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  • #31
    Originally posted by Dowork123 View Post

    Sorry I just saw this....dont take the doxy before trying IPL if that痴 the route you want to go. Ebi is correct, I believe it could effect your skin very badly. Although I知 on a large dose, and I go outside everyday to take my daughter for a walk and haven稚 noticed any sides thankfully. Good luck.
    While some (not all) ppl experience some sunburns while on doxy, this is at antibiotic dosages. Doxy for MGD is usually around 40mg per day, I suspect most ppl to not be affected by doxy + sunlight. Similarly, doxy+IPL at 40mg / day should be quite safe. Doxy also has a 1/2 life of 18 hrs, so after a day or two clears most of it out of your system.

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    • #32
      Originally posted by phenix01 View Post

      Serum will not solve the problem, it's just a fix. IPL may solve the meibomian gland problem if those are inflamed and if the inflammation is the source of your problem. I am speculating it may be my case.
      My personal opinion is that serum does not fundamentally help MGD. However, one working theory is that MGD arises when our nerves are misfiring due to dry eyes, which causes more MGD. The theory is that fixing the nerve problem might help the MGD, serum can help heal the nerves potentially.

      However, I do promote IPL for MGD as well. I think there is no harm to do serum + IPL. Serum most likely can't hurt at all, there's very low risk for using serum except for the cost and inconvenience.

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      • #33
        Originally posted by phenix01 View Post

        Thanks for the note. Doxy would be my LAST resort.
        Doxy should not be your last resort , I defer to your medical provider for this judgement call. Doxy (and azithromycin) are really safe antibiotics. Additionally, the dosage you will be on for doxy for MGD is typically 40mg, which is a -really- low dose.

        I would actually encourage you to get on a trial of azithromycin (especially topical azithromycin if you can get access to it), the theory is that azithromycin can help (very quickly) flush out and liquify your gland secretions. Afterwards, you can go on other medication to control and reduce the inflammation.

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        • #34
          Originally posted by phenix01 View Post

          Serum will not solve the problem, it's just a fix. IPL may solve the meibomian gland problem if those are inflamed and if the inflammation is the source of your problem. I am speculating it may be my case.
          My problem is also inflammation. Reading the forums, I think I also have problem with cornea sensation. I have lost my cornea sensation. So the nerves do not send signal to my brain to make tears and this cause inflammation. I am also speculating as well. Anyway, using serum does not hurt. It is a bit troublesome but it worth it.

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          • #35
            Originally posted by ebi1368 View Post

            My problem is also inflammation. Reading the forums, I think I also have problem with cornea sensation. I have lost my cornea sensation. So the nerves do not send signal to my brain to make tears and this cause inflammation. I am also speculating as well. Anyway, using serum does not hurt. It is a bit troublesome but it worth it.
            I would suggest you to give 50% serum a try. It's really low risk, get on it at least a few months.

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            • #36
              Originally posted by deep_dry_eye View Post

              My personal opinion is that serum does not fundamentally help MGD. However, one working theory is that MGD arises when our nerves are misfiring due to dry eyes, which causes more MGD. The theory is that fixing the nerve problem might help the MGD, serum can help heal the nerves potentially.

              However, I do promote IPL for MGD as well. I think there is no harm to do serum + IPL. Serum most likely can't hurt at all, there's very low risk for using serum except for the cost and inconvenience.
              I believe 100% my eyelids aren稚 functioning properly because my cornea on the right eye is so dry and damaged. The left eye is great, so is my blink. The right eye burns, is very sandpapery and the lids are so weak, all my supporting muscles are sore from trying to compete the blink.

              Has serum helped, I believe so. I agree it doesn稚 directly help MGD. But the better my ocular surface, the better the entire system functions.

              Im on a lot of doxy, 100mg 2x a day. Tapering to 100mg once a day for a month then down to 50mg maintenance.

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              • #37
                Originally posted by Dowork123 View Post

                I believe 100% my eyelids aren稚 functioning properly because my cornea on the right eye is so dry and damaged. The left eye is great, so is my blink. The right eye burns, is very sandpapery and the lids are so weak, all my supporting muscles are sore from trying to compete the blink.

                Has serum helped, I believe so. I agree it doesn稚 directly help MGD. But the better my ocular surface, the better the entire system functions.

                Im on a lot of doxy, 100mg 2x a day. Tapering to 100mg once a day for a month then down to 50mg maintenance.
                I think you should consider azithromycin , there are many studies out there that suggest azithromycin to be (substantially) better than doxy.

                Doxy 40mg is pretty low dose, and quite common for MGD.

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                • #38


                  Originally posted by deep_dry_eye View Post

                  I think you should consider azithromycin , there are many studies out there that suggest azithromycin to be (substantially) better than doxy.

                  Doxy 40mg is pretty low dose, and quite common for MGD.
                  I react poorly to azythromycin...found that out years ago. The doxy also..I cannot handle the hyclate salt or capsules. I have to have monohydrate tablets.

                  I will be down to 50mg very soon. One doc wanted me on 50mg a week, my corneal specialist told me 100mg 2x a day, then taper to 50mg. I wanted to take the most aggressive approach...assuming my stomach could handle it and It could, thankfully.

                  When I got my protocol from my new doc, I ran it past the specialist. He said increase doxy and take less steroids. He said 2x a day with the methylpred rather than 4/3/2/1 taper. But I chose the heavy taper again, I wanted to be aggressive. So I kind of pieced this protocol from two doctors.

                  When I went in after a month my Schirmer went from 3 in the left eye to 20 and 2 in the right eye to 12. My meibum ran clear and expressed easily. My inflammadry was negative in both eyes. I知 feeling better, not perfect, but better.

                  Im still having an issue with the right eye. If the right eye felt like the left, I壇 be way less stressed for sure. I知 not sure what to do with it. I値l be asking my docs opinion when I see him next month. The only difference between the two eyes is a debridement and a course of moxafloxacin. Hopefully I can get it resolved and move on finally.

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                  • #39
                    Originally posted by Dowork123 View Post



                    I react poorly to azythromycin...found that out years ago. The doxy also..I cannot handle the hyclate salt or capsules. I have to have monohydrate tablets.

                    I will be down to 50mg very soon. One doc wanted me on 50mg a week, my corneal specialist told me 100mg 2x a day, then taper to 50mg. I wanted to take the most aggressive approach...assuming my stomach could handle it and It could, thankfully.

                    When I got my protocol from my new doc, I ran it past the specialist. He said increase doxy and take less steroids. He said 2x a day with the methylpred rather than 4/3/2/1 taper. But I chose the heavy taper again, I wanted to be aggressive. So I kind of pieced this protocol from two doctors.

                    When I went in after a month my Schirmer went from 3 in the left eye to 20 and 2 in the right eye to 12. My meibum ran clear and expressed easily. My inflammadry was negative in both eyes. I知 feeling better, not perfect, but better.

                    Im still having an issue with the right eye. If the right eye felt like the left, I壇 be way less stressed for sure. I知 not sure what to do with it. I値l be asking my docs opinion when I see him next month. The only difference between the two eyes is a debridement and a course of moxafloxacin. Hopefully I can get it resolved and move on finally.
                    What kind of reaction do you have w/ azythromycin? azythromycin is one of the most common and safest (and most prescribed) antibiotics out there. There are other macrolides , I suspect Erythromycin would do something similar. See wikipedia page for Macrolides:

                    https://en.wikipedia.org/wiki/Macrolide

                    erythromycin in ophthalmic form (as an ointment) is readily available in Canada. i suspect you can give that a try if topical azythromycin is not available in your country, for example, local ophthalmic form (perhaps) is much better than systematic.

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                    • #40
                      Originally posted by deep_dry_eye View Post

                      What kind of reaction do you have w/ azythromycin? azythromycin is one of the most common and safest (and most prescribed) antibiotics out there. There are other macrolides , I suspect Erythromycin would do something similar. See wikipedia page for Macrolides:

                      https://en.wikipedia.org/wiki/Macrolide

                      erythromycin in ophthalmic form (as an ointment) is readily available in Canada. i suspect you can give that a try if topical azythromycin is not available in your country, for example, local ophthalmic form (perhaps) is much better than systematic.
                      Lol..ok, so dr Jain prescribed 1mm (tiny amount) of erythromycin at night also. I was allergic to that very badly. I mean inflamed, I地 pain, just bad. I used it for four days before I called and told them about the pain and itching. He told me to switch to an otc ointment. I was allergic to all of them also. So now I知 using a gel.

                      Z paks upset my stomach beyond belief. I get extreme gastrointestinal distress. The doxy is actually pretty easy on my stomach. Again, only the tablets and the monohydrate version. So even a different type of doxy messed up my gut. Extreme heartburn that will not go away. Then an upset gut as well. I知 super sensitive to every drug. I was allergic to restasis too lol. I mean everything bothers me to some degree.

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                      • #41
                        I just want to address the title of this discussion and some of the content:

                        The Mastrota paddle is a medical implement designed for in-clinic use by a trained professional, not for home use by patients. Visitors reading threads like this may want to try out things being described and may harm themselves in the process.

                        I really want to encourage everyone to not attempt forms of gland manipulation at home that have not been specifically approved for them by their own eyecare professional.

                        Thanks all
                        Rebecca Petris
                        The Dry Eye Foundation
                        dryeyefoundation.org
                        800-484-0244

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                        • #42
                          I just brough one, different brand, for my doctor for a better result and safety.
                          Last edited by MGD1701; 30-Sep-2018, 10:42.

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                          • #43
                            Old topic I know, but doing some research about this topic myself - as I am trying pinching the eyelids rather than massaging with pressure - I came across follwing, interesting citation:
                            There are some physicians who have expressed concern that probing may damage the gland in some way (D3). Independent studies have specifically evaluated this with confocal microscopy and meibography and found no adverse effects on the morphology of acinar units or scarring.10,12 The many peer-reviewed published papers and presentations on MGP all found no adverse effects.323 However, all studies did show significant benefit by using gland probing with relief of symptoms and signs of o-MGD (see perspective #1).323
                            source: https://www.dovepress.com/intraducta...t-article-OPTH

                            I am not promoting self-expression with paddle but rather pointing into the expression direction (e.g. pinching the eyelids after heat treatment).
                            Also take into account that over-expression might be thing:
                            These glands are sensitive and too much pressure or squeezing too frequently could destroy them. Also the production of meibum is a gradual ongoing process so squeezing them too often or too hard can empty them faster than the meibum is replaced. Then since there is insufficient meibum available to properly protect the tear film, you then find yourself suffering from more dry irritated eyes.

                            This can become a vicious circle with further squeezing leading to the empty glands becoming stuck together internally and ultimately dropping out.
                            source: https://blepharitiscure.com/
                            Last edited by gilles; 02-Jun-2020, 05:57.

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