Best thing I have done for my dry eyes!! Amazing. I am only on number 2 and my sad painful eyes look SO much better and feel like they used to before this started 4 years ago. I really can't say enough and I am still shocked on how much better my eyes are. I have ocular rosacea, Posterior belph and MGD evapo dry eye. My IPL is done on the lid and face. LOVE LOVE LOVE
@@redflower-jp2zj Hey There, I have VERY dry eyes (4 years) cannot live without Xiidra and they hurt (did) every day of my life and I use drops 10x a day along with heat, nulids and massage. I did one session and felt an immediate relief, not huge but enough to notice that they seemed not as dry and I could see clearer and my skin starting to glow. 2nd one was a big difference. Some mornings I almost forget to put the Xiidra in and no OC drops hardly all day. I have to make myself do heat, it just feel's like I do not need it now!! CRAZY. Also not red and not swollen. My lashes actually stick out of the bottom of my lid instead of the top because the margin below was so swollen. No 3 is in 2 more weeks. I went with 4 to start 2 weeks apart but she was away so one got spread out to 4 weeks. Again BEST thing I have done. She said 4-6 depending, 2-3 weeks apart then 1 a year or so for up keep. My skin looks the best it has ever looked as a side note. LOVE LOVE LOVE LOVE hahahahahaha hope that helps Oh and I did lipiflow and that was nothing compared to this, I got no relief from that.
I had my first treatment done yesterday and I am afraid to say how much better I feel ... just for fear that something wont be as good tomorrow. It's amazing!
I am scheduled to have IPL done for my dry eye and ocular rosacea. I just had a high heat treatment done that lasted 15 minutes and my glads were so badly clogged they wouldn’t let bad oil out. I suffer from bad eyelid inflammation. So the eye dr said yep you are an IPL candidate.
Belated thanks for this. I didn’t know you could get it, found a provider through my insurance and even though I ended up getting E-Eye instead of lid IPL I was one of the 70%-ish something that it works for. The change after the first treatment was almost frightening, didn’t realize how bad my MGD was until it wasn’t. The base treatments are done and I’m now in maintenance.
I have been diagnosed with dry eye and blepharitis. I've also just been diagnosed with rosacea and I'm wondering if I have ocular rosacea as well? Thank you for this helpful video.
Dr. D, I love your humorous personality!!! Ok, I have posted and asked you so much. Now, I am a bit confused. Yes, I’m dx. With MGD, DED, blepharitis, and more. I want to tell YOU my symptoms and if possible will you give me your opinion if it sounds right with my dx. As I have said in posts, It was never explained to me about my dx. So, I’m asking for you to give your opinion. I’m 66 female. Current symptoms for almost 2 years, ESPECIALLY after cataract surgeries are both eyes feel like they are FULL of something. Vision is blurry. Eyes hurt, burn, teary. I use my phone as internet. Now, it’s extremely limited due to eye burning. Seems to burn worse when I wear my ex. Glasses. At night I wear contour mask. Fit well and when I wake my eyes seem very watery. I do use ocusoft when I wake and before bed. The white of my eyes appear so discolored. Yellowish color. My eyes appear to be sinking back farther into my head. CT scan said normal but my records say a dx that means sunken eyes. All around eyes are dark. I don’t/can’t wear makeup or skincare because it hurts. One of my biggest concern and painful things was the last time I saw an optometrist DED specialist, she said to me “there is nothing more we can do for you”. I left feeling so hopeless! I know I have been very repetitive with a lot I’ve said to you on posts but I’m so scared. You make me feel hope. To end again, in my personal opinion and based on personal experience, I suggest to anyone who has “nuclear sclerosis “/cataracts, unless it’s a necessary thing to do surgery to remove them, I suggest you first make sure your eyes are not dry, nothing like MGD, etc. if so, TREAT THAT FIRST. Next, talk to your opthamologist about the type of cataract surgery. Such as IOL’s, lasik or even if it’s severe enough to do right then. If I could do it over, knowing then what I know now, I WOULD NEVER HAVE HAD ANY SURGERIES ON MY EYES. I would have continued wearing reading glasses. In my personal opinion I do believe and know cataract surgery does make DED worse. Treat DED, etc. first until it’s fully under control. Unfortunately my opthamologist NEVER told me anything about this. Until it was too late. Now, I’m truly living through hell! Thank YOU Dr. D for your videos. You are a Godsend Blessing! Now, your opinion if possible! I wish I could send you a before/after pic of my eyes. Truly a Blessing! Still hoping to be in your area by July. I’m relocating with my son and his co. Is not quite ready. It will happen soon. In meantime I am going to a new opthamologist in May and then a great eye center in June. Hopefully you after. Don’t get aggravated with me and my posts please. I may be repetitive but it does give me an outlet for my frustration and definitely hope. What kind of dr. Tells patients “nothing else we can do for you”. You give me so much hope! And, you make me giggle when you are silly! Keep it up. We need so many more like you!!!
@@Kongstrong519 Hi Brandon I have ocular rosacea dry eye. I have rosacea on my cheeks. I'm currently on session 3 of my IPL. I will be doing about 8 session. It has helped alot for my rosacea the redness has become less and leaves the skin smooth.
@@jessicalove805 that’s awesome! I have since gotten surgery with an amazing Dr. And 90% of my dry eye problems have gone away after dealing with them for 7 years and nearly 13 different Dr’s. If your interested his name is Dr Maskin in Tampa Fl
Hey Dr D Just a question. I'm going to get IPL for my ocular rosacea and dry eye. I had a Chazalion removed 6 months ago, I had that for one one year prior. Left with a bit of a scar that sometimes gets inflamed. I get such red lid margins that it looks like I'm a drug addict half way through the day. I also have lines of little white small dots above my upper lash line (glands of zeis)? I think they are a little clogged too as after I have a warm shower or hot compress and do gentle massage sometimes stuff comes out. I have been on steroid drops, doxy, I perform lid hygiene twice a day, with intense lubricant eye drops as often as I can. I don't think the doxy was helping and I developed severe sun sensitivity to it . Anyway my question is. I recently had 2 sessions of pulsed dye laser for diffuse redness and enlarged capillaries. Celtic skin here. I definitely saw an improvement in my skin ( had it done on the nose, cheeks, almost periorbital, and forehead) Its slow going but I realise background redness is slower to treat than bigger veins. Having another session soon. I want to get IPL for my eyes, but the places here in Ireland only offer it with the "E EYE" IPL And treat the cheeks. Using goggles and not treating upper eyelid directly. Do you think it's still worth it? Euro 600 for 3 treatments. Each pulsed dye laser treatment I get is 450. Thank you I love your content 🤓 X
Hi! I have had ocular rosacea for 15 years and it always comes back. I’ve started IPL for my face (I have only had one session and I have 2-3 left) but I’m wearing metal glasses. I’m hearing it can help with my ocular rosacea/dry eyes?!! Wow! How well does it work for that without treating eyelids Va treating the eyelids directly? I’m very interested to find out and decide if I should try them on eyelids (I’m scared! 🙈🙈). Thank you!
I had IoL for cataract in 1995 and now am on glaucoma eye drops. I have had chronic blepharitis all my life and now dry eye as well. Can IPL be done if you have lens implants and glaucoma??? I hate looking like a drunk with constant red eyes from glaucoma meds. Could this help?
I'm not sure but ,if anyone else trying to find out rosacea skin condition try Mackorny Facial Miracle Blueprint (should be on google have a look ) ? Ive heard some incredible things about it and my neighbor got amazing success with it. #rosacea eyes
Wow, my doc & staff missed the boat. I had this treatment 7x - very effective & painless. Unfortunately, they did not use the same eye shield. It was a tape over the eyes. Why & should I be concerned with eye damage? Great vid🌻
Thank you! Don't be concerned. Not all docs use the shields like I do. I just prefer because I can treat the top lids and get closer to the meibomian glands themselves. But I have patients who prefer not to have those shields inserted and in that case I use a sticker type eye cover as well. Did you feel that IPL helped your dry eye symptoms?
@@EyeSchoolwithDrD Yes, but after 2 months, they will get clogged again. Ive had 6 treatments. I use everything natural, use browser, eye love & just bought NuLids. I may try keto to lower inflammation if NuLids doesn't help. Have you had patients whose dry eyes were helped a bit more with keto?
how much time passed since doing the session? how many sessions did you take? and what's the severity of your dryness? is it still in effect till today?
I had cataract removed on both eyes about 17 months ago and since have been told I have ocular rosacea… never do my eyes feel normal! Is this procedure done after cataract surgery?
Yes!!! Also seeing glands “come back” after being emptied via thermal heat + expression. The combo I believe is making a huge difference. But at the same time, our gland imaging capabilities have a long way to go. Are glands we are assuming have “died” or atrophied just “glands in distress”? I’m not sure we can definitely say at this time BUT clinically yes I have seen dark glands pre treatment turn into glands with new meibum and better structure!
Great to know that you have the best IPL, M22 - like Drs Periman, Toyos'. 1) OK to avoid numbing drop - bad for eyes? 2) Would ointment or gel be BETTER than drop BEFORE placing the metal shields? Oinmtnet might block glands? OK to skip numming dropThanks for sharing.
Thank you! I posted this video on LinkedIn and Dr Toyos "liked' it and I was so happy. =) Yes, I'm particular about which treatment and the M22 had plenty of highly respected specialist backing it! I always do the numbing drop + an artificial tear and corneas look perfect afterward. I think insertion of the shield would be more difficult on me if the numbing drop weren't on board and therefore less comfortable for the patient too. I know numbing drops can be difficult on the cornea but I do think in most cases the benefit outweighs the risk. If you're particularly pain tolerant and ok with your eyes being touched you could request no numbing. I do a preservative free drop, either retaine MGD or Optase. Ointment would be ok depending on the patient, but then they would be blurred afterward and most people don't appreciate ointment during the day.
What are the purposes of the numbing drop (avoid discomfort?) + artificial tear (protect cornea?) BEFORE IPL? I assume GEL might be even better? Thanks.
@@eaglec.8865 yes that’s right. Gel seems like it would work just fine. I haven’t used just gel yet in my clinic. I will check with Dr Periman on her protocol and get back to you!
I’m on my 3rd treatment my dr. Also expresses the oil from my lids. I do not see any improvement as far as reducing the redness. Each time I ask to have the power increased. I do not know what type of machine the IPL is but he says my setting is on 15. I’m concerned if I have more and my eyes are still red that is not working for me. When do you know when to stop? Have you had patients that eyes never whiten ? What I’d the max I should try? I do them every 2 weeks I will be getting my 4th one in 2 weeks. I’m also using a steroid eye drop. Thank you for suggestions.
I have been struggling with ocular rosacea for 20 years and have tried almost everything. Currently I’m using Miebo eye drops as well as Optimel (Manuka honey) drops and do lid scrubs and warm compresses and expression. I’ve tried the lipiflow treatment and it worked.. for 4 weeks, so it’s not sustainable. I’d love to try IPL, but I am told it has no billing code so my insurance will not pick it up and the cost is $1,600 per session. Has anyone had success with getting their insurance to cover IPL?
What are your thoughts on numbing cream on the face during treatment? I had my first treatment done yesterday at the optometrist’s office and they use the M22 and lid covers. When I asked about numbing the skin, the response was negative due to the treatment not working as well. Is this true? I haven’t found any info on numbing cream on the skin reducing effectiveness. Thanks for the informative video!
I don't know of any research indicating that it makes the treatment less effective. IPL works on pigment and I don't believe the numbing gel would have any impact on pigment or blood vessel visibility. However, I do not use topical numbing cream. It just hasn't been necessary for any of my patients on the dry eye settings. If someone needed/wanted it however, I wouldn't be opposed to using it.
@@EyeSchoolwithDrD Thank you! For my treatment they did one pass on a low setting and the device was on my under eye skin twice. The rest was on my lower face. Then two passes at a higher very painful level all around my lower face. I was expecting the device to actually be used on my eye lids and asked after and was told they only use that on cysts on the lids. Do you do passes on the closed lids for ocular rosacea?
@@muse3241 I utilize metal eye shields and actually I show them at the end of this video. I use them on everyone. I’ve only had 1-2 patients say they didn’t want them. With those I am able to get right up to the lash margin and treat both upper and lower lids. It’s acceptable to not treat the lids directly; some clinics don’t! I talk about the dry eye/ocular rosacea treatment pattern in this video. I use a combo of the protocols by Dr. Toyos and Dr. Periman.
Hello, I had my first ipl for ocular rosacea. My dr used small eye shields. I noticed a flash of light when he did my lids. Is that normal to see a flash?
That's from a bad laser tech. I have had IPLs for years, including on my upper lids with ocular shields, and have never lost any lashes because my techs are experienced. They will grow back, though. Laser hair removal isn't really permanent.
Dr. D, I've been diagnosed with ocular rosacea, much worse in my right eye. In your opinion, is Alrex eye drops, 1 drop, 3 times a day safe to use for months? I have a feeling my eye doctor may want me to do this indefinitely. He would have kept me on antibiotic if it didn't eventually upset my stomach. I'm worried about steroids damaging the skin around the eye with long term use. An elderly parent has thinning skin and it is a causing chronic problems.
Alrex is a steroid so the risks long term will be elevated eye pressure (only some people are “steroid responders” though) and cataracts. Steroids are great for getting the situation under control at first but we now have many more options (IPL, tearcare, lipiflow, ilux, radio frequency, low level light therapy) Id look at IPL seriously, it’s been used in facial and ocular rosacea for 20+ years and has many studies backing its effectivity..in my opinion and in my practice I use steroids sparingly and for short periods of time. I don’t know your specific case however 😃 hope that helps
@@EyeSchoolwithDrD Thank you for taking the time to reply. I was on Loteprednol for 3 weeks, my pressure did go up to about 23. I've recently been diagnosed with glaucoma beforehand. I thought perhaps it was from the prednisone drops I was using in my right eye only but soon my left eye pressure raised too. (I've been on and off varying strengths of steroid drops over the past year.) Since my pressure wasn't too high, my doc started me on the Alrex and my next follow up is in 3 months. He insists in his opinion it won't harm me. I don't think he's not telling the truth but I just don't feel good about long term anything with a steroid. I looked up the cost of IPL, it seems it's not covered with insurance and runs around $400 a session. Perhaps there is an alternative that is more budget friendly? What is a good way to find doctors like you that are near me?
@@user-gh3rv1of2b I would probably try a few different ways. You can google dry eye specialist and then call to see what they offer. Dr Jenna and Travis Zigler have a dry eye doctor locator in their website. Tearcare has a doctor locator and I believe Lumenis (IPL) does as well. If you send me an email with your location I am happy to post in my ocular surface Facebook groups to find a doc near you with the specialty equipment. Your doctor may even have some of these advanced procedures or know someone locally who does and they may be willing to refer you for the technology!
Definitely a personal choice. If your Rosacea affects your whole face maybe do the whole thing, since facial rosacea contributes to the increase of inflammation on the surface of the eye. I really like the aesthetic benefits of IPL for tone etc so if I'm getting it done I have my whole face done to get rid of extra blood vessels and sun spots. Toyos protocol is cheeks and lids, so you don't HAVE to do full face for dry eye.
IPL is also used for hair removal, so yes, it can! I have found that the risk of losing lashes is higher if I get ultrasound gel on the lashes themselves. It seems that when this happens the light pulses are able to make it to the lash. I've had one or two patients who report lash loss after the first session even with me being careful to avoid the lashes and also using my technique of no gel on them. But, in their 2nd-4th sessions I was able to prevent further lash loss by making a shield and holding it against the lashes during treatment.
@@EyeSchoolwithDrDoh I already have short sparse lashes. Can't afford to lose them. Will lighter lashes have less damage since they say for laser hair removal it needs to be darker hair???
Did doxycycline work better for you? I have used it for many patients either alone or in combination with IPL. Would love to hear more about your experience.
Stop😂, this is an act, right ? Yeah, so much better when you stay of script. Just wing every video...🫣 even though it seems like youre already kinda winging it. 🥸
Best thing I have done for my dry eyes!! Amazing. I am only on number 2 and my sad painful eyes look SO much better and feel like they used to before this started 4 years ago. I really can't say enough and I am still shocked on how much better my eyes are. I have ocular rosacea, Posterior belph and MGD evapo dry eye. My IPL is done on the lid and face. LOVE LOVE LOVE
how much time passed since doing the session?
how many sessions did you take? and what's the severity of your dryness?
@@redflower-jp2zj Hey There, I have VERY dry eyes (4 years) cannot live without Xiidra and they hurt (did) every day of my life and I use drops 10x a day along with heat, nulids and massage. I did one session and felt an immediate relief, not huge but enough to notice that they seemed not as dry and I could see clearer and my skin starting to glow. 2nd one was a big difference. Some mornings I almost forget to put the Xiidra in and no OC drops hardly all day. I have to make myself do heat, it just feel's like I do not need it now!! CRAZY. Also not red and not swollen. My lashes actually stick out of the bottom of my lid instead of the top because the margin below was so swollen. No 3 is in 2 more weeks. I went with 4 to start 2 weeks apart but she was away so one got spread out to 4 weeks. Again BEST thing I have done. She said 4-6 depending, 2-3 weeks apart then 1 a year or so for up keep. My skin looks the best it has ever looked as a side note. LOVE LOVE LOVE LOVE hahahahahaha hope that helps Oh and I did lipiflow and that was nothing compared to this, I got no relief from that.
Did you experience loss of eyelashes from the treatments?
I had my first treatment done yesterday and I am afraid to say how much better I feel ... just for fear that something wont be as good tomorrow. It's amazing!
@@michelleturner5765 Not at all.
Such a wonderful, talented young lady ! I’d love to be her patient
I am scheduled to have IPL done for my dry eye and ocular rosacea. I just had a high heat treatment done that lasted 15 minutes and my glads were so badly clogged they wouldn’t let bad oil out. I suffer from bad eyelid inflammation. So the eye dr said yep you are an IPL candidate.
Belated thanks for this. I didn’t know you could get it, found a provider through my insurance and even though I ended up getting E-Eye instead of lid IPL I was one of the 70%-ish something that it works for. The change after the first treatment was almost frightening, didn’t realize how bad my MGD was until it wasn’t. The base treatments are done and I’m now in maintenance.
I have been diagnosed with dry eye and blepharitis. I've also just been diagnosed with rosacea and I'm wondering if I have ocular rosacea as well? Thank you for this helpful video.
Dr. D, I love your humorous personality!!! Ok, I have posted and asked you so much. Now, I am a bit confused. Yes, I’m dx. With MGD, DED, blepharitis, and more. I want to tell YOU my symptoms and if possible will you give me your opinion if it sounds right with my dx.
As I have said in posts, It was never explained to me about my dx. So, I’m asking for you to give your opinion.
I’m 66 female. Current symptoms for almost 2 years, ESPECIALLY after cataract surgeries are both eyes feel like they are FULL of something. Vision is blurry. Eyes hurt, burn, teary. I use my phone as internet. Now, it’s extremely limited due to eye burning. Seems to burn worse when I wear my ex. Glasses. At night I wear contour mask. Fit well and when I wake my eyes seem very watery. I do use ocusoft when I wake and before bed. The white of my eyes appear so discolored. Yellowish color.
My eyes appear to be sinking back farther into my head. CT scan said normal but my records say a dx that means sunken eyes. All around eyes are dark. I don’t/can’t wear makeup or skincare because it hurts. One of my biggest concern and painful things was the last time I saw an optometrist DED specialist, she said to me “there is nothing more we can do for you”. I left feeling so hopeless!
I know I have been very repetitive with a lot I’ve said to you on posts but I’m so scared. You make me feel hope.
To end again, in my personal opinion and based on personal experience, I suggest to anyone who has “nuclear sclerosis “/cataracts, unless it’s a necessary thing to do surgery to remove them, I suggest you first make sure your eyes are not dry, nothing like MGD, etc. if so, TREAT THAT FIRST. Next, talk to your opthamologist about the type of cataract surgery. Such as IOL’s, lasik or even if it’s severe enough to do right then. If I could do it over, knowing then what I know now, I WOULD NEVER HAVE HAD ANY SURGERIES ON MY EYES. I would have continued wearing reading glasses. In my personal opinion I do believe and know cataract surgery does make DED worse. Treat DED, etc. first until it’s fully under control. Unfortunately my opthamologist NEVER told me anything about this. Until it was too late. Now, I’m truly living through hell! Thank YOU Dr. D for your videos. You are a Godsend Blessing!
Now, your opinion if possible! I wish I could send you a before/after pic of my eyes.
Truly a Blessing! Still hoping to be in your area by July. I’m relocating with my son and his co. Is not quite ready. It will happen soon. In meantime I am going to a new opthamologist in May and then a great eye center in June. Hopefully you after. Don’t get aggravated with me and my posts please. I may be repetitive but it does give me an outlet for my frustration and definitely hope.
What kind of dr. Tells patients “nothing else we can do for you”. You give me so much hope! And, you make me giggle when you are silly! Keep it up. We need so many more like you!!!
Excellent. Very well done. Thank you.
I just finished my 4th IPL treatment for face and eyelids. It does help!
did you also have rosacea? curious how it'll work for me
@@Kongstrong519 Hi Brandon I have ocular rosacea dry eye. I have rosacea on my cheeks. I'm currently on session 3 of my IPL. I will be doing about 8 session. It has helped alot for my rosacea the redness has become less and leaves the skin smooth.
@@jessicalove805 that’s awesome! I have since gotten surgery with an amazing Dr. And 90% of my dry eye problems have gone away after dealing with them for 7 years and nearly 13 different Dr’s. If your interested his name is Dr Maskin in Tampa Fl
@@Kongstrong519 what kind of surgery did you do for dry eyes? Thanks!
@@janeherrmann2406 surgery to remove my conjunctivochalasis (CCH) in both eyes
Hey Dr D
Just a question.
I'm going to get IPL for my ocular rosacea and dry eye. I had a Chazalion removed 6 months ago, I had that for one one year prior. Left with a bit of a scar that sometimes gets inflamed.
I get such red lid margins that it looks like I'm a drug addict half way through the day.
I also have lines of little white small dots above my upper lash line (glands of zeis)? I think they are a little clogged too as after I have a warm shower or hot compress and do gentle massage sometimes stuff comes out.
I have been on steroid drops, doxy, I perform lid hygiene twice a day, with intense lubricant eye drops as often as I can.
I don't think the doxy was helping and I developed severe sun sensitivity to it .
Anyway my question is. I recently had 2 sessions of pulsed dye laser for diffuse redness and enlarged capillaries. Celtic skin here. I definitely saw an improvement in my skin ( had it done on the nose, cheeks, almost periorbital, and forehead) Its slow going but I realise background redness is slower to treat than bigger veins.
Having another session soon.
I want to get IPL for my eyes, but the places here in Ireland only offer it with the "E EYE" IPL And treat the cheeks.
Using goggles and not treating upper eyelid directly.
Do you think it's still worth it?
Euro 600 for 3 treatments.
Each pulsed dye laser treatment I get is 450.
Thank you
I love your content 🤓
X
Great channel. So glad I found you! What do you think of Nira around the eye? Thank you!!
Thank you, I really enjoy your videos. How about a map-dot fingerprint video? We are trying to get mine under control. Thanks again!
I have a map dot fingerprint case I could do with Recurrent Corneal Erosion!
The EBMD video went live last week!
Thanks so much!! I plan on coming in for the IPL soon!!
hello dr.. what about IRPL ..they say it is more effective ..please what DO YOU think?
Hi! I have had ocular rosacea for 15 years and it always comes back. I’ve started IPL for my face (I have only had one session and I have 2-3 left) but I’m wearing metal glasses. I’m hearing it can help with my ocular rosacea/dry eyes?!! Wow! How well does it work for that without treating eyelids Va treating the eyelids directly? I’m very interested to find out and decide if I should try them on eyelids (I’m scared! 🙈🙈). Thank you!
11:50 Uses ocular shields to get closer to the eyelid.
very informative, thank you!
I had IoL for cataract in 1995 and now am on glaucoma eye drops. I have had chronic blepharitis all my life and now dry eye as well. Can IPL be done if you have lens implants and glaucoma??? I hate looking like a drunk with constant red eyes from glaucoma meds. Could this help?
Changing the channel name! I like it!
Thanks! We're growing and not everyone knows where Salisbury is! :)
I'm not sure but ,if anyone else trying to find out rosacea skin condition try Mackorny Facial Miracle Blueprint (should be on google have a look ) ? Ive heard some incredible things about it and my neighbor got amazing success with it.
#rosacea eyes
Wow, my doc & staff missed the boat. I had this treatment 7x - very effective & painless. Unfortunately, they did not use the same eye shield. It was a tape over the eyes. Why & should I be concerned with eye damage? Great vid🌻
Thank you! Don't be concerned. Not all docs use the shields like I do. I just prefer because I can treat the top lids and get closer to the meibomian glands themselves. But I have patients who prefer not to have those shields inserted and in that case I use a sticker type eye cover as well. Did you feel that IPL helped your dry eye symptoms?
@@EyeSchoolwithDrD Yes, but after 2 months, they will get clogged again. Ive had 6 treatments. I use everything natural, use browser, eye love & just bought NuLids. I may try keto to lower inflammation if NuLids doesn't help. Have you had patients whose dry eyes were helped a bit more with keto?
how much time passed since doing the session?
how many sessions did you take? and what's the severity of your dryness?
is it still in effect till today?
I had cataract removed on both eyes about 17 months ago and since have been told I have ocular rosacea… never do my eyes feel normal! Is this procedure done after cataract surgery?
is there a homemade device? WHAT HELPS AS TREATMENT?
rain or shine, you do look lovely dr d
I heard IPL in some cases helps restore some meibomian glands that had atrophied? Is that true Dr? have you heard of this?
Yes!!! Also seeing glands “come back” after being emptied via thermal heat + expression. The combo I believe is making a huge difference. But at the same time, our gland imaging capabilities have a long way to go. Are glands we are assuming have “died” or atrophied just “glands in distress”? I’m not sure we can definitely say at this time BUT clinically yes I have seen dark glands pre treatment turn into glands with new meibum and better structure!
@@EyeSchoolwithDrD that's amazing! and gives me hope! thanks D!
Great to know that you have the best IPL, M22 - like Drs Periman, Toyos'. 1) OK to avoid numbing drop - bad for eyes? 2) Would ointment or gel be BETTER than drop BEFORE placing the metal shields? Oinmtnet might block glands? OK to skip numming dropThanks for sharing.
Thank you! I posted this video on LinkedIn and Dr Toyos "liked' it and I was so happy. =) Yes, I'm particular about which treatment and the M22 had plenty of highly respected specialist backing it! I always do the numbing drop + an artificial tear and corneas look perfect afterward. I think insertion of the shield would be more difficult on me if the numbing drop weren't on board and therefore less comfortable for the patient too. I know numbing drops can be difficult on the cornea but I do think in most cases the benefit outweighs the risk. If you're particularly pain tolerant and ok with your eyes being touched you could request no numbing. I do a preservative free drop, either retaine MGD or Optase. Ointment would be ok depending on the patient, but then they would be blurred afterward and most people don't appreciate ointment during the day.
What are the purposes of the
numbing drop (avoid discomfort?) + artificial tear (protect cornea?) BEFORE IPL? I assume GEL might be even better? Thanks.
@@eaglec.8865 yes that’s right. Gel seems like it would work just fine. I haven’t used just gel yet in my clinic. I will check with Dr Periman on her protocol and get back to you!
Where do I find a Dr who does ocular IPL?
How do you know if this is the cause of the dry eye? How do I know it’s my mobium glands ?
I’m on my 3rd treatment my dr. Also expresses the oil from my lids. I do not see any improvement as far as reducing the redness. Each time I ask to have the power increased. I do not know what type of machine the IPL is but he says my setting is on 15. I’m concerned if I have more and my eyes are still red that is not working for me. When do you know when to stop? Have you had patients that eyes never whiten ? What I’d the max I should try? I do them every 2 weeks I will be getting my 4th one in 2 weeks. I’m also using a steroid eye drop. Thank you for suggestions.
Agree I like the name too😎
Someone did it and what effects? The inflammation of the eyelid has changed? Can MGD be cured with this?
Will there be relief after first treatment?
Thank you!
Hey dr, can getting a simple ipl photofacial helps meibomian glands to re function?
How long do the eye benefits last for? months or days?
months, but require maintenance sessions every 6 to 12 months
I have been struggling with ocular rosacea for 20 years and have tried almost everything. Currently I’m using Miebo eye drops as well as Optimel (Manuka honey) drops and do lid scrubs and warm compresses and expression.
I’ve tried the lipiflow treatment and it worked.. for 4 weeks, so it’s not sustainable.
I’d love to try IPL, but I am told it has no billing code so my insurance will not pick it up and the cost is $1,600 per session. Has anyone had success with getting their insurance to cover IPL?
Medicare
Dear Dr, should 'Azasite' drop (rub into lid before bedtime) be discontinue 2 weeks (or 1 week) prior to IPL as with doxy? Thanks.
Is this Azasite?
Discontinuing doxy is not necessary before IPL according to what I've read.
What are your thoughts on numbing cream on the face during treatment? I had my first treatment done yesterday at the optometrist’s office and they use the M22 and lid covers. When I asked about numbing the skin, the response was negative due to the treatment not working as well. Is this true? I haven’t found any info on numbing cream on the skin reducing effectiveness. Thanks for the informative video!
I don't know of any research indicating that it makes the treatment less effective. IPL works on pigment and I don't believe the numbing gel would have any impact on pigment or blood vessel visibility. However, I do not use topical numbing cream. It just hasn't been necessary for any of my patients on the dry eye settings. If someone needed/wanted it however, I wouldn't be opposed to using it.
@@EyeSchoolwithDrD Thank you! For my treatment they did one pass on a low setting and the device was on my under eye skin twice. The rest was on my lower face. Then two passes at a higher very painful level all around my lower face. I was expecting the device to actually be used on my eye lids and asked after and was told they only use that on cysts on the lids. Do you do passes on the closed lids for ocular rosacea?
@@muse3241 I utilize metal eye shields and actually I show them at the end of this video. I use them on everyone. I’ve only had 1-2 patients say they didn’t want them. With those I am able to get right up to the lash margin and treat both upper and lower lids. It’s acceptable to not treat the lids directly; some clinics don’t! I talk about the dry eye/ocular rosacea treatment pattern in this video. I use a combo of the protocols by Dr. Toyos and Dr. Periman.
Hello, I had my first ipl for ocular rosacea. My dr used small eye shields. I noticed a flash of light when he did my lids. Is that normal to see a flash?
Hi Doc. I had 4 IPL treatments done over a 4 week course, the treatment did not work. Could this be because the treatments weren't spaced out enough?
Have you had patients lose eyelashes from this treatment? How do you prevent it?
That's from a bad laser tech. I have had IPLs for years, including on my upper lids with ocular shields, and have never lost any lashes because my techs are experienced. They will grow back, though. Laser hair removal isn't really permanent.
How does this relate to Epithelial basement membrane dystrophy?
Dr. D, I've been diagnosed with ocular rosacea, much worse in my right eye. In your opinion, is Alrex eye drops, 1 drop, 3 times a day safe to use for months? I have a feeling my eye doctor may want me to do this indefinitely. He would have kept me on antibiotic if it didn't eventually upset my stomach.
I'm worried about steroids damaging the skin around the eye with long term use. An elderly parent has thinning skin and it is a causing chronic problems.
Alrex is a steroid so the risks long term will be elevated eye pressure (only some people are “steroid responders” though) and cataracts. Steroids are great for getting the situation under control at first but we now have many more options (IPL, tearcare, lipiflow, ilux, radio frequency, low level light therapy) Id look at IPL seriously, it’s been used in facial and ocular rosacea for 20+ years and has many studies backing its effectivity..in my opinion and in my practice I use steroids sparingly and for short periods of time. I don’t know your specific case however 😃 hope that helps
@@EyeSchoolwithDrD Thank you for taking the time to reply. I was on Loteprednol for 3 weeks, my pressure did go up to about 23. I've recently been diagnosed with glaucoma beforehand. I thought perhaps it was from the prednisone drops I was using in my right eye only but soon my left eye pressure raised too. (I've been on and off varying strengths of steroid drops over the past year.) Since my pressure wasn't too high, my doc started me on the Alrex and my next follow up is in 3 months. He insists in his opinion it won't harm me. I don't think he's not telling the truth but I just don't feel good about long term anything with a steroid.
I looked up the cost of IPL, it seems it's not covered with insurance and runs around $400 a session. Perhaps there is an alternative that is more budget friendly? What is a good way to find doctors like you that are near me?
@@user-gh3rv1of2b I would probably try a few different ways. You can google dry eye specialist and then call to see what they offer. Dr Jenna and Travis Zigler have a dry eye doctor locator in their website. Tearcare has a doctor locator and I believe Lumenis (IPL) does as well. If you send me an email with your location I am happy to post in my ocular surface Facebook groups to find a doc near you with the specialty equipment. Your doctor may even have some of these advanced procedures or know someone locally who does and they may be willing to refer you for the technology!
@@EyeSchoolwithDrD You're very kind. I will look into those options. Thank you, again.
Should I just do my eye area(blepharitus)and nose area(rosacea)or go ahead and do my entire face? I am 48, so have fine lines, acne scars?
Definitely a personal choice. If your Rosacea affects your whole face maybe do the whole thing, since facial rosacea contributes to the increase of inflammation on the surface of the eye. I really like the aesthetic benefits of IPL for tone etc so if I'm getting it done I have my whole face done to get rid of extra blood vessels and sun spots. Toyos protocol is cheeks and lids, so you don't HAVE to do full face for dry eye.
Is IPL safe while breastfeeding?
Does this cause eyelashes to fall out?
IPL is also used for hair removal, so yes, it can! I have found that the risk of losing lashes is higher if I get ultrasound gel on the lashes themselves. It seems that when this happens the light pulses are able to make it to the lash. I've had one or two patients who report lash loss after the first session even with me being careful to avoid the lashes and also using my technique of no gel on them. But, in their 2nd-4th sessions I was able to prevent further lash loss by making a shield and holding it against the lashes during treatment.
@@EyeSchoolwithDrDoh I already have short sparse lashes. Can't afford to lose them. Will lighter lashes have less damage since they say for laser hair removal it needs to be darker hair???
Dr. I felt heat in the back of the eyes when they did it to me, is it normal to feel the heat in the back of the eye when doing IPL teatment?
Word
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doxy is better.
Did doxycycline work better for you? I have used it for many patients either alone or in combination with IPL. Would love to hear more about your experience.
Stop😂, this is an act, right ? Yeah, so much better when you stay of script. Just wing every video...🫣 even though it seems like youre already kinda winging it. 🥸