Intraductal Probing

[Blake]

Hi Everyone!

I thought I would post that I decided to begin Intraductal Probing for MGD in our office. Right now, I have a few patients that have been waiting for the procedure and I can't wait to see how this procedure can help them!

I would be happy to post my opinions from "this side" as we get results.

Feel free to ask questions

Dr. Blake

[odydnas]

Hi Dr. Blake. Great to see another eye doc open to trying new treatments. Can you give us your thoughts on the possibility of scarring and permanent gland damage due to this procedure? It's a scenario I have heard before, and one of the reasons some docs refuse to do this procedure. Also, is this one of those procedures that needs to maintained on a regular basis?

Thanks again!

[Blake]

Hi Odydnas

Great questions. There is certainly risk involved, but I think that it is minimal. When you look at where these glands are headed (total atrophy), we would be wrong if we didn't try to restore function by whatever means necessary.

As for the frequency, I imaging that some will need to be treated multiple times, and some will do very well with one.

This is something that I will reserve for patients that have exhausted other means of treatment.

[odydnas]

Hi Dr. Blake. Thanks for the answer!!! I have another question now. Can you explain how sticking a probe into a clogged gland can "restore" meibomian gland function and get the gland producing clear good oil again? It doesnt make intuitive sense to me. Thank you again!!!!

[wetEyes]

@ odydnas

Please consider that Dr. Hughes probably charges a lot of money for the procedure and is therefore biased, just like a refractive surgeon is biased in selling LASIK/LASIK surgery and an optometrist is biased in selling contact lenses.

While he may be posting here because he wants to help dry eye sufferers, it is also possible that he just uses this community to get new customers.

[Blake]

Hi Again!

I really don't mind being questioned. My story is that ocular surface disease is a wonderfully challenging entity. I have had the opportunity to take some patients from a very poor quality of life, to a more acceptable one. If we as doctors look back on WHY we decided to do what we do, the "helping people" part should have been at the top of the list. So, in that, I am passionate about helping people. I love it when I get a challenging case and we can help. Lots of smiles and sometimes hugs.

That being said, treatment for MGD/OSD has been radically transformed in the past 5 years. We have new methods, understanding etc. My entire point for joining this board has been twofold.

1. Learn more (mission accomplished)
2. Maybe shed some light on occasion

So, I hope it doesn't come across as terse, but if I never see a patient from DryEyeTalk, that is absolutely OK. The MG probing is interesting. You are right, there is some speculation on how much, if at all, it will help patients. The science sounds decent enough for me to give it a shot on some miserable patients. So far, guarded optimism.

Hope that helps clear up some things. I really have enjoyed being here.

Dr. Blake

[wetEyes]

Thank you for your reply Dr. Hughes.

Please explain why you think treatment for MGD/OSD "has been radically transformed in the past 5 years". I think the only major advance during that period has been the finding that systemic omega 3 is somewhat effective.

[Rebecca Petris]

Thank you for your reply Dr. Hughes.

One question:
How much do you charge for the probing...

Please contact the doctor directly with questions related to cost. The bulletin board is not the best place to either inquire about or comment on specific doctors' pricing. Thanks for your understanding.

[Blake]

Thank you for your reply Dr. Hughes.

Please explain why you think treatment for MGD/OSD "has been radically transformed in the past 5 years". I think the only major advance during that period has been the finding that systemic omega 3 is somewhat effective.

Well, we may just disagree on that one. If it was just omega 3 supplementation, that would be radical enough. Add to that better clinical understanding, better drops (Rx and non), more treatment options (IPL/Probing)...more radical.

I don't think there will every be the magic bullet with OSD/MGD, but we are getting better clinical responses across the board.

Dr. Blake

[wetEyes]

Okay, I can see your point.

With regards to IPL / Probing, I'm still waiting to see a single double-masked peer-reviewed study that shows they are more effective than a skillfully performed gland expression.