Just done probing...

[quattroboy]

By complete chance, I discovered Mr. Myer Yodaiken from the Dry Eye clinic in Manchester UK did gland probing and manual expression.

I was doing a follow-up appointment with him to see how well I was doing with my partial blinking and Lipid layer.

He completed the probing and expression late yesterday afternoon.

He cleared a fair number of blocked glands, over half in my top lids. You could feel the probe clear the gland and hear the pop!

I've had very mixed messages about the state of my glands on my journey to heal my post LASIK dry eyes. From "there are only a few blocked glands", "mild MGD" to "it's just lid hygiene".

My eyes are still bloodshot this morning and little sore, from the intrusive nature of the treatment and the bad oil getting into my eyes.

[MGD1701]

Hi Thanks for sharing. It is a good sign. Great that you are proactive to solve such big problem.
What made you think you need probing? How were your symptoms before and afterwards?

[quattroboy]

Hi Thanks for sharing. It is a good sign. Great that you are proactive to solve such big problem.
So it was your own initiative to do all these? Why made you think you need probing? How were your symptoms before and afterwards?

Yes since having LASIK and discovering it had been completed on top of existing dry eyes, I've been managing my own approach to learning as much as possible and pursuing treatments.

As a result of LASIK I become AD and it kicked my existing problems with low TBUT into a different league.

Mr. Yodaiken performed Lippiview and Lippiflow in May, this was one of the first things I attempted after realising my LASIK dry eyes weren't fixing themselves.

During the follow up last Wednesday we did another Lippiview. In May all my blinks were partial, now only half. I've now managed to increase LLT in my right eye (on average) to over 100nm!!!! My left eye was around 83nm (on average).

Further more I pushing (on average) nearly 8 seconds on my TBUT. He counted it three times in each eye, on two occasions I hit the magic 10 seconds!

My Lippiview shows a fair amount of serious gland loss.

Discussing the result Mr. Yodaiken asked me to consider another treatment and when he started describing it, I simply said "You do probing???".

Well he does and was pleased I was aware of it, so we got it done.

Not cheap (£800), I thought he may find a few blocked glands given the messages I've previously been given. Hell no he was at it for nearly 50 minutes.

Probing was on my wish list to try and now I realise how many blocked glands I had I wish I'd discovered Mr. Yodaiken did it months ago and got on with it.

Reckons I should see a 10% to 20% improvement in my condition over the next few months.

He made the claim about glands regrowing after probing, hmm not sure about that one, but hey they may and that will be a bonus.

I'm pursuing other things as well. If things continue to go well I intend to post and let people know what's helped me, but I'm waiting a bit to see how much of an improvement I can make.

[MGD1701]

Nice to hear great news. But why this doctor did not recommend it when you visited him 1st time?? failed to detect??
Did he say that you had scar tissue?

LLT 100 is great. How did you manage it? just improve blinking??

[quattroboy]

Nice to hear great news. But why this doctor did not recommend it when you visited him 1st time?? failed to detect??
Did he say that you had scar tissue?

LLT 100 is great. How did you manage it? just improve blinking??

No I've been on a fair journey I intend to write a post soon in the hope it can help others but in summary (the things I think have really helped).


1. Lower plugs, these are the smart type, which not completely happy with and hope to get removed at some point. I used to have upper plugs as well.
2. Ikervis
3. Treat the Demodex. I've posted about Mr. Walker's approach several times (https://www.thebestsense.com/blephar...ere-is-the-def).
4. Blephex.
5. Probing and manual expression.

I've mixed this will daily consumption of oily fish (I don't trust supplements). Also blinking exercises.

Also pursuing a solution to my free androgen, currently taking 50mg of DHEA, awaiting blood result.

As mentioned I did Lippiflow in May don't think at that time it helped, but now I wouldn't dismiss doing it again.

Not sure why he didn't mention it in May, never thought to ask.

[quattroboy]

Lippiview results.

[MGD1701]

Thanks for sharing. Did doctor say you have scar tissue??
how about your oil quality? clear, since 100nm?

[quattroboy]

Thanks for sharing. Did doctor say you have scar tissue??
how about your oil quality? clear, since 100nm?

Yes he did.

I think my oil is still not great, not really bad but not as clear as it should be.

[Guest]

Now would be a great time to make diet changes, see if you can help that oil quality out. You may very well be doing that. Very happy for you! Great news to hear about your condition!

[quattroboy]

Now would be a great time to make diet changes, see if you can help that oil quality out. You may very well be doing that. Very happy for you! Great news to hear about your condition!

Currently eating plenty of oily fish, one portion a day.

Taking Flaxseed supplement 2000mg per day.

Cut down on my gluten.

With exception of my sweet tooth, i.e. cut down of sugar. My diet has always been very good, loads of fruit and veg. Minimum red meat.

Not sure what else to do in that respect.

[Meibum Ian]

Excellent!

A few questions, if you don't mind:

Was expression done first, to determine which glands needed to be probed?

Were only completely blocked glands probed, or did he also probe glands that merely expressed poorly?

Were glands expressed again following the probing?

[quattroboy]

Excellent!

A few questions, if you don't mind:

Was expression done first, to determine which glands needed to be probed?

Were only completely blocked glands probed, or did he also probe glands that merely expressed poorly?

Were glands expressed again following the probing?

No problem.

No expression was done afterwards.

I think he only probed the completely blocked glands. I could feel the probe go through and hear the pop.

He may have done others. It took sometime, which considering I've been told several times in the past my glands where ok, is very frustrating.

[deep_dry_eye]

Please keep us posted!

[MGD1701]

Hi quattroboy

So these glands were ''capped'' since you have heard the ''pop''?

Good to add GLA with Omega 3 - many reports support such approach - which works for me too.
I have read that best to combine 'with' big meal (not after) and twice a day.

Did doctor comment if inflammation presents, if so, recommedations?

[Milo007]

Hi quattroboy

So these glands were ''capped'' since you have heard the ''pop''?

Good to add GLA with Omega 3 - many reports support such approach - which works for me too.
I have read that best to combine 'with' big meal (not after) and twice a day.

Did doctor comment if inflammation presents, if so, recommedations?

No MGD1701 the "pop" as one 'hears' or rather senses in their mixed perception (the pop is not an audible sound actually) is the probe clearing its way through the fibro-vascular tissue both within the gland duct (if present) and/or of the 'sound' of the tearing of fibro-vascular tissue wrapping around the meibomian gland that forms a sleeve kind of structure squeezing the glandular acini and duct.

Cappings on the other hand is specifically the medical term for the blockage of the mouth of the meibomian gland orifices by epithelial tissue either in keratinized or non-keratinized form.

Imagine a rubber sleeve wrapping tightly around a flexible pipe and a probe of diameter slightly greater than the diameter of the flexible pipe making its way through. The rubber sleeve would tear off making a deflating kind of sound. It's analogical to the scar tissue wrapping around meibomian gland ducts and acinar units.