Retest results following IPL

Wow, impressed and super happy you got that 100% oil flow lol. That's great! This alone has personally changed my mind on IPL. Still not sold on lipiflow but these results are great. Did doc say how long these results will last?

May I ask, was anything else done other than IPL? Antibiotic, steroid, gland expression etc.

super cool!

[ebi1368]

farmgirl I am so happy for you. I am also going to do IPL as well. LLT for my left eye is 38 nm. I do not know if IPL will help me or not.

Did you have blocked gland as well?
I can see little dots on my eyelid. I guess it means they are not blocked.

[MGD1701]

Hi deep_dry_eye

Nerve damage
how to detect this? staining? symptom would be pain or more?
After LipiFlow I still had pain but about 2 months later, no more, until now.

Thank you.

[MGD1701]

Thanks Farmgirl for sharing great news.

Did dr comment why tear osmolarity are such big difference Left/334. R/278??
Any discomforts for this bad/left eye?

I also have one bad eye but dont feel much difference.

[farmgirl]

My first diagnosed problem was Sjogrens and it seems like everyone went, nope nothing we can do about that, here are some plugs. It was 8 years before anyone said you have MGD here is something we can do about it. I even had a lipiview done in 2010 when this first started but they have refined it with the meibography so sadly I have no pictures of my glands. The oils were much better on that test than on my first test this go around. At that time I was told I had some dropout but that the glands were producing and lipiflow wasn't necessary.

In retrospect followup through the years would have been helpful.

[deep_dry_eye]

I asked the Dr today and he said that he wants to see me again in 6 weeks and make sure they have settled. I guess we will play is by ear depending on how they are feeling. I did start the Xiidra today though and am hoping that helps with the inflammation and stimulates more tear production given that my principle problem is that I am aqueous deficient. Was your oil increase as dramatic?

Xiidra seems like a good medication, I just talked to another Ophthalmology fellow , and he claims that Xiidra is prescribed much more common than Restasis now,

I can't pinpoint it as I'm on multiple treatments , my LLT never really improved much , but I do feel symptomatically much better.

I suspect you to have a complicated case, maybe there are nerves involved as well.I would recommend you to do Prokera (AMT) as well. It costs around 1.5k CAD / eye. The idea is that your nerves might be damaged, and your nerves control your glands (oil and aqueous) . If you heal the nerves, you might not only heal your cornea (and symptomatically feel better), but also the nerves can regulate your glands better. I've definitely felt improvement after I did my Prokera (AMT). It's a really safe procedure, takes only a few minutes for insertion, and they keep the tissue (in a contact lens) on your eye for a few days for your eyes to absorb the tissue. You definitely might want to give it a try, its really low risk and might help you as well.

[farmgirl]

I asked the Dr today and he said that he wants to see me again in 6 weeks and make sure they have settled. I guess we will play is by ear depending on how they are feeling. I did start the Xiidra today though and am hoping that helps with the inflammation and stimulates more tear production given that my principle problem is that I am aqueous deficient. Was your oil increase as dramatic?

[deep_dry_eye]

I am really happy for you! Are you going to do more IPL sessions? I am personally on monthly-IPL, there is some scant anecdotal evidence that if you can control the inflammation (i.e., via IPL), you can get tissue regrowth.

While I haven't gotten any tissue regrowth, my doctor claims that my glands have shown structural improvement in the meibography.

This could be worth a try in your case!

[farmgirl]

Today I went back to test my eyes following my 4th IPL last week. I have not had the easiest week as I am still recovering from the trauma of having my glands squeezed but that should settle soon. The good news is that the test results I have are as follows bearing in mind my right eye always feels better than my left but the glands look better in the left than the right.

(LLT stands for Lipid Layer Thickness)

April 30/18
Tear Osmolarity: Left/326, R/325
LLT: Left/87, R/71
Minimum LLT: Left/57, R/48

August 29/18
Tear Osmolarity: Left/334. R/278
LLT: Left/+100, R/+100
Minimum LLT: Left/58, R/77

Overall I am thrilled that the osmolarity in the right eye now qualifies as normal even though the left went up somewhat and that the lipid layer is now well within the range of normal in both eyes. On the graph the blinks shoot up well into the 100+ range where as before nothing went into that area of the graph. That explains why I was feeling so much better after the 3rd session. Overall the glands look about the same size but fluffier. The lowers are more dramatically full.

So here is a picture that tells the story. On the first page I had 7 blinks. The oils started off flat and ended flat and were well below the gray 'normal' area. The second page I had 15 blinks and look how the oils start just outside of the normal area and sweep consistently well up into that area...kinda like a well oiled machine wouldn't you say...lol