IPL at Univ of MI - Ann Arbor Kellogg Eye Center

[edmunder]

Yes its very frustrating and psychologically very challenging. When i had lipiflow it got better then back to blocked. IPL same thing.

Part of me wants to stop doxycycline and try very high levels of probiotics plus probiotic foods such as sauerkraut, kimchi, resistant starch etc to increase bacterial health of the body.

I also want to try water fasting for 4-5 days to kill all the bad white blood cells and regenerate the immune system in my body.

I just feel like im doing the same e thing again and again. Its not working. Hard to be patient thats for sure.

[deep_dry_eye]

I have a lot of hope for you, seems like your glands are capable of producing good quality meibum. But for some unknown reason, they're unable to do it consistently and get blocked easily. But the good news is, your glands are still there and can produce oil!

I would go at least 6 rounds of IPL treatment in your case, I hope you will get improvement with each round.

Another treatment for consideration is Prokera (AMT), I suspect cases like you, there is definitely a nerve factor to it. My theory is that you are experiencing extreme symptoms due to your nerves misfiring, and your nerves control your glands. Dry eyes -> nerves gone wild -> more dry eyes -> more nerves gone wild.

Let us try and reduce the inflammation of the nerves by doing AMT.

[edmunder]

I guess I should add that many people don't get any benefit from the first treatment but I felt great. The doctor had mentioned if I see improvement to be happy because that usually means after 4-5 treatments there can be some real progress with the thinning of the oil. I am praying that will be the case. But as you can see Im also looking into manual expression other times to try and express the bad oil as much as possible.

[edmunder]

Here is some info about IPL at the Univ of MI. I began Wednesday August 29th.

Univ of MI eye care requires a doctor, I believe a corneal specialist, to ok a patient to allow them to get IPL through their office. This I found very frustrating because its a 4 hours drive there and I had already seen a corneal specialist, but this is U of M policy. I waited for 3.5 hours to see the doctor, had a 16 minute consult where I spoke most of the time. He did not look at my glands. He pressed on my eyelid and said some of the glands are giving off oil, but he did not do a manual expression. He said OK and then I paid $195 because they are out of network and my insurance said I had already seen a corneal specialist and that IPL is a experimental treatment. I was very angry for the run around and lack of care.

I made an appointment to get IPL but was never seen any information about how to prepare for the treatment, IE, should I stop taking doxcycline or any other information.

One piece of info: The doctor only does IPL wednesdays afternoons, but she is completely booked up. I saw her schedule as I left.I dont understand why the doctor doesnt add another afternoon or morning. The scheduler had remarked that people are very upset dealing with the wait times to see the doctor. As a severe dry eye sufferer hoping for treatment I understand the patients emotions.

The treatment is $400 for each visit. The first visit is longer with talking and meibography. Later visits I imagine will be quite short. I wish it was in my city, would be wonderful.

I made the trip there and the doctor who does the IPL was very professional and helpful. Most people getting IPL apparently dont know much about it so she was surprised about my knowledge of dry eye and the academic literature available.

She took pictures of my glands and which I have attached and said it looked like they are mostly intact, though the picture of the bottom glands isnt very clear. I have been told my lower lids are quite tight and hard to pull out for photos. I told her that the previous doctor should have taken pics of the glands to rule out people who dont have any glands left, because she said some people do the first consult, then come to the second consult only to be told their gland loss is too severe, seems like could be managed better.

The IPL treatment was very fast. Less than 5 minutes. We looked at my skin type and according to skin darkness she can turn the machine up higher the lighter the skin. I have extremely fair, lightly ruddy skin from my English grandmother. So she turned the machine up to its highest level she uses. There was some slight sting at some points on my face but overall it was relatively painless. I did not experience any side effects such as blistering or pigment change.

After the IPL treatment she did an extremely thorough manual expression. Each lid was gone over 3-4 times using a lot of pressure. She did a numbing drop, then did a lid. Then waited a moment. DId another numbing drop, then another lid.

On my right eye which is less painful she said the oil was slightly thick. On my left eye which is usually painful she said it was much more like toothpaste.

When she finished each gland was very clear in the mirror. I went to the bathroom and looked, and it was very beautiful to see such perfect, uncapped glands looking at me. But my eyes were a bit raw.

Next time I will bring a small cooler with a couple wash clothes, ice and also my Hypocholoric acid spray and some cotton pads to really clean the eye after the expression. I used a lot of drops and blinked my eyes.

Results: That evening my eyes were wonderful. I pressed on my eyes when I got home after dinner with family in a city along the way and the 4 hours drive I got home at 10 pm. Oil was pouring out of the glands. All of them. Even some of the outside edge of my eye that my Lipiflow dry eye doctor had said looked a bit faint on the meibography he took, they were also expressing oil.

The next few days my eyes went 90-100%. I mean a revelation. I didnt need drops and my eyes were producing tons of oil. The oil was clear and came easily from the glands.

The next day I started getting blockage and now today more blockage. Goggles back on. When I do a warm compress I can a lot of oil to come out but it seems to thicken up after that. Though some of the glands stay open, which is still better than before.

SO thats where I am now.

I am in talks with a local doctor to start doing these very thorough manual expressions because of the results it gave me. Hopefully he will agree and then I can do the IPL every 3-4 weeks and in between get another thorough expression.