great appointment

[elaine]

For the first time I have some positive news! I have had DES for almost 4 years and seen 5 doctors, most recently Dr. Latkany in NY. I ran into a colleague who asked about my goggles and she told me about her eye doctor who told her "dry eyes are my life". I kept thinking about that and finally made an appointment with Dr. Korb in Boston. I was there for three hours today. I really felt listened to. He took a history and then sent me off with his research assistant who took photos of my eyes which I could see on a large computer screen. I had been told one of my eyes don't quite shut, but I could see it in on the screen. She graded the dryness level in my eyes and had me sit for 45 minutes without my goggles on. There was no difference in the results, only the amount of pain. Then she gave me some hot compresses (which I had been told by two doctors I didn't need because I didn't have that kind of problem - who knows -) She photographed my eyes after the compresses while having me blink and then expressed my eye lids. I could see the oil coming out of the glands on the screen - it looked like a layer of gasoline on a puddle. She also had me fill out qustionnaires about frequency and severity of symptoms and pain. Then Dr. Korb discussed the results with me and he did the slit lamp test (sp?) with yellow stain. I will go back next week for more tests. (One will figurte out how many glands are functioning) He said he usually does it in 3-4 appointments, for more accurate results. Next time I am to try not to wear my goggles that day :0 He apparently has been doing a lot of research for years, and sees patients now twice a week. Previously, I have seen MDs, he is D.O. It was a wonderful experience, hope I'm not overly optimistic; it has been a roller coaster these years. Has anyone else seen or heard of this doctor??
Thanks!
Elaine

[Lucy]

WOW, Elaine, this all sounds so interesting. Well, not sure if interesting is the word-but it's more in depth examination that I've heard of! Please keep us informed about your progress with this doctor.

Elaine, for clarification, did you mean DO as in Doctor of Osteopathy, or OD as in Doctor of Optometry? The first would be the quivilant of an eye M.D. (ophthalmoologist) and the latter would be a O.D. or an optometrist. Either could handle dry eyes. Can you clarify? Thanks.

Lucy

[dianat]

That is interesting, Elaine. Keep us posted on how this proceeds. Thanks for posting.

Diana

[Rebecca Petris]

Lucy, he's an OD (optometrist) and quite well known for his research and patents in contact lens designs primarily I think.

[Francesco]

recently i discovered that optometrist know a lot of dre eye (sometimes even more than famous Ophtalmologists).....also i think they use quite frequently a screen to show you things and thats great....

[Rojzen]

Saw Dr. Korb 7 years ago; Dr. Gilwit's new device, and lid expression, generally

I also had a mostly positive experience with Dr. Korb, and his then ophthalmology associate Dr. Jack Greiner, about 7 years ago. Dr. Korb was very compassionate, yes, and his videography was really enlightening.

Diagnostics at Dr. Korb's facility were unparalleled, but ultimately, the only therapies recommended in my case were forcible lid expressions and blinking exercises. At that time, Drs. Korb and Grein were developing what I believe has become Soothe, and so, in addition to the recommendations, I was given some samples of Soothe, the mineral-oil-based product that's now widely available. (I cannot tolerate mineral oil or petrolatum in the eye, and so the product was very irritating.). . . I did the blinking exercises for months, to no avail. . .The lid expression was traumatizing and caused temporary, but rather long-lasting, damage to one eyelid, which almost had to receive corrective surgery. . .

This mixed result was surely particular to me, but I don't mind be open about my worries regarding certain kinds of eyelid expression procedures. . .I suspect that meibomian glands need, at least, to be fairly open, if these procedures are to work without causing potential swelling and other complications. . .By the same token, Dr. Latkany's self-help approach to lid expression does not seem to provide a universal solution. In my particular case, even daily self-expression of the glands does not bring them back to life, and those glands that are sealed do not, of course, express at all. . .

This is why I am now trying to pin down Dr. Gilwit, who wrote here a few days back, regarding his patented lid expression device. . .His staff, so far, has been unable to answer whether advanced cases of MGD, with some orifice obstruction, can be treated with the device, and so I am trying to access Dr. Gilwit directly. . .Notwithstanding Dr. Gilwit's posting of his phone no. here, he does not appear to be ready to take inquiries from prospective patients. . .Possibly an e-mail will work. I did learn, from calling Dr. Gilwit's office, btw, that the device he has patented has not been picked up yet by any other eye doc in the U.S. Alas. . .This means that to try it, one still has to go to Ft. Lauderdale, where Dr. Gilwit is based. . .I will, of course, post any news I get on all this.. .

[Randal]

I also had a mostly positive experience with Dr. Korb, and his then ophthalmology associate Dr. Jack Greiner, about 7 years ago. Dr. Korb was very compassionate, yes, and his videography was really enlightening.

Diagnostics at Dr. Korb's facility were unparalleled, but ultimately, the only therapies recommended in my case were forcible lid expressions and blinking exercises. At that time, Drs. Korb and Grein were developing what I believe has become Soothe, and so, in addition to the recommendations, I was given some samples of Soothe, the mineral-oil-based product that's now widely available. (I cannot tolerate mineral oil or petrolatum in the eye, and so the product was very irritating.). . . I did the blinking exercises for months, to no avail. . .The lid expression was traumatizing and caused temporary, but rather long-lasting, damage to one eyelid, which almost had to receive corrective surgery. . .

This mixed result was surely particular to me, but I don't mind be open about my worries regarding certain kinds of eyelid expression procedures. . .I suspect that meibomian glands need, at least, to be fairly open, if these procedures are to work without causing potential swelling and other complications. . .By the same token, Dr. Latkany's self-help approach to lid expression does not seem to provide a universal solution. In my particular case, even daily self-expression of the glands does not bring them back to life, and those glands that are sealed do not, of course, express at all. . .

This is why I am now trying to pin down Dr. Gilwit, who wrote here a few days back, regarding his patented lid expression device. . .His staff, so far, has been unable to answer whether advanced cases of MGD, with some orifice obstruction, can be treated with the device, and so I am trying to access Dr. Gilwit directly. . .Notwithstanding Dr. Gilwit's posting of his phone no. here, he does not appear to be ready to take inquiries from prospective patients. . .Possibly an e-mail will work. I did learn, from calling Dr. Gilwit's office, btw, that the device he has patented has not been picked up yet by any other eye doc in the U.S. Alas. . .This means that to try it, one still has to go to Ft. Lauderdale, where Dr. Gilwit is based. . .I will, of course, post any news I get on all this.. .

Rojzen:

I'm curious: What technique was used to perform the lid expression?

Thanks.

Randal

[bassfan]

Rojzen:

I'm curious: What technique was used to perform the lid expression?

Thanks.

Randal

Referenced thread can be found here about half way down (with doc's name highlighted)

Daren

[Rojzen]

forcible expression NOT same as needle puncture

To clarify, the gland expression that caused my prolonged swelling and gland induration (leading to constant abrasion of the ocular surface for several months) was NOT the procedure involving a tiny needle that punctures open a sealed gland. . .

The procedure I had involved intense, extremely heavy pressure exerted by a pair of small BLUNT instruments to the sides of the glands. The eyelid was everted, so that the instruments could essentially pinch the gland orifice, if I recall. I would say the effect was like using a blunt tweezer. Anyway, when the glands wouldn't secrete, the doctor pressed harder and harder, until something was secreted. . .By then, the lid was swollen. Within a day or so, the swelling became a hard little lump. I have no idea whether any secretions ever continued to flow from that site, and I never went back for this procedure to be done to the remaining three lids. I just felt lucky that the hardness went down, and I didn't end up needing reconstructive eyelid surgery.

This procedure was NOT done by Dr. Korb, but, rather, by a colleague of his who is an ophthalmologist. This latter doctor was unable to make sense of what happened to me when I called for followup, so I never flew back up to Boston to see him again.

It is my impression that the expression procedures being done today are not as crude as what I experienced. The needle method seems very sensible and gentle, and may address the problem of blocked glands. . .Whether it can open glands over which METAPLASIA has formed, I don't know. . .

I have asked Dr. Gilwit, who has invented an expression device, and written about it here, whether cases involving metaplastic overgrowth are treatable with his system. . .We shall see, I hope. . .

I personally wish there were loads more doctors who could do some kind of lid expression. . .Most still don't even seem to know how to tell whether meibomians are secreting. . .I've had some docs say my glands secrete nothing and are sealed over with metaplasia, and other docs tell me that many of my glands do secrete, when pressed. . .Crazy, isn't it? Perhaps doctors operate in mutually alternative realities. . .

[stella]

Forgive me if i am too simplistic--- but I have always felt the need to express my own glands, and managed i think to do so -- with relief
I pinch the eyelids side ways and jostle them ,then run the back of a clean finger nail across the eyelid margins.the bottom lids are hard to do
I find this gives me relief from the prickle and itch of mebomianitis - and i can use as much or as little pressure as i need therefore am not in danger of damaging anything
I dont think i would allow anyone else to do this or similar procedures as i would be scared they could damage such delicate structures
Also if you do it yourself you can do it anytime without appointments
It is best done after applying heat

[mike838]

Hello all. Its been a while since ive been on here but as a paitient of dr. Korb at one time I will share my experience. I have flown to a few Doctors in the country also in search of help with my dry eyes. Korb was the last dr I saw I went to Miami and saw a dr that was supposed to be one of the best he gave me a list of things to do and after a few weeks my eyes felt worse. I saw korb and also had a good experience. I had him express my eyes and yes it was painfull I was also skepktil about this but he continued them a few more times over weeks. I went from very very dry eyes to doing alot better. I haven't seen him in a while but I know he had some much less painfull procedures in the works

[elaine]

Dr. Korb

Thanks everyone for all the feedback. I am trying not to get overly optimistic, but to be going in SOME direction besides the dr. throwing his hands up and saying everything has been done. I am a little nervous about the procedure that was explained to me (though it makes sense..) where they put a qtip under the lower eye lid to push out the oils from the back. Mike, I'm glad to hear Dr. Korb worked for you. You don't have to go back anymore? How long have your eyes been better??
Elaine

[Meebo]

I also had a mostly positive experience with Dr. Korb, and his then ophthalmology associate Dr. Jack Greiner, about 7 years ago. Dr. Korb was very compassionate, yes, and his videography was really enlightening.

Diagnostics at Dr. Korb's facility were unparalleled, but ultimately, the only therapies recommended in my case were forcible lid expressions and blinking exercises. At that time, Drs. Korb and Grein were developing what I believe has become Soothe, and so, in addition to the recommendations, I was given some samples of Soothe, the mineral-oil-based product that's now widely available. (I cannot tolerate mineral oil or petrolatum in the eye, and so the product was very irritating.). . . I did the blinking exercises for months, to no avail. . .The lid expression was traumatizing and caused temporary, but rather long-lasting, damage to one eyelid, which almost had to receive corrective surgery. . .

This mixed result was surely particular to me, but I don't mind be open about my worries regarding certain kinds of eyelid expression procedures. . .I suspect that meibomian glands need, at least, to be fairly open, if these procedures are to work without causing potential swelling and other complications. . .By the same token, Dr. Latkany's self-help approach to lid expression does not seem to provide a universal solution. In my particular case, even daily self-expression of the glands does not bring them back to life, and those glands that are sealed do not, of course, express at all. . .

This is why I am now trying to pin down Dr. Gilwit, who wrote here a few days back, regarding his patented lid expression device. His staff, so far, has been unable to answer whether advanced cases of MGD, with some orifice obstruction, can be treated with the device, and so I am trying to access Dr. Gilwit directly. . .Notwithstanding Dr. Gilwit's posting of his phone no. here, he does not appear to be ready to take inquiries from prospective patients. . .Possibly an e-mail will work. I did learn, from calling Dr. Gilwit's office, btw, that the device he has patented has not been picked up yet by any other eye doc in the U.S. Alas. . .This means that to try it, one still has to go to Ft. Lauderdale, where Dr. Gilwit is based. . .I will, of course, post any news I get on all this.. .

I have ocular rosacea, hence, MGD which I should state is non-inflammatory. I am interested in finding out exactly what Dr. Gilwits procedure entails. I am willing to go to FL, however, i would really like to hear from someone that has experienced the procedure. I am in discussion allready with his office about coming down, but I feel I need more info before committing. For the most part this procedure does sound promosing. Maybe there are some doctors that are aware of his procedure that we can get some info from?