IPL questions

[How]

Just wondering--if you have rosacea is there a point to getting IPL specifically for eyes or would it be better to get the regular treatments for facial rosacea, since they have said it also apparently helps eyes?

Does anyone know if you can have IPL (for facial rosacea) if you have sebhorreic dermatitis on your face? Does it also help seb derm?

And can you have it if you have very slow healing time for scars?

[deep_dry_eye]

IMO, I believe it can still help as the IPL for eyes are more targeted at the lids/glands.

My understanding, ppl with rosacea are good candidates for IPL.

[How]

Thank you for answering. I wonder if I am a good candidate though since scars do not heal fast for me anymore (not sure why.)

[How]

Well I went to see an optometrist and he said I wasn't showing signs of ocular rosacea. He says it's still possible I might have it, that it could flare up and be visible, but, seems right now I don't.

So I guess that means IPL is not really indicated for me?

He also was of the opinion that a lot of the more expensive dry eye related treatments didn't really work, at least, not consistently enough to be recommended. Said someone he knew personally had tried lipiflow for instance, and it didn't help them.

[deep_dry_eye]

Well I went to see an optometrist and he said I wasn't showing signs of ocular rosacea. He says it's still possible I might have it, that it could flare up and be visible, but, seems right now I don't.

So I guess that means IPL is not really indicated for me?

He also was of the opinion that a lot of the more expensive dry eye related treatments didn't really work, at least, not consistently enough to be recommended. Said someone he knew personally had tried lipiflow for instance, and it didn't help them.

Every patient is different -- you shouldn't take a small sample size as statistical significance.

I don't have ocular rosacea or any of the typical signs of rosacea , but I firmly believe IPL helps me. The only way to know whether IPL is for your or not is to give it a try. Does it cost a lot of money? Yes. Is it guaranteed to work? No. But personally, spending that $$$ for a chance of getting better is worth it to me. That is obviously a personal question/answer for yourself.

[How]

Hi deep_dry_eye,

Thank you very much for commenting. I am glad to hear the IPL worked for you. I didn't meant to paint the situation as the optometrist running with just one case, this was based on a number of people he said this. The reason he highlighted that one case was the person was a doctor. But his take is the results are not consistent.

Nonetheless I've had a bit of a rethink of IPL partly based on your comment but also because I think I am sorting out what the issues are now.

I didn't mention it at the optometrist (forgot) but, I seem to fit the signs for a demodex issue. I'm losing a ton of lashes now and if this keeps up I'll have the eyes of a lizard...I'm getting a bit frantic about it too. So I did yet more research and it seems it really could be that. I also happened to use a tiny bit of rubbing alcohol under one eyebrow the other day (eyebrows are itchy, and flaky too) which I realize is not the greatest idea but I made sure not to get it in my eye...and for a whole day the area was not itchy OR flaky, and no matter what I do it always is. So that suggests something was killed off by the rubbing alcohol. (I am not suggesting anyone try putting rubbing alcohol near their eye either!)

Demodex would explain a lot of the problems though, it would explain the flaking in lash line, the overall problem with my skin too since it's flaking all around my face, why I'm so itchy, why it feels like something is crawling in my eyebrows (sorry for the graphic detail!) It would also explain the toxic eye feeling too. I rinse my eyes several times a day and they get temporarily better, I believe simply because I'm removing some of the toxins.

I also recall seeing what looked like a round ring of dandruff at the base of a lash before too.

Very warm compresses also seem to make me worse, not better. They are probably helping to dry the eye out and also causing my eyes to become more inflamed when they are too hot.

I think what's happened is something has triggered the demodex to get out of balance, from what I read they release bacteria when they die, so that explained the infection I had and why the drops generally made me feel better. And now the demodex to some degree have damaged my glands, hopefully not irreversibly but I'm going to have to see someone else to figure that part out. I will have to look into probing and blephex.

Optometrist said some of the glands are blocked though. My tears are evaporating too quickly. Definitely inflammation is an issue here.

My symptoms slowly started to get worse starting last summer. I was under a ton of stress in the summer for various reasons. Maybe that's what tipped the situation towards the demodex getting so out of hand. I also had to the use the computer a lot more than I normally do last year, so that would have aggravated the situation.

[How]

Also, do they use local or topical anesthetics when they do IPL?

[deep_dry_eye]

Also, do they use local or topical anesthetics when they do IPL?

None needed. You just need shielding (cornea metal shields, or stickers) -- and an gel is applied on the skin to help dissipate the heat. Metal shields are preferred as that means both the upper and lower lids can be done. There's some small jolt of discomfort , but nothing severe.

[deep_dry_eye]

Hi deep_dry_eye,

Thank you very much for commenting. I am glad to hear the IPL worked for you. I didn't meant to paint the situation as the optometrist running with just one case, this was based on a number of people he said this. The reason he highlighted that one case was the person was a doctor. But his take is the results are not consistent.

Nonetheless I've had a bit of a rethink of IPL partly based on your comment but also because I think I am sorting out what the issues are now.

I didn't mention it at the optometrist (forgot) but, I seem to fit the signs for a demodex issue. I'm losing a ton of lashes now and if this keeps up I'll have the eyes of a lizard...I'm getting a bit frantic about it too. So I did yet more research and it seems it really could be that. I also happened to use a tiny bit of rubbing alcohol under one eyebrow the other day (eyebrows are itchy, and flaky too) which I realize is not the greatest idea but I made sure not to get it in my eye...and for a whole day the area was not itchy OR flaky, and no matter what I do it always is. So that suggests something was killed off by the rubbing alcohol. (I am not suggesting anyone try putting rubbing alcohol near their eye either!)

Demodex would explain a lot of the problems though, it would explain the flaking in lash line, the overall problem with my skin too since it's flaking all around my face, why I'm so itchy, why it feels like something is crawling in my eyebrows (sorry for the graphic detail!) It would also explain the toxic eye feeling too. I rinse my eyes several times a day and they get temporarily better, I believe simply because I'm removing some of the toxins.

I also recall seeing what looked like a round ring of dandruff at the base of a lash before too.

Very warm compresses also seem to make me worse, not better. They are probably helping to dry the eye out and also causing my eyes to become more inflamed when they are too hot.

I think what's happened is something has triggered the demodex to get out of balance, from what I read they release bacteria when they die, so that explained the infection I had and why the drops generally made me feel better. And now the demodex to some degree have damaged my glands, hopefully not irreversibly but I'm going to have to see someone else to figure that part out. I will have to look into probing and blephex.

Optometrist said some of the glands are blocked though. My tears are evaporating too quickly. Definitely inflammation is an issue here.

My symptoms slowly started to get worse starting last summer. I was under a ton of stress in the summer for various reasons. Maybe that's what tipped the situation towards the demodex getting so out of hand. I also had to the use the computer a lot more than I normally do last year, so that would have aggravated the situation.

A skilled optometrist should be able to spot demodex if it is indeed demodex.

Blocked glands and low breakup time suggest classical signs of MGD. I still suggest getting on inflammatory medication (a combination of Xiidra and Restasis), as well as IPL. If you have access to Azyter (or topical azithromycin) , I also recommend a course of that.

If you have not done LipiFlow, I also recommend that.

The key is to remove the blockages (with LipiFlow), kick start the glands (Azithromycin), control and reduce the inflammation (Xiidra, Restasis), and also hit the underlying cause of the inflammation (IPL).

[How]

None needed. You just need shielding (cornea metal shields, or stickers) -- and an gel is applied on the skin to help dissipate the heat. Metal shields are preferred as that means both the upper and lower lids can be done. There's some small jolt of discomfort , but nothing severe.

Good to know. And thanks for getting back to me so fast!

[How]

A skilled optometrist should be able to spot demodex if it is indeed demodex.

Blocked glands and low breakup time suggest classical signs of MGD. I still suggest getting on inflammatory medication (a combination of Xiidra and Restasis), as well as IPL. If you have access to Azyter (or topical azithromycin) , I also recommend a course of that.

If you have not done LipiFlow, I also recommend that.

The key is to remove the blockages (with LipiFlow), kick start the glands (Azithromycin), control and reduce the inflammation (Xiidra, Restasis), and also hit the underlying cause of the inflammation (IPL).

One of the optometrists I saw did agree that flaking in my eyebrows and on my face might be tied to the eye issues. However I was not told why that would be, if that was related to demodex. I do agree about MGD. I'll have a look at Xiidra and Restasis and Azithromycin, thanks for the suggestions.

Forgive my being new to so much of this, but, what is the difference in terms of effects between probing and Lipiflow? Do they basically do the same thing (unblock glands)?

[deep_dry_eye]

One of the optometrists I saw did agree that flaking in my eyebrows and on my face might be tied to the eye issues. However I was not told why that would be, if that was related to demodex. I do agree about MGD. I'll have a look at Xiidra and Restasis and Azithromycin, thanks for the suggestions.

Forgive my being new to so much of this, but, what is the difference in terms of effects between probing and Lipiflow? Do they basically do the same thing (unblock glands)?

Probing is considered much more invasive (and risky) procedure -- LipiFlow is much safer. Probing will rely on the skill of the doctor as well , whereas LipiFlow is just a very expensive heated massage to flush out ur glands. Probing may be needed if there are score tissues covering your glands, or scar tissues internally blocking your glands. It is much safer to just try LipiFlow first and see how it goes. Due to its invasiveness, probing is sometimes considered the last line of treatment rather than first line.

Definitely give Xiidra, Restasis and Azithromycin a try -- they're very safe and have a good response rate for MGD patients. Restasis less so, but I personally firmly believe my dual therapy of Xiidra and Restasis has greatly helped my case of MGD.

[How]

I really appreciate your help deep. Do you think that Xiidra and Restasis might decrease inflammation enough so that I wouldn't need Lipiflow?

Reason I ask is from what I heard they use anesthetics with it and I won't likely be able to take them.

[deep_dry_eye]

I really appreciate your help deep. Do you think that Xiidra and Restasis might decrease inflammation enough so that I wouldn't need Lipiflow?

Reason I ask is from what I heard they use anesthetics with it and I won't likely be able to take them.

It is case by case -- every patient is different -- I would definitely get on Restasis and/or Xiidra w/ or w/o LipiFlow. You can also try a z-pack first as well -- as that is usually very good at flushing out the glands.

[farmgirl]

My recommendation, first things first. Just because you hear about a treatment doesn't mean that you should race out and try it, especially if you are fairly new to this problem. The most important thing is to try to establish exactly why you have the problem in the first place. For example, the cyclosporin family of drops are more likely to help if you are aqueous deficient rather than lipid deficient. IPL is more likely to help if you have MGD. Often, as is my case, there are both things at play.

I will agree that treatment is, for the most part, trial and error, at least that had been my experience. So you start with the cheap things first. Drinking more water, omega oil supplements, diet changes, OTC drops, less time on electronic devices, punctual plugs, moisture chamber glasses, hot compresses, things like that. If time goes on and none of these things help, then is the time to start adding the more expensive treatments like IPL, lipiflow, scleral lenses. These things are reserved for the more difficult cases.

From many years on this forum, I would suggest that if it does come to where you want to try either lipiflow or IPL that it appears there are more success stories with IPL than lipiflow. In fact my Dr says that if it weren't for a handful of people in his practice who swear by lipiflow that he would just exclusively use IPL because his results have been so much better with that treatment.

These are my observations.