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I just returned from my Lipiflow treatment in Toronto Canada at the Herzig Eye Institute, so here is the report from that trip:
Just a tip: Toronto has a pretty good public trasportation system and you can get anywhere for $2.50. So instead of the $65 cab rib to downtown, just take the subway, rail car, bus system.
Herzig Eye is located on Bloor Street West just between the University of Toronto and the Yorkville area. It is across the street from the Chanel store, in the same building as Mont Blanc, a block away from the Hugo Boss store ... you get the idea. It is in a VERY nice part of town and on the way in, I got the impression that the fee I was going to pay was in part to pay the expensive rent of the area.
When I was checking in, they asked me to pay the full fee upfront (this is unusual in US medicine and I was a little put off by it). They charge you a small fee for the initial Lipiview consultation and a much larger fee for the Lipiflow treatment. They charge on a per eye basis. Each eye is more than a single IPL session. So it added up to what I thought was a moderate to large fee. PM me for exact details.
Dr. Ritesh Patel OD is the optometrist doing the Lipiflow. He is a really nice guy actually and spent maybe an hour and a half with me examining me, doing the Lipiview, the Lipiflow and then answering all of my many questions. He also told me places to visit, eat, etc. while I was in Toronto and was otherwise very helpful overall.
Lipiview:
So lipiview is an interferometer that watches you blink and then measures the lipid film in your tears. the scales goes from 0-240 I think and "lipid deficiency" is <70. I measured 45 or 50 in both eyes, so I am lipid deficient.
Also, he showed me a few examples of his previous patients and their followup results. One guy started at Lipiview score of 35 (very low) and improved to 115 after 5 weeks from his Lipiflow treatment. He said he had several other examples like that.
Slit lamp:
Then he did a slit lamp examination on me and looked for open glands in the lower lid. I had 4 open on the left and 6 open on the right.
So, this is what I am starting with. Then I am supposed to return in a month and Dr. Patel will check for progress in these 2 things.
Lipiflow:
So, then the treatment. Dr. Patel put this device on me that has a rubber contact that fits over most of the front of the sclera. Then they slip your eyelids in the outer part of the device, the part that compresses your eyelids.
Lipiflow does one eye at a time. It took 12 minutes per eye. First, you only feel the heating from the inside of your eyelids. It gets up to 43 degrees C according to Dr. Patel. It did get pretty warm. In all my days of warm compresses, I'm not sure I ever got my inner eyelids this warm, so I think it does an effective job of this.
Then after a few minutes, it starts the compression part of the treatment. The compression is very gentle at first. Then towards the end of the treatment, it was a little more rigorous, but still pretty gentle, I thought.
Actually, to be honest I was a little disappointed with how gentle the compression part was. I think I have a lot of gunk in my glands and I really wanted it all to get squeezed out.
Also, depending upon the shape of your eye, the compression part may or may not be very effective. The contact didn't exactly fit my eye very well, so I felt the compression mostly on my upper eyelids and not very much on my lowers. I told him about it and he tried to reposition the contact and he tried to press down harder to make the compression better. I have no idea if that helped, but I left thinking my lower lids were not going to be as good as my upper lids.
Well, so that was it. Dr. Patel had some other recommendations for me regarding dry eye - most of which I have heard before because I have seen so many eye doctors in the last year.
Just a tip: Toronto has a pretty good public trasportation system and you can get anywhere for $2.50. So instead of the $65 cab rib to downtown, just take the subway, rail car, bus system.
Herzig Eye is located on Bloor Street West just between the University of Toronto and the Yorkville area. It is across the street from the Chanel store, in the same building as Mont Blanc, a block away from the Hugo Boss store ... you get the idea. It is in a VERY nice part of town and on the way in, I got the impression that the fee I was going to pay was in part to pay the expensive rent of the area.
When I was checking in, they asked me to pay the full fee upfront (this is unusual in US medicine and I was a little put off by it). They charge you a small fee for the initial Lipiview consultation and a much larger fee for the Lipiflow treatment. They charge on a per eye basis. Each eye is more than a single IPL session. So it added up to what I thought was a moderate to large fee. PM me for exact details.
Dr. Ritesh Patel OD is the optometrist doing the Lipiflow. He is a really nice guy actually and spent maybe an hour and a half with me examining me, doing the Lipiview, the Lipiflow and then answering all of my many questions. He also told me places to visit, eat, etc. while I was in Toronto and was otherwise very helpful overall.
Lipiview:
So lipiview is an interferometer that watches you blink and then measures the lipid film in your tears. the scales goes from 0-240 I think and "lipid deficiency" is <70. I measured 45 or 50 in both eyes, so I am lipid deficient.
Also, he showed me a few examples of his previous patients and their followup results. One guy started at Lipiview score of 35 (very low) and improved to 115 after 5 weeks from his Lipiflow treatment. He said he had several other examples like that.
Slit lamp:
Then he did a slit lamp examination on me and looked for open glands in the lower lid. I had 4 open on the left and 6 open on the right.
So, this is what I am starting with. Then I am supposed to return in a month and Dr. Patel will check for progress in these 2 things.
Lipiflow:
So, then the treatment. Dr. Patel put this device on me that has a rubber contact that fits over most of the front of the sclera. Then they slip your eyelids in the outer part of the device, the part that compresses your eyelids.
Lipiflow does one eye at a time. It took 12 minutes per eye. First, you only feel the heating from the inside of your eyelids. It gets up to 43 degrees C according to Dr. Patel. It did get pretty warm. In all my days of warm compresses, I'm not sure I ever got my inner eyelids this warm, so I think it does an effective job of this.
Then after a few minutes, it starts the compression part of the treatment. The compression is very gentle at first. Then towards the end of the treatment, it was a little more rigorous, but still pretty gentle, I thought.
Actually, to be honest I was a little disappointed with how gentle the compression part was. I think I have a lot of gunk in my glands and I really wanted it all to get squeezed out.
Also, depending upon the shape of your eye, the compression part may or may not be very effective. The contact didn't exactly fit my eye very well, so I felt the compression mostly on my upper eyelids and not very much on my lowers. I told him about it and he tried to reposition the contact and he tried to press down harder to make the compression better. I have no idea if that helped, but I left thinking my lower lids were not going to be as good as my upper lids.
Well, so that was it. Dr. Patel had some other recommendations for me regarding dry eye - most of which I have heard before because I have seen so many eye doctors in the last year.
After that test, I saw the Doctor who did several tests like normal ones we've all had and then she did another manual test for dry eyes. Once again she came up with a score of 1 on my left eye and 2 on my right eye, out of a score of 10 - not good. But also really good for at long last, I know what causes my dry eyes. Yahoo!! 
Therefore I qualify for the Lipiflow procedure and I am scheduled for Oct 14th. I can hardly wait. I will post a review on my return. Stewart
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