My experience with IPL with Dr. Sanjay Kamat

[NeedMyEyes]

4th IPL treatment - this time with Toyos

For various reasons (vacation week, had the money and the time, etc.), I decided to go see Dr. Toyos in Memphis for my 4th IPL treatment in Memphis...

His office is near Germantown (a nice suburb of Memphis) in an nice office building with a few other non-medical businesses (law offices, etc.). Dr. Toyos is the MD and there are a few OD (optometrists) there also as well as a few administrative folks and assistants, etc. Everyone was really nice, of course. Actually, if you have seen the IPL DVD that Dr. Toyos made several of the staff are on the DVD.

There were 2 parts of the clinic - the main lobby and main front desk and an adjacent area of a similar size for LASIK surgery (I think he only does this on Fridays).

As soon as I got there, it was clear this was the place that IPL was born. I think they had 4 or 5 other patients receiving IPL that morning. You could tell who was there for IPL that morning - fair skinned patients most with a bit of acne or rosacea. The staff was unusually knowledgeable about IPL and had obviously seen patient after patient with IPL.

The treatment was a bit different here than with Dr. Kamat:

First, Dr. Toyos examined my glands and showed them to me on a TV screen. He said I had "severe disease" with meibomian gland capping, tons of little telangectasia on my eyelids as well as little meibomian gland "cysts" especially on my upperlids. Also, many, many blocked glands.

I have to be honest - I have never really seen my eyelids this close up and it really, REALLY gave me an appreciation for my condition and what I am up against. And I have to say - it's bad, it's really really bad.

I have done my own research on this condition and have seen lots of pictures on the internet and my eyelids could be published in any journal or textbook in the world as "severe posterior blepharitis with meibomian gland dysfunction". Here are some pics I found on the web that look sort of like my lids:



except my lids are a little lighter in color and tons more little vessels on the margin.

After this, I had a microdermabrasion and then the IPL.

Dr. Toyos did the IPL on some higher settings than Dr. Kamat and I could definitely feel it this time. Actually, it hurt and was pretty uncomfortable. Dr. Toyos thought this was because of the blood vessels I have under my skin that were absorbing the light. I hope that's what it was, because that means the treatment is going to work.

Then came the lid expression which was pretty hard and definitely hurt but wasn't as hard as I thought it would be. He video taped this and I have to say when I watched the video, I was disappointed at how much came out of the glands - basically nothing.

Well, but I don't have ANY toothpaste or silly string. I have buttery oil, clear oil, and some crystals. So maybe if you don't have toothpaste, you don't see anything? I'm not sure.

After that Dr. Toyos took a little needle and popped some of my capped glands and meibomian gland cysts. I watched the video and I'm glad he popped them, of course, but I want to see the video next time to see if they came back. I found a video on youtube that looks just like what he did:

Well it wasn't exactly like this. Dr. Toyos used a needle and he just popped the glands and then popped very easily. Also, he popped maybe 5 or 6 total.

Then he put in several drops and prescribed several medications including some antioxidant vitamins and some others.

[irish eyes]

You are very good to have posted all this stuff - thank you.

I'm a little curious about what you said in an earlier posting in June:

"....I think my Meibomian Glands are getting to the point where an eye doctor won't be able to find any dysfunction unless they knew me from before......"

This was with someone called Dr Kamat.

You say that Dr Toyos:

"........ examined my glands and showed them to me on a TV screen. He said I had "severe disease" with meibomian gland capping, tons of little telangectasia on my eyelids as well as little meibomian gland "cysts" especially on my upperlids. Also, many, many blocked glands.....".

Presumably Dr Toyos could see that you had previously had IPL?

Since watching the videos of gland expression, I cannot think of my glands in the same light again! My upper lids are very bad.

Thanks

[NeedMyEyes]

Hi, Irish Eyes, yes this process has been a bit confusing for me...

I went to the eye center at Walmart to get a prescription for Wiley's. There I asked them to look at my MG's in the slit lamp. This was after Lipiflow I think. She said my glands made good oil and yes I DID have a few little vessels on my eyelids but that was just because I had very fair skin... so basically she couldn't really see any meibomian gland dysfunction. I'll admit that since it is Walmart maybe she is not an expert at Meibomian glands.

Then I went to Dr. Toyos and that is what he said - severe disease. And I looked at the DVD recording of my eyelids and I agree that it is pretty bad. So that's all I can say.

My glands open then close then open then close. And the little vessels seem to have been there since the beginning of this process (now about a year ago). So I don't know if the inflammation / vessels are better or worse. The glands open and close. And I have had capping of glands for at least a few months, maybe before that - I'm not sure.

Dr. Toyos said the following about my previous stuff - he said that I *should* have toothpaste in my glands because my disease is so bad. However, he thinks that the IPL / Lipiflow / probing that I had done have prevented that from happening and he saw several glands making normal secretions. So clearly the things I was doing were helping according to him.