IPL with Dr Toyos

[msienkiewicz]

Still have my fingers crossed for you Autumn.

Lucy, for you and I here in grand old Michigan, Dr. Berkowitz of Accents Cosmetic Surgery and Medical Spa, was familiar with Dr. T's work, and said that he would treat my facial rosacea along with my eyes if all else fails. He still has some tricks up his sleeve apparently. I plan to have my facial rosecea done anyway, and maybe I will gleen some results from that. His number is 1-586-254-7692. He is the medical director of the spa as well as an opthamologist and occular plastic surgeon on the "other side" - the Vision Institute of Michigan. They are connected and housed in the same building. I know I posted all this already, but thought you might like to know of an option closer to home. I don't think he has ever done the procedure yet, but he was very interested, and told me he would do it.

There's always hope,
Melissa

[Lucy]

Hi Melissa-
Thank you for posting this information for me (basically). I will be watching to see if you post about any experiences with this dr. I am bummed because he is a Lasik surgeon, of course. But.......if he could do anything, I could manage. Who knows, maybe I'll consult with him. It's probably a 2-3 hour drive one way, so it's not bad on distance. Thanks, Lucy

[sazy123]

I just talked to another client of Dr. Toyos and he said that his eyes feel great. However, he didn't see results until 2-3 weeks after the fourth treatment.

autumn how do you get to talk to them do they give you the number at the clinic?

Thats great, so people shouldn't loose hope and need to stick it out if not showing signs, easier said than done though. Abit like restasis, some respond after 3 months others take 6 and some might take up to 8 months ( a guy i know is doing very well on restasis, but he was getting fed up- only at 8 months did he really notice the difference).

[20/20_Hindsight]

Does anyone know if this could possibly help Lasik dry eye? I am aqueous deficient, and no eye doctor has ever commented on my meibomian glands being problematic. I was dry while wearing contacts before Lasik but went over the cliff after Lasik with severe dry eye all the time, and corneal erosions for 8 years.

[sazy123]

Does anyone know if this could possibly help Lasik dry eye? I am aqueous deficient, and no eye doctor has ever commented on my meibomian glands being problematic. I was dry while wearing contacts before Lasik but went over the cliff after Lasik with severe dry eye all the time, and corneal erosions for 8 years.

I think autumn asked him this and he said that if the lasik caused MGD then probably. Autumn has had lasik i think and others have also.

But im not sure if it will help aqueous deficiency, in a study he did- it showed increase in tear quantity- but that may have been indirectly from benefit to the m glands.

You could always make a trip, if he doesn't think it will help you he doesn't charge for the consultation- only if you have the IPL.

Alot of doctors dont diagnose MGD, because they dont know much about it, its possible to have both though.

http://www.eyeworld.org/article.php?sid=2698

[autumnn]

I would not believe that you dont have MGD unless you have a doc specifically take a close look and check your TBUT and glands. MGD is a common cause of dry eye. Though Dr. Toyos spends a lot of time with his clients, I am assuming that this can not continue forever from a practical business standpoint- I believe that he is becoming busier and busier. One must be patient if one has to wait to see him. But, understand, that above all he does care.

[irish eyes]

- I believe that he is becoming busier and busier. One must be patient if one has to wait to see him. But, understand, that above all he does care.

Hi again Autumn

I take it that the increase in activity could be down to demand for IPL?

[20/20_Hindsight]

Sazy123, Autumn,

Thanks for your replies. I did have one doctor press on my lower lid margin and say everything looked fine (with what came out, I assume?) with regards to the meibomian glands.

However, my TBUT is low. Whenever I have been tested, it ranged from 3-4 seconds usually, in both eyes. I don't know if aqueous deficiency can be tied to TBUT, but always was under the impression that the lipid layer from the MG's was what helped with that.

[sazy123]

Sazy123, Autumn,

Thanks for your replies. I did have one doctor press on my lower lid margin and say everything looked fine (with what came out, I assume?) with regards to the meibomian glands.

However, my TBUT is low. Whenever I have been tested, it ranged from 3-4 seconds usually, in both eyes. I don't know if aqueous deficiency can be tied to TBUT, but always was under the impression that the lipid layer from the MG's was what helped with that.

Hi, if your TBUT is that low i would assume MGD as well. Mine is 4/5 secs and i have it.
but it wouldnt hurt seeing someone who actualy knows what to look for in terms of mgd.

Improving the MG oil will prob improve aqueous because its kept on the eye, but my aqueous tests were about 20mm and 10 under anaesthesia. But what ive read its definitely possible to have both- there may be a loop going on. The other thing ive read is that people who have bad MGD seem to be more symptomatic in general than those who have lowish aqueous (only).

[autumnn]

Sazy123, Autumn,

Thanks for your replies. I did have one doctor press on my lower lid margin and say everything looked fine (with what came out, I assume?) with regards to the meibomian glands.

However, my TBUT is low. Whenever I have been tested, it ranged from 3-4 seconds usually, in both eyes. I don't know if aqueous deficiency can be tied to TBUT, but always was under the impression that the lipid layer from the MG's was what helped with that.

I was always told my oil looked "fine" and fluid like canola oil (from doctors I trusted). Yet, I had a low TBUT which seemed to be my main problem. Then, after seeing Dr. Toyos I learned that most of my glands are blocked and the ones that are open are producing "toothpaste" like secretions. I witnessed the proof after the ipl treatment and him pressing on my lids and I felt the "pop" of a gland opening up. It was very distinct. I am telling you this because my lids were always touted as looking fine and my lid hygiene was keeping inflammation and bleph at bay- I was religious about compresses and lid massage- still, it was never enough to get the glands open in my case. A low TBUT means evaporation which is often SO uncomfortable......if you can get some Wileys or Panoptix in the meantime do so, just to give yourself a break at times.

[sazy123]

Yeah my glands look fine- no obvious sings of blockage, but inner eyelids inflamed and that i think is blocking them.

[robinzb]

good to know there is a new way...
i do believe it may help a lot of people, because in summer, when temperature is high, and i walk under the intense sunshine, my eyes are feeling much better than stay indoor.

[robinzb]

Yeah my glands look fine- no obvious sings of blockage, but inner eyelids inflamed and that i think is blocking them.

hey, sazy, haven't heard from you for a long time. how have you been? From your words, you sound better than b4

[autumnn]

Nothing too new to update. I still think I am doing better but am dealing with the anxiety of "will this be my answer!??" Got a bit concerned about the left eye still burning and emailed Dr. T. He said it is normal and he often has clients with one eye that is worse than the other- usually it is because one eye has glands pumping better. He said not to worry- have more treatments to go. Easier said than done!
Still having some fogging moments in Wileys (good sign), still more moisture when glands are pressed, lids still look good.
Please note- I am new to Wileys- they could be a big part of this healing process.
Mental/emotional impact of waiting? Rollercoaster to say the least Still, something deep inside me feels better about this treatment than anything else I have ever tried.
I keep reminding myself that the last patient I spoke with felt nothing until 3 weeks after the 4th treatment (how did he get through it?).....patience is a virtue that I don't seem to possess. Where can I purchase it?
Hope all of you are well

[LasikRelatedDES]

Nothing too new to update. I still think I am doing better but am dealing with the anxiety of "will this be my answer!??" Got a bit concerned about the left eye still burning and emailed Dr. T. He said it is normal and he often has clients with one eye that is worse than the other- usually it is because one eye has glands pumping better. He said not to worry- have more treatments to go. Easier said than done!
Still having some fogging moments in Wileys (good sign), still more moisture when glands are pressed, lids still look good.
Mental/emotional impact of waiting- rollercoaster to say the least Still, something deep inside me feels better about this treatment than anything else I have ever tried.
I keep reminding myself that the last patient I spoke with felt nothing until 3 weeks after the 4th treatment.....patience is a virtue that I don't seem to possess. Where can I purchase it?
Hope all of you are well

Patience is a virtue... but with this condition you (and all of us) have already been patient for so long. Thanks for the update. I check this thread at least once a day to see how you're doing and I'm saving up for the possibility of having it done myself. Signs are encouraging so far.

One thing I'm not clear on... does Dr. Toyos have clinics in both Tennessee and California? And does he perform IPL at both? I know there was some discussion on this.

Tennessee is a lot closer to Baltimore where I currently reside!