IPL was suggested. Take care of blep/ocular rosacea before Lipiflow.

        Note: Beware of solo practices! They need to cover the $100,000.00 cost of the equipment out of pocket. The first doctor approved me as a candidate the first visit BEFORE a Lipiview eval was done!
        I believe Rebecca already posted the CONTRAINDICATIONS LIST somewhere on the forum about Lipiflow.

        Indications for Use

        The LipiFlow® System is intended for the application of localized heat and pressure therapy in adult patients with chronic cystic conditions of the eyelids, including Meibomian Gland Dysfunction (MGD), also known as evaporative Dry Eye or Lipid Deficiency Dry Eye.


        Do not use the LipiFlow® System in patients with the following conditions. Use of the device in patients with these conditions may cause injury. Safety and effectiveness of the device have not been studied in patients with these conditions.

        Ocular surgery within prior three months, including intraocular, oculo-plastic, corneal or refractive surgery procedure

        Ocular injury within prior three months

        Ocular Herpes of eye or eyelid within prior three months

        Active ocular infection e.g., viral, bacterial, mycobacterial, protozoan, or fungal infection of the cornea, conjunctiva, lacrimal gland, lacrimal sac, or eyelids including a hordeolum or stye

        Active ocular inflammation or history of chronic, recurrent ocularinflammation within prior three months e.g., retinitis, macular inflammation, choroiditis, uveitis, iritis, scleritis, episcleritis, keratitis

        Eyelid abnormalities that affect lid function e.g., entropion, ectropion, tumor, edema, blepharospasm, lagophthalmos, severe trichiasis, severe ptosis

        Ocular surface abnormality that may compromise corneal integrity (e.g., prior chemical burn, recurrent corneal erosion, corneal epithelial defect, Grade 3 corneal fluorescein staining, or map dot fingerprint dystrophy


        The Disposable may not fit all eyes, such as eyes with small palpebral fornices.

        Use of the LipiFlow® System is not recommended in patients with the following conditions.

        Patients with these conditions may have reduced treatment effectiveness because these conditions may cause ocular symptoms unrelated to cystic meibomian glands.

        Safety and effectiveness of the device have not been studied in patients with these conditions.

        Moderate to severe (Grade 2-4) allergic, vernal, or giant papillary conjunctivitis
        Severe (Grade 3 or 4) eyelid inflammation e.g., blepharochalasis, staphylococcal blepharitis or seborrheic blepharitis.

        Patients with severe eyelid inflammation should be treated medically prior to device use.

        Systemic disease conditions that cause dry eye e.g., Stevens-Johnson syndrome, vitamin A deficiency, rheumatoid arthritis, Wegener’s granulomatosis, sarcoidosis, leukemia, Riley-Day syndrome, systemic lupus erythematosus, Sjögren’s syndrome

        Taking medications known to cause dryness e.g., isotretinoin (Accutane®), and systemic antihistamines

        In addition, the treatment procedure may loosen previously inserted punctal plugs, which may worsen the patient’s dry eye symptoms.

        Potential Adverse Effects

        In the randomized, controlled clinical study, there were no serious adverse events related to the use of the LipiFlow® System.

        The non-serious device-related adverse events for the LipiFlow® System included moderate eyelid pain and moderate conjunctival hyperemia or vascular injection.

        Other slit lamp findings included eyelid hyperemia, eyelid edema, conjunctival petechial hemorrhages, conjunctival chemosis or edema, superficial punctate epithelial keratopathy, ocular surface staining, and discharge or mucus in the tear film.

        These non-serious adverse events and slit lamp findings were temporary and resolved during the four-week study without any permanent effect or need for medical treatment.

        Potential adverse effects that may occur as a result of the procedure include, but are not limited to, the onset or increase in

        Eyelid/eye pain requiring discontinuation of the treatment procedure

        Eyelid irritation or inflammation e.g., edema, dermatitis, hordeolum or chalazion

        Ocular surface irritation or inflammation e.g., corneal abrasion, conjunctival edema or conjunctival injection (hyperemia); and

        Ocular symptoms e.g., burning, stinging, tearing, itching, discharge, redness, foreign body sensation, visual disturbance, sensitivity to light

        Potential serious adverse events that are not anticipated because of the device mitigations to prevent occurrence include:

        Thermal injury to the eyelid or eye, including conjunctiva, cornea or lens;
        Physical pressure-induced injury to the eyelid;
        Ocular surface infection.

      • LaDiva
        LaDiva commented
        Editing a comment
        Soooo, after reading this, do the Lipiflow folks check for active infections before a treatment? How would you know if not? I am guessing most of us with MGD have bacterial issues.