disappointing visit at Scheie eye institute

[bunnyrabbit123]

Yesterday we (my patient husband and I) drove 2 1/2 hours to an appt. at Scheie Eye Institute in Radnor Pa. I waited almost 2 hours past scheduled appt. time, saw a doctor for about 15 minutes- only to be given the usual-clogged glands, I need to do warm compresses and lid massage, this contradicts the advice my local cornea dr. had given me- he says warm just causes further inflammation and I know that warm compress & massage plays hell with the thin skin around my lids. She recommended fish oils . at least 4000 units a day. I explained the any more than 2000 units a day causes GI upset. Well, that's because I use the wrong brand and and should buy the brand available at their optical shop.I explained to her that at the start of this misery I had done hot compresses 2 to 3 times daily, massage,doxy and fish oils religiously to no avail. I was given no answer. She recommended humidifier, I said I have 2, they run constantly. Well, I'm using the wrong kind of humidifier. She pushed the IPL treatment that's now available there. claiming great success with this.This would be $400.00 a treatment and from what I read on this forum, a lot of you have tried this without success. I'm pretty frustrated right now . I've had plugs, restasis and cautery and after 16 mos. the end result, depending on weather and temps. is watery tears, photopobia and constantly achey, irritated eyes. I really don't go out much anymore and while this is not a life threatening condition, it's really wrecked mine. Comments on IPL? I'm desperate! (can you tell?)

[LaDiva]

Hi bunnyrabbit. I have had IPL. When the course was complete, all of the oil glands were open, and my TBUT had gone from 3 to 7. Not what I had hoped for, but much better than before. I must do the warm compresses, or all goes back to first base. Warm not hot, and vaseline around the eyes during expression or the skin around my eyes becomes very dry and painful. The eye doctor said only to use scrubs once a day, and this has helped in not drying the eye area so much. Do you take the fish oil with food?

[Chemia]

Bunnyrabbit, I too have had IPL with a doctor trained by Toyos. When I started, I had a TBUT of 3-4 and after the fourth session I was told that my TBUT was 9 and all my glands were open. Ironically the doctor counted the TBUT of 9 in less than 5 secs. Go Figure!!!!
You see doctors can be dishonest and tell you what you want to hear or what makes them look good.
Actually I saw another doctor for a non-biased analysis and actually my TBUT was still poor and my glands clogged with thick oil secretions.
I actually enjoy doing warm compresses and continue to do so and I take 3.5g of nordic natural fish oil in liquid form along with thera tears.
Nordic natural is a clean tasting fish oil and I have never had any upset stomachs from it.

[bunnyrabbit123]

Dear LaDiva,
I do take fish oil with food and I'm taking a good brand ( I think)(wholemega-1000mgs.) I've tried more than once to take it 3 times a day but always get GI probs. Are you able to express your mb glands? I've never been able to do this either. I just wind up with the skin around my eyes in really bad shape from poking at it. I do agree that the warm compress feels nice but this advice contradicts what my current dr says, which is that warm aggravates inflammation-so I don't know what to do and we drove a long way to come away confused.

[bunnyrabbit123]

Chemia,
Thanks for the recommend on Nordic naturals. I'm wondering tho, if you are able to take that much daily and you still have mb's clogged with thick secretions, how effective is this approach? I have toothpaste like secretions. I'm unable to express these glands myself and god forbid a doctor should waste his time doing it for me!. Do you feel that your IPL treatments were any benefit?

[sorepeepers]

Hi Bunnyrabbit

I am so sorry to hear of your unsatisfying visit. I have not had IPL, but I am going to my first appointment tomorrow for Lipiview test. My eyes have not yet been diagnosed, except for Blepharitis and Ocular Rosacae. This Lipiview test will determine my dry eye condition. I may be a candidate for the Lipiflow treatment. If you have not already heard of this you may want to investigate. I will post again after my visit. I wish you well and hope you find some relieft soon.

[bunnyrabbit123]

Hi sorepeepers,
Bleph and ocular rosacea here as well. I have heard of Lipiflow- it is available on a really limited basis here. The doctor we saw yesterday said she had asked to purchase the equipment for this procedure but was denied by the Institute. I'm still considering the possibility of IPL and may wind up returning to Scheie, as it is the closest to where we live, although a trip to Wills eye hosp. might be considered. At any rate, I wish you safe travels and would love to hear the details of what happens with your lipiview.

[jenny2008]

bunnyrabbit123
so sorry about your disappointing visit.. i can relate.. i used to travel 2-3 hours (depending upon traffic) for my corneal specialist. loved him..then he retired-his replacement isn't worth the time or gas to get there.omg.. but i still went to him for a year! and he almost got me denied my long term disability-he just doesnt get how sick i am with sjogrens..

anyway. i went to a new rheumatologist today-a 50 minute drive-had to have someone take me. didnt care for the guy although he gave me my med refills i needed. he basically told me my eyes were shot -lacrimal glands not working-and all the opthamologists i have seen have never said that.
so anyway. good luck whether you look into ipl or lipiview. i have too considered ipl but because of the cost i have been leery.
keep us updated and good luck

[bunnyrabbit123]

Jenny2008-
How did the rheumatologist determine that your lacrimals are bad? I would think one of your opthamologists would certainly have brought this up to you. Perhaps a visit with opth before you accept this diagnosis. Is there anything you do that makes your eyes feel better?

[Hopeful2]

Hi everyone,

I just want to add that taking fish oils on their own, might not be effective if you have digestion issues. Many people, as they age, lose the ability to digest certain foods, namely proteins and oils. You may need to be taking a digestive enzyme with HCl (hydrochloric acid) along with your fish oils. If you take your fish oils with a meal, then the digestive enzyme can help with the digestion of your meal too. I take 'DigestMoreHCl'. It smells awful but as long as it works, I can put up with it

[shanku]

Just wanted to add - Digestive enzymes come in many forms. Certain foods contain natural digestive aids, such as pineapple and papaya. Adding a few bites of these foods to every meal can aid digestion.

Recently, I came across these reports on MGD:

http://www.iovs.org/content/52/4.toc

Esp. this one it has collection of everything all these different docs are going to say on how to deal with MGD:

The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on Management and Treatment of Meibomian Gland Dysfunction
http://www.iovs.org/content/52/4/2050.full.pdf+html