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My recent visit to Dr. Maskin in Tampa

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  • #16
    MGD1701

    Glands are made up of clusters of acini which produce the oil. I think its fair to say that the shorter the glands, the fewer acini and less oil is produced.

    Saline is used, I think, to flush out the surface of the eye as all four puncta are closed, the debris can't drain normally. Also provides some moisture and keeps the surface healthy naturally.

    I believe the doxy is prescribed to kill off the bacteria for better/cleaner oil. I was at a much higher dosage to start, so this is more maintenance to keep it clean.

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    • #17
      Hey Lou. As far as Dr. Maskin being anti-scleral and anti-IPL, well everyone is definitely entitled to their opinion. He is a well respected doctor, so he must have his reasons.

      I can imagine if one's lids and/or meibomian glands are inflamed, the sclerals could further irritate the glands. Mine's are not inflamed. My tear film has improved since I had the last probing and started drinking the lemon/tea in 2015, and I have been wearing my sclerals daily since then, so I personally have not seen any impact of sclerals on my glands. Of course sclerals do not resolve MGD, but do protect my cornea from dryness, help provide comfort, and correct my vision, which are equally important to me. However, I do plan to ask my scleral, probe, and dry eye specialist about sclerals potentially impacting the glands, and do some research online. Thanks for mentioning it.

      As far as IPL not being a valid MGD treatment, I think those it has helped would disagree (I've never had IPL).

      Probing for you and me helped, but for some others it has not. So like anything else, no one treatment works for or is appropriate for everyone. I think in the end, although we look for guidance from our doctors, we need to be our own advocate and research the different treatments, get second or even third opinions, be very familiar with the details of our condition, and ultimately determine for ourselves the path we take to continue to improve. Given you are doing much better than before, sounds like you are on the right track.
      Last edited by Hokucat; 16-Jul-2017, 03:28.

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      • #18
        Thanks for posting this thread. Can you tell me how much that visit to Dr. Maskin actually cost?

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        • #19
          Originally posted by Zephyrus View Post
          Thanks for posting this thread. Can you tell me how much that visit to Dr. Maskin actually cost?
          Going off of memory:
          Initial Appointment Fee $400
          Followup Appointment Fee $175
          Meibography $350 with free followups for a year
          Confocal Microscopy $700 per lid with free followups for a year
          Probing $750 per lid (additional fees for bandage contact lens and expression about $300 or so total)
          Steroid Injection after probing $500 per lid
          Cauterization $700 per puncta

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          • #20
            Thanks for the information.

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            • #21
              Lou

              i am looking into getting probing done here in Canada. There is a doctor a flight away who does it. How are you feeling now? I am just scared it could make me worse. I know Dr Maskin is likely the best but could never afford all the costs as I live in Canada and the exchange rate is crazy! Lol

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              • #22

                ​​​​​1. Dr. Calotti in Brandford
                2. Dr Maharaj in Brampton

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                • #23
                  Originally posted by Faith1989 View Post
                  Lou

                  i am looking into getting probing done here in Canada. There is a doctor a flight away who does it. How are you feeling now? I am just scared it could make me worse. I know Dr Maskin is likely the best but could never afford all the costs as I live in Canada and the exchange rate is crazy! Lol
                  Hi Faith,

                  I'm doing well most days. I guess before having the probing done you need to determine if your glands are capped or not otherwise expressing. If this is the case, it seems to make sense that probing and thereby establishing an opening (or patency as Dr. Maskin calls it) would be a good step. Closed up glands over time die off - keeping them open, keeps them active. If your issue is not closed off glands, I don't know if probing is an option that would do much.

                  I did seem to get a little worse before I got better. The first few months after probing were not great. In retrospect, I chalk it up to the glands starting to produce again and the doxycyclene taking time to clean up what the glands were producing. I personally believe the claim of damage to the glands is overblown. Dr. Maskin used a 1mm probe on me, just enough to open up the surface but not nearly long enough to impact the gland itself.

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