Storm - MGD

[spmcc]

In the readings that you gave, are they after Lipiflow or at the time Lipiflow was given.

For OD measurement: You show an improvement of only +2 (38-40) in one eye after a month and then +5 (40-45) in November. This doesn't seem like much for 2 treatments? Maybe I have mis-interpreted your numbers.

Here's what I did:

* July 9 in Toronto, ON - LipiView (assessment) and then LipiFlow (treatment)
* Aug 25 in Abbotsford, BC (7 weeks after tx in Toronto) - LipiView (assessment) ONLY
* Nov 23 in Richmond, BC - LipiView (assessment) and then LipiFlow (treatment)

Yes, the numbers are as stated above. Here's a little easy-to-read chart: link to chart

I have another appointment for LipiView (assessment) ONLY on Jan 9. I'll post an updated chart after that.

Happy Holidays!

[Storm]

My appointment is Jan 5.

[Storm]

Storms Followup to Lipiview - 30 days later

Today I had my followup appointment to the Lipiview treatment that was done 30 days ago and here are the numbers.

These numbers are a measure of the lipid layer on my tear film:

............. Previous..Today
............. _______.._____

Bad Eye ...... 31 ..... 35 .....
Good Eye .... 37 ..... 54 .....

I was pleased with the progress of my Good Eye; but my Bad Eye has a long way to go.

The optometrist also said:
- there were no dry patches on the Bad Eye as before
- she was able to express quite a lot of oil from the Bad Eye and I could feel it.
- all pores were open
- there should be more improvement over the next couple of months
- continue with all the efforts: (heat, drops, cleaning, fish oil (ughh), night taping, water, blinking exercises etc)

The Lipiview Technician said:
- the blink of the Bad eye was stil not right. The blink did not pickup the oil and spread it over the surface of the eye. She called this poor quality.

I have noticed since Sunday that when I do the blinking exercises, there is moisture (lipid) on the lower lids.

[Hopeful2]

Glad to hear of the improvements! I think when it comes to dry eye, progress is measured in 'baby steps'.

The numbers look much better and it sounds like your eyes feel better too!

Just a quick question, when you express your glands, or do blinking exrcises, does your vision get cloudy as well, or just moist? My eyes get moist with warm compresses, hot showers, but I don't particularly notice any blurring with this.

Thanks for keeping us up to date

Hopeful2

[Storm]

Blinking exercises

When I do the blinking exercise my vision does not get cloudy and only sometimes does it feel moist. Sometimes the moisture feels like water entering my eye instead of smooth oil.

[Storm]

Its been 5 weeks since Lipiflow for me and this week has been pretty good. My bad eye hasn't been hurting so much. 1st time in 2 years. I'm still using drops all the time.

[Hopeful2]

Would you say that the Lipiflow treatment, has improved your MGD? My eyes seem to alternate between the two eyes. Sometimes it is the right that is sore, but lately it has been the left that has been irritated. . . I wonder if Lipflow would make a difference. . .

[Storm]

2 Months after LipiFlow

Thing didn't so so well after my last post. I developed some sore spots during those 3 weeks.

At my LipiFlow 2 month follow up appointment, They didn't do the Lipiview so I don't have the lipid layer numbers to post. The doctor said that they only do the test at 1 month and 3 months post.

The doctor said:
- My eyes look much better than when he say be before Lipiview. Much cleaner looking.
Oil is coming from my left eye; but not much from my right eye.
- The evaporation test showed the left was evaporing in 10 seconds which is good; but only 3-4 seconds on the right eye.
- There could still be some improvement to come

As to how I feel:
My right eye is hurting most of the time so I'm getting down about it. I'm afraid that there is no improvement here.
I feel improvement in the left eye. It does not need as many drops and is not hurting.
I put drops in my eyes every 20 minutes until I'm too tired to do so (about dinner time). I put 5-6 drops in my right eye and 1-2 in my left.

I'm considering stopping my computer job. Maybe it would help. I will wait a few more followup appointments to see if there is any more improvements. I know that for one patient they repeated the Lipiflow with good results. If it can help one eye it should be able to help the other.

I asked the doctor about using Polysporin Eye Ointment for relief. He said that long term use of antibiotics can damage the glands, so I will not use it.

[Storm]

Answering Hopeful2's Question:Would you say that the Lipiflow treatment, has improved

It has helped my left eye. The lipid layer numbers are now above the severe mark and it feels like this to me. It doesn't seem to have helped my right eye with the soreness and the lipid level scores for this eye haven't shown any significant improvement.

So yes I would say my MGD has improved. I believe that without it I would have got worse as I was going downhill fast when the cold weather came. I'm going to stay positive for now.

I am going to look at goggles for some relief so I would like to know if they help and what kinds I can get.

Would you say that the Lipiflow treatment, has improved your MGD? My eyes seem to alternate between the two eyes. Sometimes it is the right that is sore, but lately it has been the left that has been irritated. . . I wonder if Lipflow would make a difference. . .

[Storm]

Next LipiVIew

My next Lipiview appointment is March 8.

[Storm]

My Followup 3 month Lipiview

i'm showing here all my Lipiview readings including my 3 month reading March 8:

These numbers are a measure of the lipid layer on my tear film:

............. Dec 9 1 month 3 month
............. _______...._______...._______

Bad Eye ..... 31 .......... 35 .......... 40
Good Eye ... 37 .......... 54 .......... 47

So basically i've had about a 30% increase in the lipid layer thickness. Unfortunately I need about another 30% increase to get out of the Severe Dry Eye range (50).

The doctor put me on Lotemax for 2 weeks and Restasis for a few months. There is some improvement; but still need drops ever 10-20 minutes and my eyes get very sore throughout the day.

[Storm]

My Follow Up 3 month Lipiview

I'm not sure whether or not to keep working.

[Hopeful2]

Sorry to your results are not as encouraging as would have been hoped for. Did the lipiflow doc offer any suggestions or explanation? How were your eyes with the warm spell that we just had? I think mine felt a little better.

How long have you been on the lotemax and restasis? I've heard it can take some time for the inflammation to come down. I really hope you find improvement with the warmer weather.

[Storm]

Just thought I'd provide an update. I've been on Restasis for 3 months and have seen some improvement. My eyes aren't hurting so much and I'm not quite so stressed about it. I take drops about every 30-90 minutes. I can go longer; but then my eyes start hurting more and I can't recover for the remainder of the day. I did have trouble with a tightening and pain along the upper margin by my lashes. The doctor said it was because the eye lid was turning inward and was not wiping across the eye surface with the right part. He also said there are some indications of allergy and gave me Patanol.

The Lotemax (for 1 week) really seems to help overall. I will continue with Restasis for another 3 months. Doctor also said the there was improvement of the eye surface. It was much better. My dry rate was 3-4 seconds so no significant change there.

Its almost summer. I hope that the improvement will continue into the fall.

[Storm]

Follow Up

Here is an update and a overall summary of where I am now.

Original LipView Measurements:
1st Reading Dec 9 2011 before Lipflow Treatment that day, with follow up measurements at 1 month and 3 months.

Dec 9 2011 ........1 month .......3 month
............. _________.........._______........_______

Bad Eye ...... 31 ................. 35 ............... 40
Good Eye ... 37 ................. 54 ............... 47

LipView Measurements for Lipflow treatment Nov 28 2012

................ Nov 28 2012 1 month 3 month
................. __________......._______.... _______

Bad Eye ........... 60 ............... 65 ............ ??
Good Eye ........ 66 ............... 96 ............ ??


After the 1st Lipiflow treatment I was put on Restasis for 6 months which seemed to help (although it was spring and summer when the humidity is much higher). I noticed a big improvement the end of August and it was at this time my evaporation rate increased to over 10 seconds in both eyes which was a big improvement over the usual 3-4 seconds. In September I had puntal plugs put in the lower ducts which helped alot. After plugs were put in I was able to change from having to use drops every 20 minutes to once every hour or two which was a big deal.

Overall here is my opinion:

1st Lipflow - 10% improvement
Restasis 6 months (Feb to August) - 20% improvement
Lower Puntal Plugs (September 2012) - 40% overall improvement
2nd Lipiflow - 50% still getting better


I was pleased to see that the oil levels had increased so much over the last year amd I am still hoping for better. My eyes don't feel dry as much as before. The biggest problem is that the eye lids get really sore. At night sometimes the whites of the eyes are red. I use drops every hour or so.

I am not able to work at the office. In October the humidity dropped to below 20% and my eyes got unbearably sore and I could not recover. I am working at home for now. I will go back to work at the office in the spring when the humidity returns.

Here is what I have done:
Fish oil (3000-4000 units daily)
Lipiflow - 2 treatements
Blink Exercises every 20 minutes - I did this for about 7 months

I am a software developer so wrote own blinking program to beep every 20 minutes to use when working to remind me to blink. I still use the program sometimes and try to blink heavily most of the time.

Walk 30-60 minutes 4-5 times a week (treadmill if working at home, or just go for a walk when working at the office)
Restasis twice a day
Eye Drops - Systane Ultra Perservative Free
Pataday - for allegic reaction
Lotamax - occasionally
Heat applied in the evening usually relieves most of the soreness for a while
Daily Vitamins including vitamin D and A
8 cups of water or fluids a day
Add humidiy to the room where I work at home