Results of meibography & dry eye assessment in london

[unicorn]

Just a quick update about my assessment at the Dry Eye Centre in London which I had on Friday.

This is a clinic run at Burnett Hodd optometrists in Devonshire street.

I had meibography, lipiview, lid debridement and gland expression (using forceps, although it was very gentle).

Caroline, who does the assessments, is very nice and was thorough and helpful in her advice. The meibography showed minor gland loss in my left ey but not in my right. Lipiview numbers were 57 and 64 so not great. She said my eyes looked typical for someone with ocular rosacea with some blocked glands and thickened oil. She recommends i start low-dose doxy again (Efracea) and use the Blephasteam goggles.

Of more interest is the 'cysts' - like fluid filled blisters really- that I have under my upper lids. She's never seen anything like them and is going to email Dr Korb to see if he has any ideas. The suggestion is that these are being caused by chronic friction. I also have lid wiper epitheliopathy. She is wondering if a very slippery daily contact lens may help so I am probably going to work with my local optometrist on this. She has also recommended I use an ointment such as VitAPos at night and an oily artificial tear, Emustil, during the day.

All in all a very useful appointment I think and I would certainly not hesitate to recommend the place to anyone who can get to London. I travelled down from Glasgow and I think it was worth the effort!

Hope this helps someone.

[unicorn]

Forgot to say, they are also one of the few places in the UK to offer BlephEx treatments (I think this is mainly helpful for anterior blepharitis). Caroline also seems very clued up about Demodex - she said she had recently seen someone with a very bad case of it. What made me laugh was the big rubber Demodex sitting on her desk - no idea where you would buy such a thing!

[JJdryeye]

What are Blephasteam goggles? It sounds like you're in good hands, please let us know how you respond to these treatments.

[spmcc]

Unicorn,

I'm so happy that you had a good appointment. Hopefully some improvements will occur.

When you say you had lid debridement, did you have Blephex or debridement with golf club spud like this...?

[littlemermaid]

Unicorn, so glad you are feeling better and the London trip went well. Did Caroline prescribe Efracea herself? Great that she can email Dr Korb direct. It will be good to hear whether it's an allergic papillary conjunctivitis, or friction? Really hope you get comfort.

I am wondering if we should all ask the private services of the NHS Trust eye hospitals if they will consider supplying custom-fit scleral lenses? and consider supplying autologous serum and PRP at European prices? Thoughts anyone?

[unicorn]

JJdryeye, these are the Blephasteam goggles: http://www.spectrum-thea.co.uk/Apps/...nt.aspx?fid=31

Spmcc, the debridement was with a small metal tool, presumably the golf club spud thingy. It was done under anaesthetic but you could feel it was a bit sharp. Just a strong tickly feeling really.

Littlemermaid, sadly I wouldn't say I'm feeling any better but thank you for the good wishes. No, Caroline didn't prescribe the Efracea herself. It is available NHS in Scotland but not, as far as i know, in England. Yes, it's great she can email Dr Korb - he is a close family friend, it seems. I'll try not to get my hopes up too much regarding a reply but you never know. I don't think it is an allergic papillary type conjunctivitis, although there are some papillae and follicles there (I think she said a dry eye can look like an allergic eye, and also that once you have these papillae/follicles, they never completely go away). I wish I could post a photo of these cysts - maybe I'll try and get Mr Unicorn to do it later.

Do private sector ophths in the UK never supply lenses or autologous serum? I have given up with my previous (NHS) consultant, as his attitude was fast leading me into a nervous breakdown

[littlemermaid]

Unicorn, Yes, I think they refer to optometrists for scleral lenses. I think someone could make a fortune offering a great fit and fine materials, though. Autologous serum is expensive here, difficult to get NHS, and people are going to Alicante. Next time we see a senior doc I'll ask - an independent pharmacy lab service could start up and do well. So glad you've found kind support - it's more than half the battle. London has been so nice through Spring and into Summer this year, warm and breezy, but with plenty misty rain - the gardens and parks are looking gorgeous.

[khmedia]

Hi Unicorn,

I've sent you a private message on this topic. I'd be grateful to hear from you!

Kevin

[cathy8889]

Hello, thanks for reporting on your visit to dry eye centre In London, I would like to have a meibograohy done just so I know what I'm working with and if damage is reversable, I fear that I've had these symptoms for a long time and worries me that permanent damage could have been done.

Has anyone else visited the dry eye centre in London and would you recommend it? Is there anywhere else in uk that offers similar testing of meibomian glands?

Many thanks

Cath