Back to Square One, 5 years post-LASIK

[deep_dry_eye]

Just to update: I will be getting lipiflow on Wednesday. The ophthalmologist told me my glands are blocked and aren't secreting anything when he stabbed my eye with Q tips. I dont think they are the correct tool to apply enough pressure. When I express at home using my expressor tool, I do see clear oil. It's slow and thick, but it's there. I also started a short course of azithromycin today. Studies have shown that a 5 day Z-pack was superior to 1 month of doxy with fewer side effects. I prescribed myself 500 mg daily azithro for today, tomorrow and wed in prep for lipiflow. I am hoping that azithro will augment lipiflow by thinning the oil and reducing inflammation.

Those studies are from Iran -- I wouldn't trust those studies very much. However topical azithromycin has been used to much effective as for reducing inflammation and thinning out the oil. I've personally have had a lot of luck via topical azithromycin (Azyter), however I can't get that in Canada anymore. I am also considering oral azithromycin. Oral azithromycin should do the same, as it is systemic (as opposed to localized topical azithromycin drops). I wouldn't go w/ 5 day course tho, I would go w/ a longer course and take it every 2 days. Azithromycin has a much longer 1/2 life compared to say doxy. If I were you, I would use the same dosage as acne azithromycin usage. The logic is, the doxy dosage we use for dry eyes is the same for acne, so I suspect if we use the same dosage of azithromycin for dry eyes as acne, it should be effective as well (especially since topical azithromycin has much history w/ MGD/thick oil).

[hosanna13]

Yes, even in the study, only half of ppl found clinical benefit in either arm...so it's 50/50 whether or not antibiotics would help you. I personally cant tolerate doxy because it gave me a gastric ulcer. I might start applying azasite (azithromycin eye drop) on my margins only using a q tip. I dont think it would be good for my eyes to use a drop with preservatives everyday on my cornea. I cant believe Canada would stop making these drops unavailable? Perhaps you can find them for a good price online via an Indian pharmacy.

[hosanna13]

Just had lipiflow this afternoon. If anything, my eyes feel more irritated from all the lidocaine drops used. The tech put in 3 drops in each eye 1 min apart. Is this really necessary? How many drops were put in for other people?

My eyes are red and inflammed now and I know I will have to use steroids for a few days to clear this up. As for the procedure itself, it was a bit anxiety inducing to put in the cups, but the warm massage felt nice. I wish I could do that for my lids everynight without the lidocaine drops. I am now going to maintain my glands by applying azasite on the lid margins at night only before bed.

[MGD1701]

my dr did not give me any drops prior to LipiFlow. What are the purpose of lidocaine drops?

I did not have red nor inflammation before and afterwards.

Did you ask dr if you have scar tissue?

[hosanna13]

The lidocaine is to numb the sclera so that the cup is more comfortable. Wow, wasn't the cup painful for your eyes? I came back home and expressed my lids, there seems to be more oil expressing now. I saw my glands on lipiview, they look sparse. No scar tissue. I think as an Asian female, i was just born with sparse glands. Mgd is more prevalent in Asian females than any other demographic ;(

[hosanna13]

As a side note, the lipiflow machine only costs $25k. I am wondering if people have considered buying these for home use, say for weekly therapy. The "disposable" wires can easily be disinfected with alcohol wipes. I can't imagine one 12 min lipiflow treatment is significant, this is probably something you need to do on a regular basis for maintenance. The lipiview machine is what costs a lot more, and totally unnecessary after the first time.

[deep_dry_eye]

As a side note, the lipiflow machine only costs $25k. I am wondering if people have considered buying these for home use, say for weekly therapy. The "disposable" wires can easily be disinfected with alcohol wipes. I can't imagine one 12 min lipiflow treatment is significant, this is probably something you need to do on a regular basis for maintenance. The lipiview machine is what costs a lot more, and totally unnecessary after the first time.

Yeah -- the ODs make huge profits off us. My understanding is that the applicator cost only $375 per treatment for both eyes as well.

[hosanna13]

The applicator can also be disinfected easily. They are creating so much waste just to profit from the disposables.

[deep_dry_eye]

To Canadians / Toronto area ppl -- if you're willing to purchase a machine tgt or something. We might be able to work something out. PM me.

[hosanna13]

That's a brilliant idea. I wish I lived near Toronto so that we could share the machine!

[hosanna13]

1 week update after Lipiflow:
Finger crossed, but my eyes feel much better now. Almost back to "normal" on some days. Of course I still can't sit in front of a fan, but my eyes are not as painfully dry. I tried Azasite on eyelid margins for a few nights after Lipiflow, but couldn't tolerate the dryness and pain the day after. My eyes feel better without Azasite.

[Hokucat]

Thanks for the update, hosanna. So Lipiflow and Azasite are the only treatments/changes you have made in the last few weeks? Did you take any other meds or make any diet changes?

I hope you continue to feel even better!

[hosanna13]

In the last week, I have been taking 1g fish oil three times daily, 0.5 tbs flaxseed oil, green tea with lemon. All the studies say that it takes months for omega3/6/9 to help MGD, so I doubt the oil supplements are doing anything yet. Since lipiflow, I see more oil coming out of my glands with expression after hot compress (I use the actual medical tool, not Q tips). I hope to get lipiflow as a maintenance therapy at least every 3 months since it's covered at my hospital for free.

[hosanna13]

I forgot, I also took a Z-pak, or 5 day course of azithromycin. 1st day is 500 mg, days 2-5 are 250 mg. I started it 2 day before lipiflow.

[deep_dry_eye]

In the last week, I have been taking 1g fish oil three times daily, 0.5 tbs flaxseed oil, green tea with lemon. All the studies say that it takes months for omega3/6/9 to help MGD, so I doubt the oil supplements are doing anything yet. Since lipiflow, I see more oil coming out of my glands with expression after hot compress (I use the actual medical tool, not Q tips). I hope to get lipiflow as a maintenance therapy at least every 3 months since it's covered at my hospital for free.

wow! which country/hospital are you from/goto?