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  • #16
    Hi Hokucat
    Thanks so much for sharing as always. Curious to know
    1) Do you think you could gain more relief/success if you did probing or took care of scar tissues issues before LipiFlow?

    2) Scar tissues - Since you now feel much better, do these scar tissues still present?
    Any ideas where these scar tissues come from?

    Lastly, I found this viedo which you might be interested. I dont know how to post a new post. Could you be so kind to tell me how?
    Sjogren's Syndrome: Beyond Dry Eyes and Mouth by Frederick Vivino, MD, 2016.Dec.
    https://www.youtube.com/watch?v=COnBpgmNU6k
    Last edited by MGD1701; 17-Apr-2017, 08:16.

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    • #17
      Hey MGD1701. All good questions!

      1) I'm not sure if I had scar tissue at the time I had LipiFlow, since my LipiView showed my tear film in low normal range and that was several years ago, so for me it's hard to say. But it makes sense if one does have scar tissue to resolve it first, otherwise LipiFlow, IPL, warm compress, diet changes, etc. likely will have little or no impact.

      2) Since I've gotten better, I don't know if the scar tissue is still present or active, because it was only the doctors who did the probing who told me I had scar tissue. They were the only doctors who really examined my glands closely. I probably should go back to one of them to check this at some point. It hasn't been a priority since I've been doing so well relative to before, and my other eye doctors tell me the surface of my cornea and sclera looks good and I have some tear film now. As far as what causes scar tissue, I've read different theories, there does not appear to be only one cause.

      Thank you for the Sjogren's video! I will take a look later today.

      To start a new post, you can select the Forum you want it to be in, then select New Topic, then it will show Create New Topic where you write something, then Post. I think you will have a lot of good info to start your own posts!
      Last edited by Hokucat; 17-Apr-2017, 11:10.

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      • #18
        So... Had my lipiview assessment.... Very bad incomplete blinking (almost all blinks were incomplete), scores of 42 and 28 but....All the glands look fine and normal just not producing oil. Maybe called due to all my incomplete blinking? No scarring and only 5 glands expressing oil.

        So looks like lots of blocked glands....

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        • #19
          Hi Kami. Your glands not producing oil and/or being blocked can definitely be the result of incomplete blinking or not blinking enough. So what did they advise for treatment? Did they tell you to at least do blinking exercises every hour? If not taken care of at some point, they can atrophy and permanently be gone.

          How did they confirm there's no scar tissue? Sometimes the scar tissue is inside the glands and not evident from outside.

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          • #20
            Hi hoku,

            Yes indeed lots of blinking exercises. She was surprised that all my glands were fine as was I. I'm going to try them over the next few days. She simply told me the glands weren't producing oil but not scarred or blocked over the top so yes potential scarring/ blockage internally but it hasn't caused duct swelling so maybe blocked right at the top of the glands openings?

            I'm guessing lipiflow may help here as there are no major obstructions or atrophy?

            Thoughts?

            Kami

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            • #21
              Hi Kami. Glad they thought your glands looked fine, with no obvious scarring. If your glands are blocked with thick oil or producing little oil, I've read about more success in this forum with IPL than LipiFlow, but it might also be cause LipiFlow is so expensive, not that many people try it. I recall Pythonidler who has done both said IPL cost less and may work just as well, if not better. I've never had IPL, I went directly to probing (which worked for me), so am not the best person to compare LipiFlow vs IPL. I'm sure Pythonidler can give you lots of advice on this.

              BTW, probing would clear both scar tissue and blockage from thick oil build up in one procedure, if you're concerned you might have some scar tissue inside the glands that could not be seen from your exam yesterday. So another option is to do probing first, and then maintain it with periodic IPLs, LipiFlows, expressions, diet changes, etc. The downsides are probing is more invasive, and is not yet practiced by as many doctors as LipiFlow and IPL, so it may be difficult to find a doctor near you. The up side is it might be covered by your insurance...mines covered all but 10% of the probing costs, but covered nothing when I did LipiFlow.

              Ok, good luck with whichever route you take, and remember to do your blinking exercises too! Below is a link to blink reminders from this website you can install on your computer. I recently set up an hourly blink reminder on my iPhone, because it's so easy to forget to blink and I'm not usually at my computer!

              http://www.dryeyezone.com/reminders/
              Last edited by Hokucat; 18-Apr-2017, 20:44.

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              • #22
                Thank you! Ipl would be a no go for me as I've a darker skin type so can't have it done. My confusion is that the glands present fine with no. Obvious deep blockage etc. Yet they don't produce oil.... So is the blockage small and more at the surface?

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                • #23
                  Hi Kami. Ok, so IPL is not an option. When I did LipiFlow, it reminded me of a high tech warm compress for $1,200. If warm compresses help you, perhaps LipiFlow will help. It didn't help me, but I might have had some scar tissue at the time.

                  Some people find gland expression helpful to unblock their glands. You might also look into diet changes, which for me was the game changer to help my meibum flow and not block up my glands any more, after first unblocking my glands with the probe.

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                  • #24
                    I'm doing the vit b,c,d, zinc, Omega etc so trying to stock up there! Also doing the green tea with lemon.... Compresses definitely help. I can see pools of oil after. Even now if I press hard enough (without compress) I can sometimes get a little oil from a few glands. Leads me to believe there's a small blockage somewhere given the pressure I'm having to use?

                    i don't understand compresses .... They release oil but the fact that mgd persists suggests that the glands just block again?

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                    • #25
                      Hey Kami. Warm compresses help thin or liquefy the oils. Likely your oils are a little thick, that's why compresses help you. But unless you find a way to improve the flow of your oil, it will probably keep getting blocked up.

                      Here's a link to an article that might be of some interest to you on this website that discusses compresses and some warnings about self expressing glands:

                      http://dryeyezone.com/encyclopedia/mgcare.html

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                      • #26
                        Thanks hoku. Makes sense! Just had a note through from the lipiview test..... Suggesting blockages are starting.... Might be useful to try hit the glands early before they get worse?



                        To summarise my findings the lipiview found that your Lipid layer thickness was reduced and you are a partial blinker. Looks like your glands are starting to become blocked resulting in less oil being produced. Although you still have most of your glands functioning there was some evidence of blockage and mild dilation. They did have a slightly capped appearance. Nothing too bad.

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                        • #27
                          Yes Kami, the sooner you address it the better. Thanks for summarizing your LipiView findings. Maybe ask what the "slightly capped appearance" might indicate.

                          It sounds like you are planning to do the LipiFlow since IPL is not an option. I do hope it works for you, let us know how it goes!

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                          • #28
                            Hi
                            capped means (I think) that there's blockages where the glands open up into the eyelids. Maybe thickened oil that's accumulated and is now building up. I'm hoping lipiflow will melt the accumulated oil and break it out so to speak before the glands become even more dilated and get to a point to where they start to scar over

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                            • #29
                              Oh and my oil is normal not thickened apparently so all I can think it is is blockages!

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                              • #30
                                Hi Dryeyekami
                                Just curious what treatment recommendations your doctor made, their order and home theraphy?
                                If I were you, my order would be: 1) probing 2) LipiFlow for better results, based on my experiece/learnt/read.

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