IPL success!!

[jack1988]

Hi everyone,

I just want to give a good news story!

I have MGD (diagnosed just 4 months ago), I'm 33 and I was so scared when it first happened. My NHS optometrist just told me to use eye drops and hot compresses, but when I came across this forum I realised I needed to take my own action and pay to see a private specialist.
I went to BBR in Hereford who were brilliant. They did a bunch of diagnostic tests and really listened to me and calmed my anxiety.
My TBUT was 3 seconds in my left eye and 6 in my right, and my oil was like butter. Not great! I didn't need Lipiflow as my glands are all open, just very sluggish.

I did my first IPL last Wednesday, and in the last 6 days I've used eye drops maybe 6 times in total. Down from about 4-6 times per day! My eyes feel 95% normal. I no longer have stinging and burning in my eyes, except a handful of days where I stay up too late, which I will happily take.
And this is after the first treatment! They said I probably won't feel any improvement until my 3rd session but I feel a huge improvement to the point that I am no longer thinking about my eyes except pure joy.
I have read up on it, and some people are considered early responders and will feel the benefit straight away, it seems that's me!
For all of those who think they can't be treated, please please please consider IPL!
I'm no longer depressed and anxious, I feel great.

All
I'm doing at the moment is my relaxing hot compresses twice a day, and using EvoTears once or twice a day if I need to (but mostly no drops at all). I wear EyeSeals 4.0 to bed, and that's it!

It's only because of this forum that I took matters into my own hands and paid for private care, and I'm so glad I did.

I'll update again after my second session.

Good luck everyone

Cat xx

What made you choose Evotears btw? Have you tried any other drops? I have MGD and use Hypromollese but it doesn't always work!

I have tried NovaTears (same as Evo) and they irritate my eyes a little bit. Is that something you have noticed too?

[gilles]

gilles my eye doctor said I have no signs of bleph at all so there's no real need for me to practice rigorous eyelid hygiene unless I feel I really want to. Obviously I wash my face normally but I don't really fret about perfect lid hygiene! But that's just me!

I also don't know the root cause of my dysfunction, but I did suffer from adult acne until very recently and have oily skin generally. I also wore contact lenses to death until I could no longer wear them (so uncomfortable), and my job as a proofreader staring at screens for far too long are, I think, my "multifaceted" reasons it's happened to me. I'm 34 and have zero other health problems so I don't believe it's a biological thing, or a systemic thing. I just thing I've abused my eyes for too long unfortunately. However, I am now feeling much much better after IPL and not wearing makeup for 6 months thanks to covid and working from home.


Fun fact that weirdly made me feel a lot better, Jennifer Aniston suffers from chronic dry eye! There's a few articles out there where she talks about it quite a bit.

We share the oily skin, acne, and computer screen part (software developer). I also think having been at friends in a room full of cigarette smoke and allergens (his cat used to lay on the coach) and having chalazions because of that, while my other friend also had chalazions at that time, played a big role. Chalazions might be the reason of old meibum plugging the gland.

I guess the eyelid hygiene could play a inflammatory role, because this blephasol makes my skin a bit red on the sides (it can be a bit harsh on the skin).
By the way, if I understand it correctly, what you mean is anterior blepharitis with bleph? While what we both share (mgd, or posterior blepharitis), it is true that the hygiene part plays a bigger role with the anterior bleph.

I also came across an article about Jennifer Aniston having trouble with dry eyes. I'll look into it is I'm curious to see which bleph. she is dealing with.

[KittyCat]

gilles my eye doctor said I have no signs of bleph at all so there's no real need for me to practice rigorous eyelid hygiene unless I feel I really want to. Obviously I wash my face normally but I don't really fret about perfect lid hygiene! But that's just me!

I also don't know the root cause of my dysfunction, but I did suffer from adult acne until very recently and have oily skin generally. I also wore contact lenses to death until I could no longer wear them (so uncomfortable), and my job as a proofreader staring at screens for far too long are, I think, my "multifaceted" reasons it's happened to me. I'm 34 and have zero other health problems so I don't believe it's a biological thing, or a systemic thing. I just thing I've abused my eyes for too long unfortunately. However, I am now feeling much much better after IPL and not wearing makeup for 6 months thanks to covid and working from home.


Fun fact that weirdly made me feel a lot better, Jennifer Aniston suffers from chronic dry eye! There's a few articles out there where she talks about it quite a bit.

[gilles]

gilles I use something called 'Vital Baby Aquaint' as recommended by another UK user, as it's available on Amazon UK and pretty cheap! It's just Hypochloric Acid and I just spray it on my finger and rub it onto my eyes in the morning, just to get rid of any sleep crustiness and to moisten my eyelids. That's all I do as far as eyelid hygiene goes as I don't have any bleph! It's nice and refreshing. Sometimes I'll do it during the day if my eyes are feeling a bit dry and I don't want to use a lot of drops, but that's a rare day! For eyedrops I use Hyco San Dual and I use those anywhere between twice a day and maybe 6 times a day max.

Cat

I don't know the cause of the dysfunctioning of my glands, so to rule out the bacterial part I try to clean my eyelids. Maybe it is of no use and will only exacerbate the inflammation. I guess eyelid hygiene is only useful if having flaky and itchy eyelids with lots of dirt, bacteria and dandruff; which I don't have.

[KittyCat]

gilles I use something called 'Vital Baby Aquaint' as recommended by another UK user, as it's available on Amazon UK and pretty cheap! It's just Hypochloric Acid and I just spray it on my finger and rub it onto my eyes in the morning, just to get rid of any sleep crustiness and to moisten my eyelids. That's all I do as far as eyelid hygiene goes as I don't have any bleph! It's nice and refreshing. Sometimes I'll do it during the day if my eyes are feeling a bit dry and I don't want to use a lot of drops, but that's a rare day! For eyedrops I use Hyco San Dual and I use those anywhere between twice a day and maybe 6 times a day max.

Cat

[gilles]

KittyCat, you said your routine now is warm compresses twice a day and blink exercises. Do you include eyelid hygiene (lid debriment, eyelid scrubs, etc.)?

[KittyCat]

Eyelid inflammation is blepharitis. So all the symptoms associated with blepharitis - puffy eyelids, potential scaling of the surface, flaky skin, blocked glands (even), crusting, lashes missing, demodex, etc.
My understanding is that IPL works by reducing the gland inflammation. In some cases glands become blocked due to the glands being inflamed (many reasons - s dermatitis, bacteria, etc).

Aaaah, so benja5290 and gilles in that case I have no inflammation that I know of. I'm lucky enough to have no signs of bleph, and my doctor has never told me I have any active inflammation.
.

[KittyCat]

Awesome! Did they do the IPL directly on your eyelids with a corneal shield, or just around your face?

The unfortunate thing about IPL is it can't be done on darker skin, the melanin is like natural sunscreen and absorbs too much energy.

But it's not just the manual expression, there is good data that the IPL itself helps stop the inflammation. I've had warming and manual expression done and I didn't notice much difference, the glands just get clogged up again.

Hey lipino,

I wore eye shields and had 5 pulses each eye, nose to ear on my lower eyelid!

Cat

[gilles]

I had my 1st IPL 2 weeks ago. The doctor used a metal tool to express glands both upper and lower lids. It really hurt. She said my oils were a stage 1.

So your oil is of good quality, being as it is 'only' stage 1?
Did they mention a hypothesis of the cause of your dry eyes, knowing the oil is quite good (and no blockages; as I would imagine it'd probably be junk coming out)?
Was there a meibography taken of the glands, to exclude gland atrophy?

[LindaDawn]

I had my 1st IPL 2 weeks ago. The doctor used a metal tool to express glands both upper and lower lids. It really hurt. She said my oils were a stage 1.

[gilles]

5 pulses on each lower eye lid!

And nothing to the upper eyelid? How is the upper eyelid treated then (against inflammation)?
This could, again, prove that the manual expression part is the most important part. And maybe IPL should be done separately from a warm compress with manual expression, but in one session; in order to have melted the meibum or plug with the compress rather than the IPL.

[gilles]

Hi gilles the term "eyelid inflammation" is something I see a lot, but I don't actually know what that physically looks like! How do I check this?

I didn't have a meibography per se, I had infrared images of my eye lids taken, which showed the shape of my lower eye lid glands. The only thing "wrong" that my doctor could see, is that a couple of them weren't straight but rather starting to twist a bit, possibly making it more difficult for oil to flow freely? I don't know. But then she checked the state of the oil by pressing the glands and seeing what kind of consistency the oil is. So I think the imaging shows the shape and length of the glands (atrophy or non atrophy for example), and then manual expression should be carried out afterwards to see the state of the oil coming out. You need both of these things for a full picture I guess!

Oh, I thought a infrared image of the glands was automatically a meibography.
How did they perform manual expression to check the oil? With a squeeze from the fingers in one of the bottom eyelids?
They should use that tool from Donald Korb (where the pressure = pressure of a blink) as a standard, in order to have consistent pressure and results. And do it at both eyes.

I remember now that when doctors do it to my glands they sometime say there is nothing coming out, then one does it at the right eye (good eye) and there comes some oil out. And another doctor who said it came out, but very slowly (so meaning it is thick oil).

[gilles]

Eyelid inflammation is blepharitis. So all the symptoms associated with blepharitis - puffy eyelids, potential scaling of the surface, flaky skin, blocked glands (even), crusting, lashes missing, demodex, etc.
My understanding is that IPL works by reducing the gland inflammation. In some cases glands become blocked due to the glands being inflamed (many reasons - s dermatitis, bacteria, etc).

For me, it has never been flaky, scaling like. It rather is the at the exterior of the eyelid, where the most lower line of the eyelid (bottom part of the upper eyelid, top part of the bottom eyelid) is a bit swollen en red.

[benja5290]

Hi gilles the term "eyelid inflammation" is something I see a lot, but I don't actually know what that physically looks like! How do I check this?

Eyelid inflammation is blepharitis. So all the symptoms associated with blepharitis - puffy eyelids, potential scaling of the surface, flaky skin, blocked glands (even), crusting, lashes missing, demodex, etc.
My understanding is that IPL works by reducing the gland inflammation. In some cases glands become blocked due to the glands being inflamed (many reasons - s dermatitis, bacteria, etc).

[KittyCat]

Hi gilles the term "eyelid inflammation" is something I see a lot, but I don't actually know what that physically looks like! How do I check this?

I didn't have a meibography per se, I had infrared images of my eye lids taken, which showed the shape of my lower eye lid glands. The only thing "wrong" that my doctor could see, is that a couple of them weren't straight but rather starting to twist a bit, possibly making it more difficult for oil to flow freely? I don't know. But then she checked the state of the oil by pressing the glands and seeing what kind of consistency the oil is. So I think the imaging shows the shape and length of the glands (atrophy or non atrophy for example), and then manual expression should be carried out afterwards to see the state of the oil coming out. You need both of these things for a full picture I guess!