IPL with Dr Toyos

[sazy123]

So looking at that powerpoint. If you can find a doctor near by who does this expression, you could just go have the IPL done with dermatologist, and the next day you could go and have the expression done with the eye doctor, and anything prescriptions of azasite etc.

That would be a way to do it which would take away the costs of the plane flights to tennasee every month, and if you have insurance.. the insurrance may cover the cost of the IPL with the derm and the appointment with the eye doctor? at the leats it would cover the appointment to see the eye doctor, as this is probably done in a routine visit.

Just an idea.

Otherwise im wondering if there is anything that we could buy on the web that is like that paddle that could be sterilized? and following instructions of the power point.

[cristiandryeyes]

Look, all I know is I shouldn't be trying to find out how to get my hands on the Mastrota meibomian Paddle or Gutierrez expressor..WTF is that? Hey! I'm the patient, remember ? I mean, these tools should be a MUST for all Drs out there, I'm pretty sure if I talk to my doctor about them...he would have absolutely no idea.

feels like running down a dead end road to me...I just can't afford 4 trips to the US, you know...You have no idea how hard I press my glands but nothing will come out , actually today I think I killed one of them, yep...one of them has weird black color.

(...)

[irish eyes]

.....,,,,,,,, Gutierrez expressor..WTF is that? .

(...)

This is what it is.

For less severe cases of meibomian gland dysfunction, Mario Gutierrez, OD, FAAO, has developed the MG Expressor Kit (Gulden Ophthalmics), which combines the traditional therapies of warm compresses and massage, though in a more rigorous form. The kit includes a gel mask that can be warmed, the expressor tool and sanitary caps that can be placed over the roller. Dr. Gutierrez described the technique.

“Once the lids are warm, it liquefies the contents of the meibomian glands,” he told PCON. “Then, we basically roll the tool on the eyelid near the eyelid margin, and that helps express the liquefied meibomian gland content.

“I typically warm up the eyelids, use the roller, really work the nasal eyelids — the glands — a little bit more,” he continued. “This seems to help the patient become less symptomatic if we can get the nasal meibomian glands working well. Then I’ll go back and warm the lids a little bit more, maybe for a minute or two more, and then go back and roll it one more time to try and liberate as much of the expressions as possible.”

http://www.pconsupersite.com/default.asp?ID=20162

[sazy123]

Look, all I know is I shouldn't be trying to find out how to get my hands on the Mastrota meibomian Paddle or Gutierrez expressor..WTF is that? Hey! I'm the patient, remember ? I mean, these tools should be a MUST for all Drs out there, I'm pretty sure if I talk to my doctor about them...he would have absolutely no idea.

feels like running down a dead end road to me...I just can't afford 4 trips to the US, you know...You have no idea how hard I press my glands but nothing will come out , actually today I think I killed one of them, yep...one of them has weird black color.

(...)

I know its extremely frustrating for us europeans!

what about emailing eye doctors in spain, telling them about this expression tool and send them the powerpoint and ask them if they can order the tool from the US and do it for you. Then go else where and have IPL done. That is what i would try to look into if i couldnt to go to the US. Luckily i had a student loan and grant that im not using so i used that last year..

I think i read another post from someone in france that there doc was interested in the IPL, No idea where i read it or who though... so you may be able to make a trip to them if you can find them. DR T's was doing some IPL training in italy... so maybe emailing DR T and asking him who he trained in italy and can you have contact details. Trips in the EU would be alot less expensive.

Those are a few ideas. Otherwise, try to the IPL and do light expression yourself.

[irish eyes]

Hi

No - I couldn't get it to work. I just got lots of symbols and formulae.

Not to worry though because I think the images provided on the Gulden website gave a clear enough idea of how the paddle actually works.

I'm not sure it's something I could tackle myself though - I'm prone to `frozen shoulder' so that would hinder my movement somewhat!!

It's such a simple theory though isn't it? Like you say, I cannot see why some competent person couldn't perform this procedure with a Q-tip or improvise in some other way.

Which reminds me - when I got my first attack of uveitis (iritis) the emergency doctor on duty was really bored and not very interested in how I was describing my symptoms. His desk was messy and he couldn't find a Q-tip to turn my eyelid inside out - so he improvised by straightening out a paper clip that he found on his desk. Of course I nearly went through the roof -but at least he began to take me seriously.

[rhad]

Unfortunately the Mastrota Paddle is not available to just anyone. distributors will only sell them to Ophtamologists/Optometrists, etc. I got a hold of one from an online distributor, I guess they thought I was a doctor..haha. I would be surprised if you can get a hold of one. I paid $60 for mine... kind of a lot for such a simple tool..it is very useful though... cause you need a tool that you can put behind your lid, inside your upper and lower lid, so you can squeeze the tooth-paste like oil out, it's like like squeezing a zit or a pimple, but you don't apply a lot of pressure, you just hold the pressure until the oil starts coming up out of the gland.

I agree with you Sazy123, the tool does not address the underlying cause, the Inflammation, or whatever is causing the Oil to just Thicken right back up after they glands have been expressed using the tool. It provides relief, when the lids are very inflammed, it's usually because they glands become congested. that's why you'll feel immediate relief after expressing them. but yes, the oil just thicken up again.. I don't think it's bacterial either, I think it is inflammation that leads to the oil becoming thick...as inflammation in any part of the body will disrupt most the biological activity in the cells where the inflammation is occuring, I think that's why the oil and fatty acid becomes unbalanced and become wax like. studies even show that their are significantly higher wax esters in meibomian gland secretions..but why is the question here..

as for fish oil, I also agree with you on this one, for very mild dry eye only (non inflammatory in nature) they might help, but as most people don't feel a difference i don't fish oil is effective, in fact I feel better not taking fish oil period. I all around feel better.

rhad

[rhad]

Yea, I think Inflammation plays a big role in it, but it's unclear what come first. it's like saying which one came first the Chicken or the egg? does inflammation cause the oil to thicken? or is the thicker oil production (possibly caused by the failure of some other biological process) obstructing the gland, which causes the inflammation...it's hard to know

rhad

[Aaron77]

I completely agree with Sazy. I think dermatologists and doctors qualified to perform IPL can be educated about dry eye and the possibility that IPL may help. I don't see why they cannot order the paddle or use the Q-tips and have a go at the glands. There is enough information out there where they could master the lid expression technique. I actually have to drive 2 hours next week to have a doctor express my glands - I found one and for the first time I get a manual expression.

How much of a difference do you feel the manual expression is making?

[cristiandryeyes]

I'm not sure inflammation as a cause of MGD/Clogged glands/thick oil.
I was on Accutane for 6 months and after I had finished the treatment, I started to develop a slow but progressive blepharitis, it took 2 years until I could notice DE symptoms...so you tell me what has inflammation to do with all this...that drug altered my healthy glands, it ruinded them...I guess there must be several kinds of MGD as we have several kinds of DES.

I don't know what is stopping science from developing a drug that restores normal composition of MG oils...

[sazy123]

So if its all about inflammation, then shouldn't restasis help with meibomian glands. If not, then how would one combat inflammation beisdes using restasis or azasite

Inflammation is what is causing the dry eye 95% of the time. Something is causing the inflammation (that is the route cause), i.e dilated blood vessels in rosacea. Thick oil just results, and clogs up the glands.

I believe as well as inflammation causing thick oil, it just stops the glands producing much oil full stop... otherwise the oil would keep building up and we would all have very thick eyelids.

Its like with rosacea, inflammation causes dry skin, as it effects mucous membranes, thats what the MG's are.

I have very inflammed inner eyelid margins, nothing shifts it, expression will only provide very little benefit because the inflammation remains.

For an example of how much inflammation really stops the glands working. In my case my eyes get better when i have another illness going on, the inflammation of my eyelids will go away and my glands work fine straight away, it only takes 15 mins for the inflammation to go away and the oil starts flowing. Likewise, when the acute illness gets better, the inflammation soon returns and so does the dry eye and all the symptoms.

[rhad]

Inflammation is what is causing the dry eye 95% of the time. Something is causing the inflammation (that is the route cause), i.e dilated blood vessels in rosacea. Thick oil just results, and clogs up the glands.

I believe as well as inflammation causing thick oil, it just stops the glands producing much oil full stop... otherwise the oil would keep building up and we would all have very thick eyelids.

Its like with rosacea, inflammation causes dry skin, as it effects mucous membranes, thats what the MG's are.

I have very inflammed inner eyelid margins, nothing shifts it, expression will only provide very little benefit because the inflammation remains.

For an example of how much inflammation really stops the glands working. In my case my eyes get better when i have another illness going on, the inflammation of my eyelids will go away and my glands work fine straight away, it only takes 15 mins for the inflammation to go away and the oil starts flowing. Likewise, when the acute illness gets better, the inflammation soon returns and so does the dry eye and all the symptoms.

I agree 100% with what you just said Sazy123. I have noticed the same exact thing. with an acute illness the inflammation (Immune System is the Source) is diverted to the sick area of the body, and glands function normally. your right this is exactly how I see it works.. it's the immune system or some biological process not working correctly..

ChristianDryEyes....and for science developing a drug to fix Meibomian Gland Dysfunction..hahahahhaha funny...not gonna happen, you just said the drugs are what ruined your meibomian gland function....

rhad

[Michael2]

it's interesting you guys have that effect from being sick

when i got the flu, my nose was so runny that i slept the night with my mouth open and when i woke up my eyes were in a new level of agony.

also, having a cold was so much harder to deal with when i have dry eyes

[Guest]

When I have a really bad cold, my eyes tend to water a bit, which feels sooooooo nice! At least there's one good thing about being sick!

[sazy123]

Rhad.. finely someone who notcies the same effect!! i know there are others out there.

For me its not just a cold, its anything, from facial pain (which i had for a year= no dry eye for a year until i got rid of the facial pain stupidly, now it wont come back), bad throat which i get on and off and try to cause so i can get relief from my eyes, to general sickness i.e the flu.

The inflammation of inner eyelids goes right away and i can see how much better the oil is flowing from my glands, it is much thicker, i can also see the expression of oil from my glands.

Other than this everything (including steroids) have been ineffective at removing the inflammation.

Your right, ive had the same theory for years: the auto immune inflammation goes away because the body is focusing on something else and has to repair that first.

[beatles116]

just got back form third treatment with dr. toyos. last time i was at 30 percent glands working, now i'm at all of them working....at first they were all closed and 3 second tbut......the photophobia is abating also and the inflammation too.....
i go back for last treatment next month......i'm very pleaed....its an intense treatment but it really has to be to get the glands unclogged and flowing.....said my oil had some crystals in them but should improve....i would recommend this treatment to anyone who has mgd......if anyone has an questions u can email me at tomrobf@gmail.com