Great Treatment for DES and MGD. I have my life back!

[Nancy Derby]

I was diagnosed with DES and MGD 3 yrs. ago in the midwest. I sought out a dry eye specialist who used Dr. Steven ******'s eyelid probing method. I had little success, warm compresses, massaging, Restasis, nothing worked well. I moved to Florida (1) year ago and went to see Dr. Steven ****** in Tampa, Florida. After consultation, more testing, and conformation of DES and MGD, Dr. ****** further discovered that I had conjunctivochalasis of the conjunctiva in both eyes. Some tears distribute to the outer corners instead of across the eye and the eyes cannot stay wet. He talked to me about surgery to correct this problem and I agreed. It involves 4 surgeries, Dr. ****** gently removes all scarring and then when reconstructing the ocular surface he uses amniotic membranes to smoothe the surface pleats. Amazing! It made a big difference. Surgeries and healing time are quick and not difficult. Dr. ****** also has cauterized the tear ducts and has performed the eyelid probing and used an expresser to release the mucin. This is the best I have felt in 3 yrs. I have very little maintenance now. My treatment involves doxycycline 20 mg. once a day, lubricant 2-3 times per day, Pataday 1-2 times per day and I wear nitegoggles at bedtime. I am off of Restasis and no longer use warm compresses and do squeezes or massaging. I have read other blogs and that others have not had a good experience or good results. My lesson which I learned for myself is, "After giving your present doctor a chance but have not had good results, keep searching and stay hopeful." I highly recommend Dr. Steven ******. He is kind, thorough, caring, and continues to research these problems so to intervene when necessary. For the first time in 3 years I feel like reading, watercolor painting, and gardening. In fact, after my recent eyelid probing I went shopping and enjoyed the rest of the day, Yes..the same day! Eyelid probing for me will have to be repeated approximately once a year. Piece of cake!! I am so grateful to Dr. ******.
Nancy D.

[snurre86]

Im glad for your sake Nancy I have a couple of question! How much did you pay for the entire procedure? Were it covered by your insurance? How is your meibomian glands today, are the producing clear oil?

[joanna]

hello Nancy, thanks for sharing your story! The same question, how much does it cost? Just to know if I can even think of going there. And how long did you wait to see dr ******?

[Nancy Derby]

Hello, thank you for your reply. I have Traditional Medicare and supplemental Blue/Cross for insurance and between the two they covered mostly all of the expenses. For information go to www.dr******.com and click on to office information. Call his office in Tampa, Florida at toll free number 1-888-455-9200. The office will answer all of your questions and they will answer about insurance, costs, etc. I know that Dr. ****** has patients from 5 different continents.

[Pinky]

Hi Nancy,
You write that you had surgery to correct conjunctivochalasis, and that you also had cautery of the tear ducts (puncta?) and eyelid probing. Can you tell me in what order you had these procedures done? If you had the latter treatments done around the same time as your surgery, how do you know what was most responsible for your symptomatic improvement?

[Nancy Derby]

Hi Pinky,
First visit to Dr. ******, he took me off of Restasis the other doctor had put me on. The tests with Dr. ****** showed a scorce of (0) zero in each eye. The previous doctor put me on Restasis but in the two years I was seeing him never again tested me or examined me. The Restasis was not working for me and I was still very dry. Dr. ****** then cauterized the lower tear ducts only. He does not believe in plugs as they create too much bacteria. He told me more news that the other doctor never told me and that was that I have conjunctivochalasis (pleating) and the tears are not staying across the eyes. After the surgeries and healing, I could see and feel more tears on my eyes, but we knew there was more work to do to to improve this problem even further. More testing showed my count (previously 0) went up higher to a score of 6 in my eyes meaning more tears are now staying on my eyes but still not wet enough as I do have evaporative dry eye. He then cauterized the upper lids and we set up a probing session. After more cauterizing the tears were spilling over the lower lids and I would dab off of my face each day. Then came the probing session, after the probing, no more spillovers. The mucin (oil, water, mucous) being released from the probing solved that problem. I went to see Dr. ****** yesterday now for another followup, after the exam he said the glands are releasing more mucin now and it is clear. My eyes feels very good except for itching at the inside corners or tear ducts. This is due to allergies, he changed my prescription from the Pataday eyedrops to Lastacaft (a trial size) as this is supposed to be stronger. Pataday is good, but doesn't last long enough for me. Just started using this today and have to return for follow up in two weeks. There really isn't any order a doctor has to follow, however, as doctors work the proper needs, the solutions come slowly and is done according to your needs. This is how is it supposed to be with doctors. A doctor should not do any procedure if it is not necessary. Previously the doctor in the Midwest only kept probing me, I had 5 probings done in one year. It would only help for about 3 weeks! then I would start over with awful symptoms. He did not test me further or discover any other causes or work with the other problems I also had. The probing is simple, and sometimes all that is needed. Dr. ****** who developed the eyelid probing says, "Probing should only be necessay once a year or once every two years." It will always depend on the doctors findings to determine the treatment for you, and again I will say the doctor will take things slowly, bit by bit, and if he is knowledgable enough he will see what is working or what is not working. I recommend moving on to another doctor if you do not get satisfaction. Sometimes one doctore 'misses' seeing another problem that you have. So, in conclusion...it appeared to be a group of solutions that helped me. Most importantly. Don't give up! Thanks for writing.