Back to Square One, 5 years post-LASIK

[hosanna13]

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

[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]

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

[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]

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.

[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 ;(

[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]

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.

[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.

[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]

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.

[Hokucat]

Hosanna, I use the Costco Kirkland Green Tea, it's a combination of matcha and sencha. I put the bag in warm water and hit it against the side of the cup with a spoon at least 100 times, so it gets a dark green and really strong, then squeeze in the juice of 1/6 slice of a medium/large Meyer lemon. I often add in crushed ginger and a small handful of goji berries, and then drink it right away (2x daily), so it does not lose potency from being exposed to air too long. I've read any green tea that is more on the brown/green side has been over processed and the antioxidants compromised, so would stay away from those teas.

Yes, I also had aqueous deficiency too. No oil and no tears was debilitating!

[hosanna13]

Those tests have not been offered to me, but I will ask the ophthalmologist on Monday. The optometrist did not think my dry eyes were due to inflammation; this also explains why Restasis didn't work for me. I really think I just have aqueous deficiency (due to severed nerves) on top of MGD. I really hope lipiflow helps.

I just started wearing my scleral lenses again today. I don't like wearing them, but the alternative is being in 10/10 pain at work.

In the meantime, my regimen will be manuka honey on eyelids, fish oil (1g/daily), flaxseed oil (1 tbsp/daily), and adding lemon to the copious amounts of green tea I already drink everyday. The hot vapors from my mug are soothing for a few minutes at least...

[MGD1701]

Probing: I asked one dr if probing, IPL etc would help me. Yes, was the answer. But 3 doctors said I dont need it since no scar tissue been found.
Seems scar tissue is related to inflammation which I dont have for the last 1.5 years.

Most doctors are not solution-driven nor knowledgable, best is you find solutions by yourself and ask their opinions - that might be more effective.
In the meantime, best you rule out possible causes in order to identify real causes.

Osmolarity test & InflammaDry test: Have you dont these useful tests? Lots of benefits - monitor status, tear quality etc.
These are pretty standards now in USA.

[hosanna13]

Huh I will have to try the green tea and lemon combo then. Do you use a particular brand of green tea? Matcha powder has more antioxidants, so maybe I should start mixing pure matcha powder and hot water to get a more potent 'green tea.' Do you have aqueous deficiency, too, or just MGD? The optometrist said that what little tears I do have are evaporating instantaneously due to lack of the lipid layer.