Hi guys,need suggestions.Lipiflow? xiidra work on blepharitis? or need add restasis?

Folks... lots of room for respectful disagreement here but please be circumspect. Making decisions about prescription drugs ought to be between the patient and their doctor. I understand people may have strong opinions for or against a drug, but it is ALWAYS most helpful and supportive to offer your experiences plus information you've come across MINUS dogma about what does/doesn't work and, for approved treatments, what is/isn't dangerous.

We all know that there is a very wide spectrum of dry eye patients - not just in terms of disease, and response to treatments, but in terms of their relationships with their doctors and their feelings about medical versus natural treatments etc.

Thanks all

I agree, even looking back at my comments, I'm not happy with how I presented them. Was super agitated that day...I need to refrain from giving advise for a while.

[Rebecca Petris]

Folks... lots of room for respectful disagreement here but please be circumspect. Making decisions about prescription drugs ought to be between the patient and their doctor. I understand people may have strong opinions for or against a drug, but it is ALWAYS most helpful and supportive to offer your experiences plus information you've come across MINUS dogma about what does/doesn't work and, for approved treatments, what is/isn't dangerous.

We all know that there is a very wide spectrum of dry eye patients - not just in terms of disease, and response to treatments, but in terms of their relationships with their doctors and their feelings about medical versus natural treatments etc.

Thanks all

[hyzlt7980]

If you like Xiidra, try to take it again and record if your symptoms persist. Maybe it was a coincidence. You could also do punctal occlusion when instilling drops.

yes. You are right. The side effect is gone and now I am good

[hopeful_hiker]

xiidra is very effective. I took it for 12 days and I can see a lot improvement. But I got headache, dizzy and eye discomfort from it. very sad. I will probably go to do lipiflow and switch to restasis

If you like Xiidra, try to take it again and record if your symptoms persist. Maybe it was a coincidence. You could also do punctal occlusion when instilling drops.

You know, I want to speak to that because I don't really agree with these things as a blanket statement, though all of it may be true for many people. Dry eye is a really wide spectrum of diseases and states. There are people who have dry eye from specific causes where it goes away when those causes are addressed. I also think we have to be careful with the "gets worse as you age" prognosis. Disease progression and symptom progression are two different things... the latter is what tends to matter most to most of us.

I always try to be careful of what I say. I try to preface everything with, well this helped me, hopefully you can take something from it. That being said, my understanding is that MGD is progressive and chronic. I wasn't trying to be a Debbie downer or be so matter of fact. I just felt given the diagnosis, it applied.

But everything you said is true. I mean, this person could have been diagnosed wrong, in which case I would also be wrong. There are also many situations in which dry eye can and will go away....I hope that's the case here. Let me also say, I hope you're right for a lot of us. It's hard thinking the future will only get harder...yet that seems to be the case.

[deep_dry_eye]

Thank you, guy.

I live in east Canada. And only place I can find IPL is Toronto and Montreal. Need take plane.

Now, I hesitate to do lipiflow. because my lipiview result looks good.(one 70+, one 90), but I still got uncomfortable.

You did it once right �HHow do you feel about it

LipiView LLT is an unreliable metric. There is high variance. The bigger question is, if there is inflammation in the glands, if there are, you should do IPL.

[hyzlt7980]

http://dryeyenews.com/centers-of-excellence/

here are the locations that do IPL in the USA and other countries trained by Dr Toyos.

There is another kind of IPL offered widely in Europe and i saw some in Hong King too called E-eye. Ive read facebook dry eye group many people have success with that there.

Go big now and stop all progression. I was like you a year ago and didnt get the help I needed. Now my eyes are very bad.

I start IPL end of August. 4 hour drive one way. For a 30 minute procedure. Luckily i have family and friends to drive.

Thank you, guy.

I live in east Canada. And only place I can find IPL is Toronto and Montreal. Need take plane.

Now, I hesitate to do lipiflow. because my lipiview result looks good.(one 70+, one 90), but I still got uncomfortable.

You did it once right �HHow do you feel about it

[edmunder]

http://dryeyenews.com/centers-of-excellence/

here are the locations that do IPL in the USA and other countries trained by Dr Toyos.

There is another kind of IPL offered widely in Europe and i saw some in Hong King too called E-eye. Ive read facebook dry eye group many people have success with that there.

Go big now and stop all progression. I was like you a year ago and didnt get the help I needed. Now my eyes are very bad.

I start IPL end of August. 4 hour drive one way. For a 30 minute procedure. Luckily i have family and friends to drive.

[Rebecca Petris]

First off, sad to say, you cannot cure this. You can however manage it and make things better. But it will progress as you age.

You know, I want to speak to that because I don't really agree with these things as a blanket statement, though all of it may be true for many people. Dry eye is a really wide spectrum of diseases and states. There are people who have dry eye from specific causes where it goes away when those causes are addressed. I also think we have to be careful with the "gets worse as you age" prognosis. Disease progression and symptom progression are two different things... the latter is what tends to matter most to most of us.

[hyzlt7980]

hyzlt7980 , I�m not a doctor, but looking at your gland images, it looks like some of your glands are short (starting to atrophy), and you have some gland loss in the inner corners, mostly in the two lower pictures. I would get this confirmed from another doctor, given your current one says you have no gland loss. If you do have some short or loss glands, and/or given it�s already been confirmed you have blocked glands, LipiFlow may be a good first procedural treatment for your MGD. IPL is good too, but not as readily available. Some people have gotten results doing both when just LipiFlow alone didn�t work.

As mentioned above, likely you will not be able to wear regular contacts again. However, you might be able to wear scleral lenses, which have been increasingly used to manage dry eye symptoms. The lenses are dome-shaped so they are filled with saline to protect the corneas, and the lens edges lay on the sclera/white part of the eye. Not everyone can tolerate sclerals, but it could be worth a consult to see if you can, and if it provides comfort. I wear mines 12 hours a day, and it helps with daily functioning and comfort.

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome

Thank you very much for the reply. I think I will do lipiflow in case I lose gland. God, hope it can help

[hyzlt7980]

They do they exact same thing in different ways. They both block T cell mediated inflammation. Restasis stops new T cell formation, that's why it takes a long time to work. Because the existing T cells need to die off before you notice an effect. Xiidra destroys T cells that are currently active. So it works much faster because there's no lag time.

So I will respectfully disagree with you. This person said, dry eye is not a problem for me. So that says to me, he's doing pretty good. If he's doing pretty good, I suggest he stays away from immunosuppressive drugs. They are extremely dangerous and should be respected in my humble opinion. No disrespect, but steroids, xiidra and restasis are for level two dry eye sufferers, people for whome the traditional treatments failed. So I think he should fail with those treatments first, then consider a dry eye drug.

Thanks for you suggestion. xiidra work great for me but also bring annoying side effect. I will consider do lipiflow

[hyzlt7980]

lipiflow is low risk, and will probably help. it just costs money.

restasis and xiidra both reduce inflammation, im personally on both at the same time. xiidra is a new and good drug, and more responsive than restasis

xiidra is very effective. I took it for 12 days and I can see a lot improvement. But I got headache, dizzy and eye discomfort from it. very sad. I will probably go to do lipiflow and switch to restasis

[hyzlt7980]

Well you are ahead of the curve. You are getting treatment before its bad.

Im not sure what to do. If its inflamed you should do IPL. if you can get IPL locally you dhould start and fo it monthly for a while. 6 months.

I dont know if you will be able to wear contacts again. Good luck.

Well. sadly in a small city, no IPL offered. xiidra works great but with some annoying side effect. I think I will do lipiflow and swich to restasis

[hyzlt7980]

Hi there! I have pretty bad MGD with gland drop out. I use Xiidra and have been since 2016. I think it helps with inflammation control but it hasn�t made much of a difference in symptoms. I used a steroid a while back which helped the most for a while, but I�m terrified to use again since it raised my eye pressure. Plus you can�t stay on it a long time. I plan to have Lipiflow done.

omg. I have used xiidra for almost 2 week. It helps a lot for me. I do not need to rub my eye and rarely use eye drops. However, I got some headache which is not serious but annoying. I also have some symptom like high eye pressure. I have not consulted this with doctor. That is so sad to have side effect otherwise xiidra can make me live normally

[Hokucat]

hyzlt7980 , I�m not a doctor, but looking at your gland images, it looks like some of your glands are short (starting to atrophy), and you have some gland loss in the inner corners, mostly in the two lower pictures. I would get this confirmed from another doctor, given your current one says you have no gland loss. If you do have some short or loss glands, and/or given it�s already been confirmed you have blocked glands, LipiFlow may be a good first procedural treatment for your MGD. IPL is good too, but not as readily available. Some people have gotten results doing both when just LipiFlow alone didn�t work.

As mentioned above, likely you will not be able to wear regular contacts again. However, you might be able to wear scleral lenses, which have been increasingly used to manage dry eye symptoms. The lenses are dome-shaped so they are filled with saline to protect the corneas, and the lens edges lay on the sclera/white part of the eye. Not everyone can tolerate sclerals, but it could be worth a consult to see if you can, and if it provides comfort. I wear mines 12 hours a day, and it helps with daily functioning and comfort.

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome