IPL for red veins in eyes

[drydm]

Hi, did IPL reduce red veins in your eyes? I have this permanent red veins. Some times they are more visible sometimes less. Some doctors say it will go, also there are those who say it will stay and there is nothing to do. I have been checked with a private doctor who said all my glands are open however the oil is thick. And he advised IPL.
I tried to explain that I made my red veins worse with warm compresses but he said it's impossible and it's just a disease. Also, he seemed to have no interest to give me any other treatment but insisted on IPL. However, I would like to find any other alternative to IPL.
So now I'm in between 3 months of doxy or IPL.
Did you have any positive result of any of treatment regarding red veins?

Thanks!

[Topher3]

Do ipl instead of doxy, ipl WITH manual expression afterwards. Doxy will only do so much. But if you have internal blockages within the glands you need that manual expression after the ipl liquifies the oil to really drain the gland. Also the intense light is great for inflammation and will definitely help in that regard also with bacteria.
In regards to red veins I suffer from these and nothing seems to take them away, that’s seems to be the consensus on this forum that I’ve seen anyway. However if the glands unblock and you have good oil maybe your lipid layer will be able to repair itself and help rid you of some veins that are there due to irritation.

Goodluck

[Milo007]

In regards to red veins I suffer from these and nothing seems to take them away, that’s seems to be the consensus on this forum that I’ve seen anyway. However if the glands unblock and you have good oil maybe your lipid layer will be able to repair itself and help rid you of some veins that are there due to irritation.

Goodluck

Red capillaries are technically dialated blood vessels which are trying to compensate for the under nutrition of the conjunctiva and the cornea by increasing the volume of blood flow (and thereby more nutrients and oxygen). Once the blood vessels are dialated they will remain so but the engorged appearance may decrease or increase depending upon the quality of tears. If you have a low LLT and your tears are evaporating rapidly then they are not providing enough nutrition to your eyeball surface. So then the blood vessels will appear engorged. If you are able to restore tear film homeostasis somehow the engorgement of the capillaries would subside. The same applies to aqueous deficient eyes. Chronic severe dry eyes can actually cause the capillaries to grow and intersect the cornea which is a dangerous condition and may cause blindness.

[Topher3]

Red capillaries are technically dialated blood vessels which are trying to compensate for the under nutrition of the conjunctiva and the cornea by increasing the volume of blood flow (and thereby more nutrients and oxygen). Once the blood vessels are dialated they will remain so but the engorged appearance may decrease or increase depending upon the quality of tears. If you have a low LLT and your tears are evaporating rapidly then they are not providing enough nutrition to your eyeball surface. So then the blood vessels will appear engorged. If you are able to restore tear film homeostasis somehow the engorgement of the capillaries would subside. The same applies to aqueous deficient eyes. Chronic severe dry eyes can actually cause the capillaries to grow and intersect the cornea which is a dangerous condition and may cause blindness.

So technically if you could find a vitamin or mineral that’s may be able to help with the transfer of oxygen to organs this may possibly help the veins? I have read up on a few vitamins and minerals that do this but cannot recall their names.

Milo do you have red veins in your eyes or are yours pretty good?

[Milo007]

So technically if you could find a vitamin or mineral that’s may be able to help with the transfer of oxygen to organs this may possibly help the veins? I have read up on a few vitamins and minerals that do this but cannot recall their names.

Milo do you have red veins in your eyes or are yours pretty good?

Unfortunately no. The nutrition that's provided to the conjunctiva and the cornea by our natural tears cannot be substituted by just vitamins or mineral supplements. Our tears provide nutrition to them in the form of hundreds of types of very complex proteins, oxygen and other biologically active molecules that can be readily used by the conjunctiva or cornea. Supplementing tears with vitamins and minerals would be like an attempt to substitute the very complex composition of meibum with mineral oil. So there's no suitable substitutes for the extremely complex and delicate mechanisms of mother nature other than restoring the malfunctioning systems themselves.

I have had red veins before. I still get red veins when my eyes are inflamed and tears are evaporating quickly. I also get red veins when my eyes are lathered with ointments which prevents tear film stability.

[Topher3]

Unfortunately no. The nutrition that's provided to the conjunctiva and the cornea by our natural tears cannot be substituted by just vitamins or mineral supplements. Our tears provide nutrition to them in the form of hundreds of types of very complex proteins, oxygen and other biologically active molecules that can be readily used by the conjunctiva or cornea. Supplementing tears with vitamins and minerals would be like an attempt to substitute the very complex composition of meibum with mineral oil. So there's no suitable substitutes for the extremely complex and delicate mechanisms of mother nature other than restoring the malfunctioning systems themselves.

I have had red veins before. I still get red veins when my eyes are inflamed and tears are evaporating quickly. I also get red veins when my eyes are lathered with ointments which prevents tear film stability.

Thanks for the info that’s makes sense, I use tears quite a bit and I’m unsure if I should keep using them. I use them to make my eyes feel comfortable at all times for example foreign body feeling occurs I will use eyedrops. Should I be making an effort to be stop using them? I just can’t see my eyes getting better due to stopping using them but I see people making an effort to stop as much as possible. Could my eyes possibly feel better with limiting drops in the long run?

[Milo007]

Thanks for the info that’s makes sense, I use tears quite a bit and I’m unsure if I should keep using them. I use them to make my eyes feel comfortable at all times for example foreign body feeling occurs I will use eyedrops. Should I be making an effort to be stop using them? I just can’t see my eyes getting better due to stopping using them but I see people making an effort to stop as much as possible. Could my eyes possibly feel better with limiting drops in the long run?

When I was using drops almost every 10 minutes my condition deteriorated with each passing day. I didn't understand back then why it was happening. I had no idea about MGD. Now I feel it was probably due to the following few reasons :

1. The frequent instillation of drops were washing away my lipid layer which was already thin.

2. The frequent installation of drops with preservatives were both washing away my mucin layer and damaging the goblet cells (besides damaging all components of the ocular surface in general).

3. Since inflammation was very high and the local immune response was at peak anything put on my eyes (even seemingly innocuous lubricating eye drops) were causing an aggravated immune response felt as a sharp pain after instillation of eye drops.


So speaking from my experience one should not flood his eyes with artificial tears frequently. It should be restricted to once every hour or every 30 minutes at the most. The drops should be preservative free. Most importantly it's useless to rely on drops without controlling the inflammation. Drops will only mask symptoms but inflammation will slowly do the damage anyway.

I think you should get the MCGs asap and look for a doctor who will aggressively treat the inflammation. If needed cry out before the doc and tell him your eyes are burning to the point of insanity even if they look perfectly fine. Beg him to prescribe you anti inflammatories on a long term basis. Don't be afraid to use steroids if needed. Target all potential sources of inflammation and address them. You must bring the inflammation under control.

On the other hand complete discontinuation of artifical tears could be equally detrimental. Both lipid deficient and aqueous deficient tears are often hyperosmolar that's toxic to the ocular surface and invoke more inflammation. Regularly spaced instillation of tear drops eliminates tear film hyperosmolarity and washes away the accumulated inflammatory mediators from time to time. So strategic use of all avaliable options is the key. Artificial tears do have an important role to play.

[Topher3]

When I was using drops almost every 10 minutes my condition deteriorated with each passing day. I didn't understand back then why it was happening. I had no idea about MGD. Now I feel it was probably due to the following few reasons :

1. The frequent instillation of drops were washing away my lipid layer which was already thin.

2. The frequent installation of drops with preservatives were both washing away my mucin layer and damaging the goblet cells (besides damaging all components of the ocular surface in general).

3. Since inflammation was very high and the local immune response was at peak anything put on my eyes (even seemingly innocuous lubricating eye drops) were causing an aggravated immune response felt as a sharp pain after instillation of eye drops.


So speaking from my experience one should not flood his eyes with artificial tears frequently. It should be restricted to once every hour or every 30 minutes at the most. The drops should be preservative free. Most importantly it's useless to rely on drops without controlling the inflammation. Drops will only mask symptoms but inflammation will slowly do the damage anyway.

I think you should get the MCGs asap and look for a doctor who will aggressively treat the inflammation. If needed cry out before the doc and tell him your eyes are burning to the point of insanity even if they look perfectly fine. Beg him to prescribe you anti inflammatories on a long term basis. Don't be afraid to use steroids if needed. Target all potential sources of inflammation and address them. You must bring the inflammation under control.

I just can’t see the inflammation ever going because my LLT is SO low that in just creates inflammation. The only thing that can help me is MCG’s. Steroids long term regardless of penetration still have a pretty good risk of developing cataracts. And then there’s the damage of having to cut open the cornea and removing the cataract when that eventually happens probably causing more trauma. I just cannot see this inflammation ever going away if the glands are malfunctioning from the inflammation. It’s like it has its own system that cannot be taken down as it’s prohibiting my glands from producing oil which they should be capable of. It’s frustrating as ****!!!!!!!!
im hoping this azithromycin does something but so far nothing has changed at all 4 drops into the treatment. My eyes don’t feel good and I just want to use artificial eye drops but I don’t want to wash away the anti bacterial/inflammatory properties. Sigh....... just one of those days today, harder than usual to get through

[Milo007]

I just can’t see the inflammation ever going because my LLT is SO low that in just creates inflammation. The only thing that can help me is MCG’s. Steroids long term regardless of penetration still have a pretty good risk of developing cataracts. And then there’s the damage of having to cut open the cornea and removing the cataract when that eventually happens probably causing more trauma. I just cannot see this inflammation ever going away if the glands are malfunctioning from the inflammation. It’s like it has its own system that cannot be taken down as it’s prohibiting my glands from producing oil which they should be capable of. It’s frustrating as ****!!!!!!!!
im hoping this azithromycin does something but so far nothing has changed at all 4 drops into the treatment. My eyes don’t feel good and I just want to use artificial eye drops but I don’t want to wash away the anti bacterial/inflammatory properties. Sigh....... just one of those days today, harder than usual to get through

It's natural to have the fear of developing premature cataracts. But think about Dowork123. He's no other option than to use steroids. He's on steroids for the last 6 months. We don't have too many safe options unfortunately. Some risks are to be taken or you risk losing the glands forever. This disease is so frightening that it's better to live in a delusion than to digest the reality.

[drydm]

Thanks for sharing your experience Topher3, Milo007. I used to flow my eyes with artificial drops, sometimes using 3 different, changing every hour. At one point I decided to stop and used only one drops 1-2 times a day. And my eyes felt much better. So I believe there are not much benefits for eyes to use drops too often. However, red veins don't go even when my eyes feel great.
I noticed that red capillaries are thicker when I'm tired after work, at the end of the day, after laptop or reading. They get thinner with cold weather outside, after walk etc.
It's just so frustrating that nothing helps for that. Besides, I make it worse with warm compresses. I got more permanent red veins after about 10 days of warm compresses. Don't know why all doctors advise that.

Milo007 what treatment worked for you? Have you had IPL or Doxy? You mentioned anti-inflammatories, do you mean cyclosporine?
At Moorfields, my doctor didn't prescribe it to me saying that I have a tiny bit of inflammation and no need for cyclosporine. Also, he mentioned there are side effects of it and dependency. So I believe it's better to avoid it if possible.

[Milo007]

Milo007 what treatment worked for you? Have you had IPL or Doxy? You mentioned anti-inflammatories, do you mean cyclosporine?
At Moorfields, my doctor didn't prescribe it to me saying that I have a tiny bit of inflammation and no need for cyclosporine. Also, he mentioned there are side effects of it and dependency. So I believe it's better to avoid it if possible.

I have used doxycycline and topical azithromycin in the past (for a month) . I am again using them now. I use loteprednol etabonate drops and ointment as necessary (strategically to tame inflammation quickly) but with caution. I have never used cyclosporine or xiidra but I have used chloroquine phosphate eye drops for two weeks as an anti inflammatory. To be honest nothing worked as fast as loteprednol and nothing worked as good as combined doxycycline and azithromycin therapy to control inflammation on a long term basis (excluding loteprednol which cannot be used for long).

With profound respect to your doctor there's nothing called a "dependency". When they fail to find out the cause of inflammation and anti inflammatories work until they are discontinued they term the relapse as "dependency". If the root causes of inflammation can be identified and addressed successfully then one doesn't need to get dependent on anti inflammatories. If the sources of inflammation cannot be addressed by any means other than anti inflammatories then it's not exactly "dependency" but a necessity of the drugs to avoid irreversible damage from inflammation. The excuse of not prescribing you anti inflammatories by saying that your inflammation is "tiny" is ridiculous because weak anti inflammatories are supposed to work better for marginal inflammation and halt the progress of inflammation. Otherwise this "tiny" unchecked inflammation can take an ominous form over months or years causing permanent tissue damage.

The possible side effects of immuno modulation will always exist but it's better than losing your glands which is irreversible by the standards of modern technology.

You have a good chance of arresting further damage to your glands since your inflammation is still marginal and the vicious cycle of MGD is about to amplify. If you are financially unrestrained to afford out of pocket medical advice then I would suggest you to find a dry eye specialist who's willing to prescribe you anti inflammatories even for a few months.

Also please get moisture chamber glasses as these will help you avoid inflammation related to dessication of your tear film which plays a huge role in the cycle of MGD.

When I asked my opthalmologist about moisture chamber glasses she said they were for the extreme cases where people find it hard even to keep their eyes open. I thanked her and walked out of the chamber without speaking a single word after that. Another opthalmologist did a lipiview of my eyes and my LLT was reported to be low. So I asked for a lipiflow. He confidently said that I didn't need a lipiflow since there was no significant gland drop out and he offers it only to patients with significant gland atrophy.I think most doctors wait for patients to reach to that "extreme" stage when nothing is going to work since you have lost most of your glands. Then they would try out everything on you including lipiflow, IPL, sclerals and what not only to make an effort in vain. But they won't care about your glands when they are still there and need to be conserved. So many of us have basically given up on these so called "doctors" and decided to do a PhD ourselves on dry eye disease by gathering knowledge and experience from this forum (the DEZ University) to self treat ourselves in the best possible way. But you might be lucky to find a good doctor.

[Guest]

Topher3Milo007

i agree with Milo, let me also say...I read a study that looked at hundreds of patients taking lotoprednol etabonate. They had patients on steroids for 6 years ranging from 300 drops to over 3500 drops over that time. Only 3 patients had any complications. So I’d say if you could get compunded alrex, or use Lotemax gel, you should be ok if you watch your pressure. Even if you’re not, I don’t have a choice so what can I do but accept it and take the damn drops. ****ing blows nuts!

[drydm]

I have used doxycycline and topical azithromycin in the past (for a month) . I am again using them now. I use loteprednol etabonate drops and ointment as necessary (strategically to tame inflammation quickly) but with caution. I have never used cyclosporine or xiidra but I have used chloroquine phosphate eye drops for two weeks as an anti inflammatory. To be honest nothing worked as fast as loteprednol and nothing worked as good as combined doxycycline and azithromycin therapy to control inflammation on a long term basis (excluding loteprednol which cannot be used for long).

Thanks Milo for your tips! Will try to meet another specialist to discuss other ways of treatment. However I get to conclusion that they are too commercialised here in London and each try to push their own treatment - IPL, IRPL etc. Not sure if it worth that.

[Milo007]

Thanks Milo for your tips! Will try to meet another specialist to discuss other ways of treatment. However I get to conclusion that they are too commercialised here in London and each try to push their own treatment - IPL, IRPL etc. Not sure if it worth that.

Alix is from UK. You might message her to know more about good eye specialists near you. Unfortunately she hasn't been able to find a good dry eye specialist yet.

Have you tried moisture chamber glasses?

[drydm]

Alix is from UK. You might message her to know more about good eye specialists near you. Unfortunately she hasn't been able to find a good dry eye specialist yet.

Have you tried moisture chamber glasses?

I haven't tried chamber glasses yet. I found one but don't really know where to use them. I can't wear them at work. Just at home? Do you use them all time or occasionally? What kind of effect did you have?
Have you done IPL? If so did you find any improvements?