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Advice On Treating Meibomian Gland Dysfunction (Lipiflow/Q Tips/other ideas??)

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  • deep_dry_eye
    replied
    Originally posted by MGD1701 View Post
    Hi deep_dry_eye

    Warm compress
    I do about 13 min, 43-45C and feel oil flowing & feel great afterwards. Not sure if 5 min is enough???
    Recent study by Dr C Blackie (partner of Dr Korb) shows 45C and reheat can achhieve the best results.

    many or most opinion leaders in USA recommend HydroEye (omega 3 + GLA etc).

    What have helped me: omega 3 + GLA + pure HOCL spray, like Avenova.

    Restasis
    You are lucky to get it. No doctors prescribed me which was a big mistake.
    Prof./Dr Sheri Rowen says she prescribes it right in the beginning to control inflammation and I think she is very right. None of 10 doctors said I had inflammation but the Lid spray with HOCL works - which explains I did have but maybe too low so doctors failed to detect it???? That is why I said Prof. Rowen is very right.
    I visited 10+ drs, most of them did not prescribe it to me till I hit the 11th. You need to ask for it. Most drs are not well informed on how to treat dry eye.

    Get yourself on Restasis and Xiidra.

    Warm compress, its different per patient, and yes I read 15 mins 45C is better.

    Leave a comment:


  • MGD1701
    replied
    Hi deep_dry_eye

    Restasis
    You are lucky to get it. No doctors prescribed me which was a big mistake.
    Prof./Dr Sheri Rowen says she prescribes it right in the beginning to control inflammation and I think she is very right. None of 10 doctors said I had inflammation but the Lid spray with HOCL works - which explains I did have but maybe too low so doctors failed to detect it???? That is why I said Prof. Rowen is very right.
    Last edited by MGD1701; 30-Jun-2018, 05:08.

    Leave a comment:


  • deep_dry_eye
    replied
    MGD1701,

    I did LipiFlow 4x in the past, not doing any more LipiFlow atm, but doing IPL monthly now.

    I still do warm compress daily, approx x4 each 5 mins. I feel oil expressed after each warm compress around 80% of the time. On bad days, I don't feel any oil.

    I do omega 3, PRN or Nordic Naturals , however I don't find that it helps.

    I also do Xiidra and Restasis both BID, I find both drugs to be critical in reducing inflammation. I highly urge you to consider both BID and ask your dr about it.

    I also do autologous QID, however I don't find autologous to help.

    Leave a comment:


  • MGD1701
    replied
    Hi deep_dry_eye

    Great you tackle your problems actively - very wise.

    You mentioned in another post that you did LipiFlow 4 times and do IPL monthly.
    I assume you then dont need to do warm compress at all at home?
    I wonder if dr recommends you omega 3 supplements and lid hygiene?? These are equally important/effectively..

    I did LipiFlow too in order to save glands - right decision - helped about 65%.
    Luckily, recently I have finally found a dr who expresses my glands.
    I will do it on a regular basis - this is all I need.
    I am so happy - it is so so hard to find! No idea why, as it is so easy - just with q-tip, takes about 30 sec. for 1 eye.
    Last edited by MGD1701; 25-Jun-2018, 02:08.

    Leave a comment:


  • deep_dry_eye
    replied
    MGD1701, are you from Canada? I would love to compare notes w/ you if you are from Canada.

    Yes, these treatments are expensive for a variety a reasons (ranging from profit machines for drs; but also these machines are also expensive). Regardless of price, it should be an option for those who can afford them. Personally, I find these options while expensive, worth it, because the alternative is permanent damage to my eyes which would obviously impact my career and future earnings.

    Leave a comment:


  • MGD1701
    replied
    Well, some doctors who do not have IPL nor LipiFlow, treat dry eye with great success. For example, Prof. Dara Chan (from Canada). She says most of her patients can not afford these expensive treatments so she offers expression. I have high respect for her great passion to help. So lucky to habe such doctor.

    Warm Compress
    She recommends 20 times a day, each time 5 min. and it is effective.

    ---------------------------------------------
    IPL, according to opinion leader, Professor Preeya Gupta (from USA)

    most successful for patients with
    *advanced MGD, (mild to serve) evaporative DED
    *+/- Rosacea or Seborrheic Dermatitis
    *Telangectasia lid margins

    . a non-laser light source
    .suitable for almost any patient

    (Dr Toyos, 1st dr who applied IPL to treat dry eye, mentioned in one of his videos that there is NEW model which suits for (almost) all skin types, I recalled)
    Last edited by MGD1701; 24-Jun-2018, 15:02.

    Leave a comment:


  • deep_dry_eye
    replied
    Are you on Restasis + Xiidra? Those drugs can help reduce inflammation and help MGD.

    $690 for two eyes is quite cheap from LipiFlow prices I've seen. You should also consider IPL, as IPL can also help reduce inflammation in your glands.

    Leave a comment:


  • Hokucat
    replied
    Hi Kabuto. Do you know the quality of the oil from your glands (normal, frothy, thick like Crisco Oil), and if there are some glands producing little or no oil? Your eye doctor should be able to see this by pressing firmly on several of your glands.

    If there is still some oil, gland expression, LipiFlow, or IPL by themselves or in combination has helped some in this forum. From what I’ve read, seems less people have been helped by LipiFlow than IPL, but LipiFlow is more widely available...both can require several treatments before seeing improvement. Gland expression is often performed just prior to IPL and probing procedures. If none of these three work, you may have scar tissue, which in that case only probing can unblock the glands. Both expression and probing are very uncomfortable procedures. Probing is also very invasive, but for my situation having many glands with scar tissue, it was necessary.

    pythonidler did a write-up that includes in-depth explanations of Treatments for MGD (plus much, much more). Would definitely recommend you read this section, as it explains expression, LipiFlow, IPL, probing, at-home treatments, etc. very well. It’’s also a great resource to help those starting their dry eye journey get up to speed, and I’’ve even learned a lot from it as a dry eye veteran.

    http://forum.dryeyezone.com/forum/dr...nduced-dry-eye

    Leave a comment:


  • Kabuto
    replied
    Originally posted by MGD1701 View Post
    Hi Kabuto

    Thanks for sharing.

    Dr. Latkany
    It is very interesting to know he '' tends to avoid Lipiflow and use Q Tip treatments.'' Any idea why? How does he treat MGD then? So curious!
    LipiFlow is FDA approved and I have tried it and it helped me about 65% - unblocked glands.

    Monitor treatment plan
    How did your dr evaluate his treatments?
    Did you take LipiView, compared Lipi layer thickness, inflammation test MMP-9, osmolarity etc?

    Thanks!
    I don't know much more about Dr Latkany's methods than you do to be honest- as mentioned, he doesn't accept my insurance, so I haven't really had the chance to talk to him about it.... But from what I understand, he tends to use Q Tip scrubs. The receptionist over the phone of his office says he doesn't use Lipiflow..

    As far as the evaluation, I'm not sure. It's a pretty comprehensive Dry Eye exam though, so I'd imagine they tested most of this stuff.

    Leave a comment:


  • MGD1701
    replied
    Hi Kabuto

    Thanks for sharing.

    Dr. Latkany
    It is very interesting to know he '' tends to avoid Lipiflow and use Q Tip treatments.'' Any idea why? How does he treat MGD then? So curious!
    LipiFlow is FDA approved and I have tried it and it helped me about 65% - unblocked glands.

    Monitor treatment plan
    How did your dr evaluate his treatments?
    Did you take LipiView, compared Lipi layer thickness, inflammation test MMP-9, osmolarity etc?

    Thanks!

    Leave a comment:


  • Advice On Treating Meibomian Gland Dysfunction (Lipiflow/Q Tips/other ideas??)

    Hi everyone,

    So about two years ago, I got a Meibomian Gland Dysfunction diagnosis. My doctor then had recommended the Bruder eye mask, lid massages afterwards, & Omega 3 supplements. After a while of doing all this, I also added Refresh Plus eye drops to the regimen.

    Now, I had another Dry Eye exam yesterday. According to their results of this latest exam, my condition hasn't really improved all that much.

    The doctor recommended I continue with Bruder/massage/Omega 3 - but recommended I change my eyedrop to either Refresh Optive Mega3 OR Retaine Eye Drops. Thus, I will change my drops and continue my regimen- but am I convinced this alone will make a big difference?

    I have some other options. My doctor said I could be a good candidate for Lipiflow- as even though the glands are blocked, they are not inherently damaged, and can be restored. This does cost about $690, as this isn't a procedure insurance covers at the moment. At this point, I'd splurge anyway, given that I really want to treat this. However, I've heard mixed feelings on Lipiflow.

    Famous NY dry eye doctor, Dr. Latkany, for example, tends to avoid Lipiflow and use Q Tip treatments. However, Dr. Latkany doesn't accept my insurance either, and I don't know the first thing about the Q Tip method...

    So as a result, I'm quite lost as to how to proceed. I'm not sure what action to take- but I do know that I really really want to treat this Dry Eye. Any suggestions on how to take action with this?
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