Too Lippflow again or not

[quattroboy]

Hi all,

Had a very positive visit with Mr. Walker yesterday morning, I've posted an update on the Human Growth factor post.

However, one negative, a number of my glands on my top lids have reblocked and looked slightly red.

This is frustrating because I had all my glands probed in November (not cheap) and Mr.Walker completed a Blepex last month clearing the same blockages. Once the Blephex was complete he declared me to be 100%, gland wise! Now I back to maybe 85%.

It's not a big thing just annoying.

So do I spend some more of her majesty's pounds getting another Lippiflow or just persist with the compresses and lid massage? As we know Lippiflow in any country is not cheap!

Just some more info.

Mr. Walker reckons Lippiflow isn't worth it, just sees it as an expensive hot compress.
Starting Doxy this week to see if this helps improves the oils.
My tear break up times are now well over 10 seconds regardless of this issue.
My last Lippview showed by LLT as around 83 in left and 100 in right.

I noticed there are more options apart from Lippflow and IPL now on the market, e.g. iFlux or Meiboflow Anyone used them?

[Fenix]

You can try Blephasteam. You can find many positive reviews on this forum.
Blephasteam should be one of the most effective way to do hot compress at home.

[CJ L.]

Have you considered scleral lenses? I too have a fairly moderate form of MGD and yesterday put a pair on order (price tag I care not to share, but desperate times...). I previously had Lipiflow done with zero results as well.

[deep_dry_eye]

I think 1 round of LipiFlow is enough. I used to do LipiFlow every 3 months, but I stopped because I found it ineffective. Meiboflow is garbage, warm compress is way better. I think you need to get to the root of the problem. Doing LipiFlow is like changing the oil in your engine , but you should really fix the reason why you are producing bad oils.

Doxy (or azithromycin) can definitely help improve your oil. IPL can also do that as well. Are you on any other drugs, Xiidra and Restasis can also help control your inflammation. My current treatment plan is Xiidra+Restasis+monthly IPL+Omega 3+GLA. I've gone from being bed ridden to working in front of the computer 8+ hrs a day.

[deep_dry_eye]

Have you considered scleral lenses? I too have a fairly moderate form of MGD and yesterday put a pair on order (price tag I care not to share, but desperate times...). I previously had Lipiflow done with zero results as well.

If you only have mild MGD , I would caution you against sclerals. Have you tried IPL/Restasis/Xiidra to help control your inflammation and produce better oils?

The reason I am against scelerals is that studies show long term contact lens use can cause more dry eyes, additionally, (big) scelerals can impact your blinking and cause any partial blinking problems to grow worse.

[quattroboy]

If you only have mild MGD , I would caution you against sclerals. Have you tried IPL/Restasis/Xiidra to help control your inflammation and produce better oils?

The reason I am against scelerals is that studies show long term contact lens use can cause more dry eyes, additionally, (big) scelerals can impact your blinking and cause any partial blinking problems to grow worse.

Yes ikervis.

I agree with your caution on scelerals I'm already a partial blinker.

My main issue is still lack of tears due to the LASIK nerve damage.

I just don't want the glands flaring up again and adding to the problem. Never mind the time and money spent clearing them.

Out of interest my bottom glands looked pink and healthy. It is just a handful in the top lids.

[CJ L.]

deep_dry_eye quattroboy I was advised against IPL and was told Xiidra/Restasis aren't the answers, as my oils are fine. I too tried Lipiflow with absolutely zero results. Before my MGD symptoms became really bad, my original objective was just to be able to wear contacts again. Now it's simply to get through the day/night. The sclerals are already on order (gulp) so try them I will. At this point I'll try anything. Truthfully, the thought of even waiting the three months Xiidra says it requires to possibly see results is hard to bare.

[deep_dry_eye]

deep_dry_eye quattroboy I was advised against IPL and was told Xiidra/Restasis aren't the answers, as my oils are fine. I too tried Lipiflow with absolutely zero results. Before my MGD symptoms became really bad, my original objective was just to be able to wear contacts again. Now it's simply to get through the day/night. The sclerals are already on order (gulp) so try them I will. At this point I'll try anything. Truthfully, the thought of even waiting the three months Xiidra says it requires to possibly see results is hard to bare.

if you do have MGD, then IPL / Xiidra / Restasis are the answers. I would suggest you to visit another Dry Eye Expert for another consult. It never hurts to get a 2nd/3rd opinion, I visited 10+ drs around the world (including some Harvard educated who were useless) to find my dr.

I would also caution you against using contacts, for unknown reasons, certain percentage of the population can not tolerate contacts long term and will develop (perhaps irreversible) dry eyes.

[deep_dry_eye]

Yes ikervis.

I agree with your caution on scelerals I'm already a partial blinker.

My main issue is still lack of tears due to the LASIK nerve damage.

I just don't want the glands flaring up again and adding to the problem. Never mind the time and money spent clearing them.

Out of interest my bottom glands looked pink and healthy. It is just a handful in the top lids.

If you believe you have nerve damage , you should consider Prokera . I've personally had some success with it. Prokera and related amniotic treatments have a chance to heal the nerves.

[Guest]

Wait until after youve been on doxy a few months Imho. After a couple months in doxy, I was able to reduce my temp on my compress for 45-47C to 40-42C. The time dropped also. I used to reheat the compress 3 times, after doxy, I heat it only once and max apply for 10 mins. AND...it was more effective. Doxy thinned my oils so damn nice.

I agree with your doc, lipiflow is an expensive hot compress. Plus, I think if you do it and you don’t address the constant blockage, it will just come back. That’s my two cents. Good luck.

[quattroboy]

If you believe you have nerve damage , you should consider Prokera . I've personally had some success with it. Prokera and related amniotic treatments have a chance to heal the nerves.

I am addressing the nerves with the NGF drops mixed by my doc with a follow up convocal in a few months.

[quattroboy]

Wait until after youve been on doxy a few months Imho. After a couple months in doxy, I was able to reduce my temp on my compress for 45-47C to 40-42C. The time dropped also. I used to reheat the compress 3 times, after doxy, I heat it only once and max apply for 10 mins. AND...it was more effective. Doxy thinned my oils so damn nice.

I agree with your doc, lipiflow is an expensive hot compress. Plus, I think if you do it and you don’t address the constant blockage, it will just come back. That’s my two cents. Good luck.

Yes I was thinking of letting the doxy have some time to work before any more time and money spent.