Hello from Sweden

[Alix]

Hi Marcus I cannot stress to you enough about getting a second opinion, even a third, fourth until you get a solution. I have lost count of the number of eye doctors I have seen in the past year, and I am still suffering from burning pain.

Lipiview is a completely different machine to Lipiflow. The Dry Eye Centre in London does not in any case offer Lipiflow as they said they believe it is ineffective. They do however offer IPL, and do manual expression afterwards.

If London is too far for you, there is a dry eye clinic in Oslo which may be worth going to.

[Fenix]

MGD1701 Thank you for your post. Since a couple of weeks back i am eating as healthy as i possibly could (maybe a bit exaggerated), avoiding added sugar completely together with eating more green and trying to get all the vitamins. If there is a chance that this might help i no longer can afford to cheat in this area since it's not close to being worth it. What is GLA? Moisture Glasses
looks interesting, seen those before and maybe it is time for a buy (if they do shipping)
I will check out the links, thank you again.

You could try to add probiotics as daily supplements. On google there are some research that shows that probiotics helps improving dry eye, maybe reducing a systemic inflammation that starts from the gut.
But ask your doctor first if you can add it to your diet.
See this: http://www.optometry.org.au/blog-new...-help-dry-eye/

[Hajen13]

Alix

Why have i not thougt of Olso before, i visited the clinics home page and got a really good impression. Thank you for the suggestion, i will write to them and explain my situation what i have done /not done and see if they can have a look at me.

Fenix Im already doing probiotics but thank you anyway


Anyway the last IPL did nothing, i am so very suprised...
Also the bepheaclean tissues for cleaning the eyelids only made things a lot worse since it was to strong for my eyes.

But thanks to this forum i have some new things to look into.

[Fenix]

Hajenthirteen I read that there are cases where IPL started giving improvement after three treatments. Maybe it is your case? The usual protocol is not at least 4 treatments of IPL?

My situation maybe is not severe as your (merging the diagnosis of my 5 opthamologists I have MGD / evaporative dry eye / blepharitis), but this routine is helping me a bit:
- Hot compresses
- Nasal rinse
- Fish Oil + Flaxseed Oil + Strong probiotics
- Healthy diet
- 2 litres of water a day
- Eyelid wipes (if blephaclean doesn't work, try other wipes. They are not all equals)

And you know what? probiotics is the thing that helped me more, but I have to be sure and investigate more.

If nothing worked, maybe the problem is not the eyes. In my case I think it is something else, so very soon I will try to check things like:
- Allergies
- Leaky gut
- Gluten Sensitivity/intollerance
- Hormones (thyroid, insulin, estrogens)
- Sjogren Syndrome (for the second time)

If they will be negative, I will try to do a detox/low infiammatory diet (plus the usual routine). Some studies says that bacteria in your gut may trigger an inflammatory eye disorder.

[farmgirl]

Sorry Marcus, I forgot to post the link to pythonidlers post...

http://forum.dryeyezone.com/forum/dr...nduced-dry-eye

I just noted that you said they don't express your glands after the IPL little wonder it is not working for you. Expression is key to getting the old oils out that are probably clogging your glands.

As regards oils those are fairly standard to take so yes, add them to your regime.

[Hajen13]

Fenix Yes i have also read and heard similar, this was my third IPL treatment though and no improvement at all so far. Thank you for going through your routine i think it is very similar to mine except the nasal rinse (how come you are doing this?) and the flax seed oil (intend to buy it today and give it a try). Soon i will also take these test i talked about earlier, as you are saying the problem might be due to something else.

I have had a lot of problems with my stomach the last years and have the diagnosis "IBS". But after starting eating healthier since a couple of weeks ago in order to help the eyes i am starting to experience a stomach that works a lot better than before and hopefully the eyes will follow.

Interesting that you think that probiotics have helped you, i have not been adding this to my diet until recently. Will continue then

farmgirl Thank you for the link, just finished reading it through. Extremely well written, think i learned a lot. Anyone who knows if he is doing better since quitting stare in to a screen all day long? Or are there other stories were people have improved a lot since giving up a work which is in front of a screen? As i mentioned before, 1 month vacations doesn't really do anything for my eyes therefore i am a bit ambivalent.

I am starting to think that after all the eyedoctor might have done expression after the IPL. He pushed against my eyelid margin with an ear picker afterwards, is that it? And is that something i should do myself after using warm compresses?


Also two new questions:

1: If Lipiflow didn't work is it really worth continuing with warm compresses? As i understand it Lipiflow is the ultimate warm compress which can reach the meiboumian glands in a totally different way than warm compresses ever will.

2: Why is meibography so important to do? I mean how can i for example use the information that 4 out of lets say 12 glands in my left lower eyelid are not working as they should?

[Alix]

Hi Marcus I am not sure what an earpicker looks like but to me what they did to you after IPL does not sound like manual expression. Manual expression is when they use mini forceps to grip the eyelids and go along them squeezing out the oil. They do this for both the upper and lower eylids. If you google this or look it up on YouTube you can see videos of doctors doing this.

As for warm eye compress, at Moorfields they tell patients that after doing this they should take a cotton bud and gently roll it over the eyelids, pushing down over the top of the uppers and pushing up over the lowers but not too hard as this will cause inflammation.

Finding out what the state of your glands are is important. If they are all there but are just blocked then IPL and warm eye compress are going to work eventually. However if they are all atrophied then these are not going to work as oil is not going to come out of atrophied glands.

Lipiview is useful as you would find out if you are a partial blinker. If you are, then blinking exercises will become important.

[Fenix]

How much does lipiview cost? Here only two or three doctors have lipiview and lipiflow, and the lipiflow costs like 1500/2000 euro.
Blephasteam + eyelid massages twice a day are comparable to a single lipiflow session?

I'm doing nasal rinses because it helps to have nose clean and free from bacteria, especially in winter.

[Alix]

The consultation at the Dry Eye Centre in London last year where they did lipiview cost 250 pounds. It might be more now.

Not sure how much Lipiflow costs in the UK but I imagine it is very expensive.

[Yzhfd]

I'm also from sweden, the eye doctors here are really stupid. DON'T trust them.

[farmgirl]

I am starting to think that after all the eyedoctor might have done expression after the IPL. He pushed against my eyelid margin with an ear picker afterwards, is that it? And is that something i should do myself after using warm compresses?

2: Why is meibography so important to do? I mean how can i for example use the information that 4 out of lets say 12 glands in my left lower eyelid are not working as they should?

If by ear picker you mean a q-tip, like a little stick with cotton on the end, yes those are also used one on the inside and one on the outside of the lid. It is quite painful if your glands are blocked, like squeezing a zit so there is no mistaking what they are doing, usually I am left calling UNCLE which is a colloquial way of saying, stop, I give up! Then they comment usually on what they are finding, take pictures to show you etc. Just pressure with a q-tip on one side of the lid will not do the job unless your oils are really fluid.

The lipiview gives you tons of info about how your glands are functioning, like are they missing or atrophied, are you a partial blinker how much oil are you producing what quality is the oil etc. It is essential to know what shape they are in because if you are losing them you really need to have an awareness so you can guard what is left of them.

[farmgirl]

I'm also from sweden, the eye doctors here are really stupid. DON'T trust them.

I am sure Yzhfd that your doctors are not stupid, they are just not educated on dry eye and how to diagnose and treat it, there is a difference.

[Hajen13]

I am sure Yzhfd that your doctors are not stupid, they are just not educated on dry eye and how to diagnose and treat it, there is a difference.

Yes this is my opinion as well. I really don't think this problem is that spread in Sweden and therefore it only exists one real clinic which is targeting the problems. As i said before i have been googling for 6 years, never ever have i come across any swede having these problems. And i exclude the usual mentions that i see from time to time that for example 1 or 2/5 of all swedes suffers from this problem. I don't believe that, and i get so angry when seeing facts like that. Don't mix up people who can take two eyedrops and everything is fine with the people that for example is on this forum.

[Hajen13]

Alix farmgirl Sorry the translation wasn't the best, as farmgirl mentioned i meant a Q-tip. Then no manual expression has been made neither after IPL or the Lipiflow. And this is strange since i have not experienced any improvement right afterwards which i should have if the oils were fluid?

Thank you both for the inputs regarding lipiview, i realise that this is now my next step in order to really understand the problem rather than just knowing that i have "MGD".

Alix Interesting about the Q-tip, is this the "only" thing you are doing after warm compresses or are you also doing massage with your fingers? I was being told years ago by this clinic that i should do circle movements with the top of my finger, going upwards on the lower lid and the opposite on the upper.

[Alix]

Hi Marcus I am just repeating what I’ve been told to do by doctors at Moorfields. They have not mentioned anything about massaging. If anyone reading this has been told to do something else please chime in.

Personally I am not doing warm eye compress anymore as it causes more inflammation and it doesn’t provide any relief. I hardly have any glands left so it’s not going to help.

I am not saying what the doctor you have been seeing is doing is wrong, but the circling motions after warm eye compress sounds strange, and it is not surprising you are not finding relief after IPL if he is not doing manual expression afterwards with forceps. This is key. Just pushing against the eyelids with a q tip is not enough.

Im glad you are looking into going to the clinic in Oslo. I agree it looks impressive - the doctors look well qualified and experienced, and are using the latest technology. I have not seen these kinds of equipment even at Moorfields or at the Dry Eye Centre so I think going there is the best thing you can do right now.