IPL, my experience

[leno89]

I have a problem when I use a computer or smartphone. After a minute or two, my eyes burn and sting (I used maximum 1-2 houres of day). I have a confirmed MGD. I am after one MiBo Thermoflo treatment, I think it is the same as LIpiflow. Nothing helped. I would like an IPL E-eye. I wonder if it helps.
The drops that contain Dexpanthenol help me the most. Others don't. My friend phenix01 do you have other diseases maybe skin?

[phenix01]

After thorough research and trying many things, I can say that while all these treatments may help, placenta based drops are also very helpful. Regener Eyes or Prokera are to be considered. Regener Eyes especially have a lot of good feedback for MGD patients.

So didn't you want to have another 1 or 2 sessions done in order to have even more sustainable and better results?

[ebi1368]

Dear all

I am now done with all 4 of my IPL treatments. I took my time to give an update because I did not want it to be like my last posts where first week after treatment I'm voicing that I'm relieved, for my symptoms to promptly come back thereafter. I have found doctors on the web actually predicting this and saying that with the first treatments, there can be a sens of relief on the first week or so as the glands are draining themselves, but it takes several treatments for the underlying problem to be sustainably improved. One doctor on the web said her patients have sustained results only from the 4th or 5th treatment. This sounds like the case for me. I have had my 4th treatment two weeks ago and I must say that the improvement vs before IPL treatments is highly noticeable.

I now forget to even carry eyedrops on me. The worst times used to be in the morning waking up when my eyes would feel like sand paper. Now in the morning, my eyes feel 8/10 normal, which is a high improvement. I still have some discomfort at times but my dr said that I have lasik induce corneal neuropathy, i.e. my nerves dont function properly as lasik was such an invasive shock for them. He diagnosed it by putting a drop that is supposed to numb all sensation (before my first IPL treatment) yet I still had dryness pain. I am now on autologous serum drops, which according to several studies online is very effective to solve corneal neuropathy over the course of a 6 months use. One thing for sure, before IPL treatment, the mix of dryness and corneal neuropathy gave me such a hard time that the pain even went up to my forehead sometimes. I now cannot recall the last time this happened. I was in such a bad shape, I am very thankful for IPL. My dr says that I now have a "good yield" of oil production, therefore I'm focusing on solving corneal neuropathy right now.

I have done a lot of research leading me to think that me wearing contact lenses for 8+ years may be one of the main contributing factors to having MGD prior to Lasik, which combined with Lasik led me to all these problems. Thanks to Lasik I was able to discover that I had MGD and take action before it is too late (before glands atrophy).

It is my understanding that you don't get MGD overnight, it is something that is slowly happening and can be caused by several reasons (no blinking fully hence glands become stagnant, not blinking enough, wearking contacts that may make your lids not adhere proprely making glands stagnant, etc.). When your glands are malfunctioning, those also do not get back on their feet overnight. I have had good improvements now but I need to continue helping my glands getting active, one way to do it that I have found helps me is glands expression once in a while. While people are usually against patient doing it themselves, and while Dr make us think it is so complicated so we make appointments with them, it is very easy to do at home. I do not recommend applying pressure to the eyeball so I use a mastrota padde. After a warm compress session, I will gently and safely express my glands, so gently that I'm not even seeking full expression, I just want to see the oil come out to make sure 100% that my glands are working and creating new oil. I also make sure to blink well and fully everyday. Doing this + the IPL treatments has led me to having good eye comfort again. Best of luck to everybody struggeling with this very inconvenient dry eye problem.

phenix01
I am so happy for you. Thanks for sharing the good news. Keep me hopeful.

[phenix01]

Dear all

I am now done with all 4 of my IPL treatments. I took my time to give an update because I did not want it to be like my last posts where first week after treatment I'm voicing that I'm relieved, for my symptoms to promptly come back thereafter. I have found doctors on the web actually predicting this and saying that with the first treatments, there can be a sens of relief on the first week or so as the glands are draining themselves, but it takes several treatments for the underlying problem to be sustainably improved. One doctor on the web said her patients have sustained results only from the 4th or 5th treatment. This sounds like the case for me. I have had my 4th treatment two weeks ago and I must say that the improvement vs before IPL treatments is highly noticeable.

I now forget to even carry eyedrops on me. The worst times used to be in the morning waking up when my eyes would feel like sand paper. Now in the morning, my eyes feel 8/10 normal, which is a high improvement. I still have some discomfort at times but my dr said that I have lasik induce corneal neuropathy, i.e. my nerves dont function properly as lasik was such an invasive shock for them. He diagnosed it by putting a drop that is supposed to numb all sensation (before my first IPL treatment) yet I still had dryness pain. I am now on autologous serum drops, which according to several studies online is very effective to solve corneal neuropathy over the course of a 6 months use. One thing for sure, before IPL treatment, the mix of dryness and corneal neuropathy gave me such a hard time that the pain even went up to my forehead sometimes. I now cannot recall the last time this happened. I was in such a bad shape, I am very thankful for IPL. My dr says that I now have a "good yield" of oil production, therefore I'm focusing on solving corneal neuropathy right now.

I have done a lot of research leading me to think that me wearing contact lenses for 8+ years may be one of the main contributing factors to having MGD prior to Lasik, which combined with Lasik led me to all these problems. Thanks to Lasik I was able to discover that I had MGD and take action before it is too late (before glands atrophy).

It is my understanding that you don't get MGD overnight, it is something that is slowly happening and can be caused by several reasons (no blinking fully hence glands become stagnant, not blinking enough, wearking contacts that may make your lids not adhere proprely making glands stagnant, etc.). When your glands are malfunctioning, those also do not get back on their feet overnight. I have had good improvements now but I need to continue helping my glands getting active, one way to do it that I have found helps me is glands expression once in a while. While people are usually against patient doing it themselves, and while Dr make us think it is so complicated so we make appointments with them, it is very easy to do at home. I do not recommend applying pressure to the eyeball so I use a mastrota padde. After a warm compress session, I will gently and safely express my glands, so gently that I'm not even seeking full expression, I just want to see the oil come out to make sure 100% that my glands are working and creating new oil. I also make sure to blink well and fully everyday. Doing this + the IPL treatments has led me to having good eye comfort again. Best of luck to everybody struggeling with this very inconvenient dry eye problem.

[ebi1368]

Those need to be removed to undergo IPL otherwise those could melt.

Intersting. My doctor did not tell me that. I hope mine is ok. I did two rounds of ipl with having plugs in.

Anyway, since I had 4 plugs my eyes are a bit better. I think my main problem is mgd thoug as I get headaches and etc

[phenix01]

Do you have upper and lower plugs?

Those need to be removed to undergo IPL otherwise those could melt.

[phenix01]

Thanks for sharing. What are your lipid layer thickness, 3 main complaints?
how many glands are opened?
Did doctor take MMP-9, osmolarity? which can also rule out like CCH, allergy etc.

Not sure about lipid layer thickness. Regarding amount of glands open, it depends which doctor I ask. One recently told me my glands are generally all producing but in low quantity.
Dr did take inflammation which resulted in no inflammation on the surface of the cornea (I use xiidra), and confirmed that osmolarity is good.

Is it plausible to obtain relief only after 4+ treatments?

[ebi1368]

UPDATE (one week after 3rd treatment)

Just like with the first two treatments, first week post 3rd treatment was good, then it comes back to not producing much oil (at least that's what it feels like). I'm strating to be out of solutions here. My doc says I have good oil osmolarity and that I'm responding well to the treatment, yet it still feels like not enough oil is getting out of my glands. Dr will increase pulse strength on my lids for 4th treatment, but I'm starting to lose hope here.

Do you have upper and lower plugs?

[MGD1701]

Thanks for sharing. What are your lipid layer thickness, 3 main complaints?
how many glands are opened?
Did doctor take MMP-9, osmolarity? which can also rule out like CCH, allergy etc.

[phenix01]

UPDATE (one week after 3rd treatment)

Just like with the first two treatments, first week post 3rd treatment was good, then it comes back to not producing much oil (at least that's what it feels like). I'm strating to be out of solutions here. My doc says I have good oil osmolarity and that I'm responding well to the treatment, yet it still feels like not enough oil is getting out of my glands. Dr will increase pulse strength on my lids for 4th treatment, but I'm starting to lose hope here.

[deep_dry_eye]

Not much improvement from treatment #1 to treatment #2. It's always great right after treatment for a week bu so far nothing sustained. Getting treatment #3 in two days..

good luck! pls keep us posted

[phenix01]

Not much improvement from treatment #1 to treatment #2. It's always great right after treatment for a week bu so far nothing sustained. Getting treatment #3 in two days..

[phenix01]

Thanks Phenix.
Just curious, how did your doctor detect corneal inflammation, with dye?
Do you/your doctor consider xiidra help with such inflammation? if not, what then?

Yes som instrument he applied on my cornea. He believes xiidra is the reason why I do not have inflammation on my cornea although my eyes are dry. Xiidra is essentially a "fix".

[phenix01]

Just to be clear, when I said inflammation, I meant inflammation of the meibomian glands (as opposed to cornea or other parts of the ocular surface). It is difficult and maybe even impossible with Today's technology to properly diagnose whether there is inflammation inside the glands.

Correct, truth is doctors can't accurately pinpoint what causes MGD. It could be inflammation within the glands, bacteria, poor blinking... it's trial an error with different treatments to see what works and infer diagnostics.

And yes you need ot fix the underlying dry eye problem to fix corneal inflammation long term. Xiidra is just a "fix", fixing it short term to help MGD treatment work better. Xiidra may help against gland inflammation too but I seriously doubt it.