IPL questions/risks

[No tears in ATL]

So I'm thinking of giving IPL a try. I have a couple of questions on side effects for the clinic before I will go through with it, though. Can anyone help?

1. What type of eye shield should the clinic be using? I read some old posts here back in 2009 about how the use of a metal contact? I think? is ideal. At the time of that post, there were some injuries in Florida from people being exposed to the light. However, this may have been IPL used for cosmetic purposes, not dry eye.

2. Is it common to lose eyelashes? Permanently? I didn't think the light even got that close to the lash line. Which leads to my next question:

3. Is the light typically passed over the upper cheek or on the actual lower eyelid? It worries me to think it could be that close.

Some of these claims may be exaggerated or completely untrue, but these are a few of the urban legends I wanted to clear up.

[LaDiva]

I had IPL done about three years ago, I think. I have tear deficiency, ocular rosacea and MGD. The doctor said he had luck using IPL on people with MGD who did not have a great deal of tear deficiency. It is said to help ocular rosacea. On the first visit, my TBUT was 3, and after the next three treatments, it was 8, which was better, but not enough for a comfortable eye. During the procedure, the eye is covered, and the light is not passed over the eye. I did not lose any eyelashes. It is slightly painful, and I had a mild burn on my cheeks for a week or so after each treatment. It doesn't work for everyone, and wasn't the magic bullet for me. Somewhere there are lists of doctors trained to do this, but I've got to clean up the dinner dishes, so a Google should uncover them. Best wishes to you, whatever you decide. https://www.youtube.com/watch?v=8SFaErUrk60

[No tears in ATL]

Thank you very much for the feedback La Diva. I more or less fit your profile, aqueous deficiency and extremely low tear breakup time, but without the ocular rosacea diagnosis. I found a press release where my clinic was trained by Dr. Toyos, who invented it, so I would hope they are as safe as possible. I would kill for a TBUT of 8, but I guess TBUT doesn't tell the whole story with dry eye. There could still be the chronic inflammation, I guess.

[LaDiva]

You are welcome NT. If you don't have rosacea, one of the MG clearing treatments might work for you. Rosacea keeps everything inflamed, and so the glands never are working properly. Perhaps yours are just plugged and need a good cleaning. Hope it is that simple.

[buntbean]

Rosacea keeps everything inflamed, and so the glands never are working properly.

That's exactly why I'm wondering if probing the glands would do any good. If the inflammation continues then it seems hopeless to think it would be anything but a temporary fix.

[heyjude0701]

No tears in ATL, have you decided whether or not you will try IPL? My profile is similar to yours and LaDiva's. I probably have ocular rosacea since I have mild rosacea on my face (dx by my dermatologist), but it has not been officially diagnosed by my ophthalmologist. He says my posterior blepharitis may be caused by ocular rosacea but it doesn't matter what is causing it because the treatment would be the same whether or not it is caused by ocular rosacea. I have been successfully using PROSE scleral lenses for the past two years but I developed a nodule on the sclera in my right eye and I can't wear the scleral lens in that eye. I am muddling through with one lens, but the photophobia, burning and difficulty focusing when I read or drive have all worsened. Like you, I read up on the 2009 flurry of posts about IPL and am wondering if I should give it a try. There are no clinics near where I live, and insurance doesn't cover the treatments. I would be willing to travel for them, but between the travel and treatment cost, it would be a big expense and I'd like to have some assurance that it will be worth it. If the treatment were that good, I would think it would be offered everywhere by now. The number of clinics doing IPL seem to have increased, but mostly in wealthy areas like Beverly Hills and other clinics in the LA area. The only research I can find is by Dr Toyos, who has connections to the company that makes the machine that delivers the ocular IPL treatment so it may not be unbiased. On the other hand, I see that the Mayo Eye Clinic in Arizona is doing IPL for dry eye; if it has the endorsement of the Mayo Clinic, maybe there are people benefitting from the treatment.

I'm looking forward to hearing whether you tried IPL. Best of luck to you and to LaDiva in managing your dry eyes! As the optician who had made a few pairs of glasses for me once said, the goal is to live everyday without having to think about your eyes. It is an elusive goal with dry eyes, but we keep trying.

[LaDiva]

Thank you for your good wishes Jude, and the same to you. I too would like to know if No Tears decided to go through with treatment. At the very least, it will temporarily help clean some of the gunk out of the glands. It super heats the glands on the bottom, and that loosens up quite a bit of goo. It is said to help the top as well, but I am not sure about that. The doctor told me that the treatment zaps some of the smaller blood vessels caused by rosacea which feed into the eye, and will help with inflammation from rosacea, although the vessels grow back.

[heyjude0701]

Which clinic did you have IPL at, LaDiva? Do you know of anyone who has had the treatment continually for a long term, say five years or more? I wish there was a clearinghouse of information.

[LaDiva]

I went to Dr. Neil Friedman in Palo Alto. He is a gem. I do not know of anyone who has had this treatment longterm. If you have aqueous deficiency, the treatments might not be much help. I'd talk with the doctor, or someone in his office. Best of luck to you, and if you decide to have IPL, please let us know how things unfold.

[heyjude0701]

I'm glad I asked you! I didn't see anyone in Palo Alto on the list I looked at; I only saw Sacramento, LA, Las Vegas and Scottsdale AZ in the west. Palo Alto would be the closest one to me now since we moved from NY to Monterey last year. I think Restasis may have helped my aqueous deficiency a bit. I will certainly give Dr Neil Friedman a call to find out about the procedure.

[LaDiva]

So happy to help. Enjoy Monterey! I love that entire coastline. Best to you.

[No tears in ATL]

I'm looking forward to hearing whether you tried IPL. Best of luck to you and to LaDiva in managing your dry eyes!

Thank you for the kind words! No, I decided not to do it. I started to have the same thoughts like you, that if it were some magic bullet, everyone would be getting this treatment. And not being covered by insurance, it is just not affordable to me right now. After watching a demo on youtube, I think I would need to be very heavily sedated not to jump out of the chair at every pulse. I know it is supposed to be relatively painless, but it the thought of a LASER near my eyeball just scares me.

[heyjude0701]

Thanks for your response, NT in ATL. I was hoping that you said you tried it and it worked but I didn't think that was the case because if it were, you would have posted about it. I'm still thinking about it but I haven't decided yet. I think I will first see if the PROSE doctor I went to in NY or BFS in Boston thinks I can have a lens made that would not irritate the scleral nodule. That would involve a trip to NY (which I have to do anyway to visit relatives) or a trip to Boston (same deal, relatives there to visit). Or I can wait until the PROSE clinic in San Francisco re-opens, probably in July, and go there. But my guess is that they cannot work around the nodule. If wearing a scleral lens in my right eye is impossible, then I'll go to the eye doctor LaDiva mentioned in Palo Alto for a consultation. This is an hour and a half drive for me (but I do have relatives I can stay with in PA so I wouldn't have to do the drive both ways in one day). Gone are the days I can drive 12 hours, hah! Wish I had those young eyes again. One hour is a big stretch for me now, and it has to be daylight but not too sunny.