Investigating my symptoms, I need your help

[Yzhfd]

Yes buddy, I believe there is an unknown disorder/disease, I might be one of the first to get it, it's because in modern times people are using their eyes so much on computers and stuff, the lacrimal glands can't cope with the use and start getting sensitive.

[Fenix]

I haven't seen the doctor yet due to coronavirus emergency. After a month I'm pretty sure that LipiFlow was a waste of money. It didn't worked for me.
I think that the next step will be Restasis eyedrops for 6 months.

[Alix]

yes, Italy. yes, you can pay every single IPL here, but doctors around the world says that to see improvements you have to do it at least 3/4 times.

The not so funny thing is that of six doctors I saw, everyone said different things. For one I have acquous deficiency, for another is evaporative dry eye, for another is an uncommon chronic allergy, for another the problem are not the eyes but some not identified cause. So to solve the problem,seems that I have to treat my eye like If I have all of those things.

Furthermore, the last doctor dind't do the schirmer test neither tbut, so in the next appointment we can't se how much the condition is improved. He just daid that I don't produce tears.

Agreed yes that is what I have been told as well but I stopped after the second one, as I thought I might see at least a small difference but there was nothing at all.

I have had a very similar experience to you over the past couple of years each doctor tells me something different. Very frustrating.

[Fenix]

I see, is that in Italy? Here in the UK, IPL is more expensive, but you pay for each session rather than a set of 4 upfront so at least if is not working you are not out of pocket.

I was told punctal plugs only work if you have aqueous deficiency and you dont produce enough tears. It doesnt work for evaporative dry eye.
I had them put in to see what happened but had them taken out as they caused too much inflammation.

yes, Italy. yes, you can pay every single IPL here, but doctors around the world says that to see improvements you have to do it at least 3/4 times.

The not so funny thing is that of six doctors I saw, everyone said different things. For one I have acquous deficiency, for another is evaporative dry eye, for another is an uncommon chronic allergy, for another the problem are not the eyes but some not identified cause. So to solve the problem,seems that I have to treat my eye like If I have all of those things.

Furthermore, the last doctor dind't do the schirmer test neither tbut, so in the next appointment we can't se how much the condition is improved. He just daid that I don't produce tears.

[Alix]

I see, is that in Italy? Here in the UK, IPL is more expensive, but you pay for each session rather than a set of 4 upfront so at least if is not working you are not out of pocket.

I was told punctal plugs only work if you have aqueous deficiency and you dont produce enough tears. It doesnt work for evaporative dry eye.
I had them put in to see what happened but had them taken out as they caused too much inflammation.

[Fenix]

I believe IPL and Lipiflow work in different ways so we cant put them in the same category. Based on my experience here in the UK, optometrists and ophthalmologists say its worth giving IPL a go though there is no guarantee it will work for everyone, whilst every single one has told me Lipiflow is an expensive waste of time.

That is why I am interested in hearing from people for whom it has actually worked.

I would say that most people who go ahead with Lipiflow are those who have tried everything else including what is in your list and nothing has worked. It is the last resort as it is very expensive, basically £100 per minute.

It's too soon for me to say if it is a waste of money. Anyway I think the price dropped since the last years, it costed me 600 euro. Here the national health system refunds 20%, so in the end it costed 480 euro.
I know that a single IPL treatment costs 250 euro, but usually you have to do 3 or 4 treatment.
Also Restasis eye drops I know that are very expensive, a box costs 135 euro.


Another thing I would like to try are punctual plugs. I would like to ask the doctor why he didn't suggest them.

[gilles]

I believe IPL and Lipiflow work in different ways so we cant put them in the same category. Based on my experience here in the UK, optometrists and ophthalmologists say its worth giving IPL a go though there is no guarantee it will work for everyone, whilst every single one has told me Lipiflow is an expensive waste of time.

That is why I am interested in hearing from people for whom it has actually worked.

I would say that most people who go ahead with Lipiflow are those who have tried everything else including what is in your list and nothing has worked. It is the last resort as it is very expensive, basically £100 per minute.

Both are being sponsored by big pharma groups, rather than science driven. This is why the specialist I am seeing kind of grouped them, and did not want to give me or anyone else false hope.
I don't know what your diagnosis is, but if the suspected origin is your skin type (mostly reflects in mgd and or ocular rosacea) and or outside factors (screen use, wind, dry air, allergies, etc.) then you could also go further in that direction. On the other hand, in my case, knowing you can't change a skin type, one can try attributes like moisture chamber glasses for in- and outdoor, humidifiers at home and work, diet (flaxseed, sunflower seed, avoid chocolate, avocado; as per anti-inflammatory and gland function influence), reduce screen time, change job. While doing these, also try to find out if there is no other origin: bad eyesight, eye-pressure deficit, auto-immune deficit, check blood results (vitamins, inflammations, allergies, hormones...).

[Alix]

I believe IPL and Lipiflow work in different ways so we cant put them in the same category. Based on my experience here in the UK, optometrists and ophthalmologists say its worth giving IPL a go though there is no guarantee it will work for everyone, whilst every single one has told me Lipiflow is an expensive waste of time.

That is why I am interested in hearing from people for whom it has actually worked.

I would say that most people who go ahead with Lipiflow are those who have tried everything else including what is in your list and nothing has worked. It is the last resort as it is very expensive, basically £100 per minute.

[gilles]

I mentoined dry eye centers to the specialist I am visiting, and he told my he does not believe in IPL nor Lipiflow, he puts his trust in science. I guess what he meant, or a way of interpreting what he meant is: IPL nor Lipiflow have the required science literature to convince him enough for their use. This is the reason why one should try the other chronological steps that I mentoined earlier first. He added: but you are free to test IPL and Lipiflow, if it helps you I'll be happy for you, and you may inform me of the results.

My hypothesis of IPL and lipiflow is that it might get deep enough and hot enough to melt the sebum/bacteria in the blocked glands, releasing/unblocking and thus stopping the cycle of inflammation. Another aspect is that the lights (laser) might be similar to sunlight (and sunlight has UV-induced immunosuppressive and anti-inflammatory aspects).

I should add, in my case he points to my skin type (oily), prone for ocular rosacea and too much sebum secretion (acne/blocked glands). Also screen use affects the blinks (staring), thus not helping in this situation. Methods to counter this:

• warmth compress (did not work for me, also tried blephasteam),
• minocycline (doxy),
• cyclosporine eyedrops (drop the auto-immune reaction, which is inflammation => rosacea and inflamed eyelids if I am not mistaken),
• eyelid hygiene (e.g. blephasol, but I don't do the routine, as it irritates the eyelids and does more bad than good).

[Alix]

Thank you. I’ve just seen some interesting videos on YouTube on this but its hard to know what the truth is as quite often people who recommend it are optometrists/eye doctors themselves who have financial interests. I would be interested to hear from people who have had similar success with Lipiflow.

[Fenix]

Thanks for replying. I am not too familiar with the technical aspects of the lipiflow machine but as far as I understand it’s the same as warm eye compress? I don’t understand how warming your eyelids for 12 minutes can have effects lasting a year?

Did the doctor explain what impact the lipiflow has on your glands?

Before having LipiFlow I said to the doctor that I already have a Blephasteam device, but he said that they are not the same thing without giving any details.
The feeling of the treatment is similar to blephasteam plus an internal and external massage of the eyelids.

This is a description found on google:
"LipiFlow Thermal Pulsation Treatment
LipiFlow is an innovative, FDA-approved procedure designed to treat the root cause of Evaporative Dry Eye, blocked or deteriorated meibomian glands. Opening these blocked glands can allow them to resume natural production of lipids needed for a healthy tear film.
LipiFlow works by applying precisely controlled heat and adaptive pressure to the inner eyelid encouraging your body to resume the natural production of lipids needed for a balanced tear film.
In a clinical study, 80% of patients reported improvement of their overall dry eye symptoms within four weeks, ranging from 10% to 100% of improvement in all evaluated symptoms.
Each LipiFlow Thermal Pulsation Treatment Session lasts 10 to 15 minutes during which the machine delivers a gentle and comfortable massage to the inner eyelid. With virtually no treatment-related complications or unpleasant side-effects reported, LipiFlow can be safely done on patients of any age or skin type."

[Alix]

Thanks for replying. I am not too familiar with the technical aspects of the lipiflow machine but as far as I understand it’s the same as warm eye compress? I don’t understand how warming your eyelids for 12 minutes can have effects lasting a year?

Did the doctor explain what impact the lipiflow has on your glands?

[Fenix]

Thanks for the update good to hear you are seeing some positive effects from this.

How long did the treatment take to have done?

Yes please keep us updated on your progress.

Tobradex (3 times at day for 10 days, then 2 times at day for 7 days, then once at day for 40 days.
Artificial tears and warm compresses non stop, I don't think forever, but at least until newer instruction.

Regarding the LipiFlow, the doctor said it can be done once a year if necessary. The Lipiflow lasts 12 minutes.

If it doesn't improve, propably he will prescribe me the Restasis eye drops.

[Alix]

Hi Alix,
I had the LipiFlow treatment and during the first days I couldn't feel any improvements, but in the last two days I started feel better, the eyes seems more "watery".
I don't know if it is becouse of LipiFlow or the entire treatment.

Thanks for the update good to hear you are seeing some positive effects from this.

How long did the treatment take to have done?

Yes please keep us updated on your progress.

[Fenix]

Hi Alix,
I had the LipiFlow treatment and during the first days I couldn't feel any improvements, but in the last two days I started feel better, the eyes seems more "watery".
I don't know if it is becouse of LipiFlow or the entire treatment.

The eye doctor gave me:

• an equivalent of tobradex eye drops (tobramycin + dexamethasone)
• artificial tears
• warm compresses 2 times at day (but actually I'm using Blephasteam istead of simple warm compresses)

He said that it takes at least one month to get the results of the treatment. I will give you updates in the next weeks.
Let me know if you have any question.