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Doxycycline vs Lipiflow for Meibomian Gland Dysfunction

What is better for MGD? Doxycycline or Lipiflow?

 

Meibomian Gland Dysfunction, also known as MGD, meibomitis, or Posterior Blepharitis, is where the glands of your eyelids, meibomian glands, are not functioning properly.  Therefore the oil, or meibum, that these glands produce is not secreted onto the surface of the eye.  The purpose of this meibum is to moisturize and lubricate the eye, while keeping the three layers of tears intact.   

There are many ways to treat meibomian gland dysfunction naturally and at home, which I discuss in great detail in another article [Click Here to Read].  In today's article I will be discussing two in-office or prescription-required procedures, Lipiflow and oral doxycycline.  

The Results

A recent study published January 17, 2018, has revealed that a single Lipiflow procedure was significantly more effective than a 3-month daily dose of oral doxycycline at improving dry eye symptoms secondary to meibomian gland dysfunction.  It did state that both choices improve meibomian gland function and signs of MGD.  Since Lipiflow has significantly lower side effects than doxycycline, it is the preferred treatment to improve symptoms of dry eye from MGD. 

Lipiflow vs Doxycyline

How was it measured?

The researchers measured 28 patients split into two groups.  14 received a single Lipiflow procedure and 14 received daily oral doxycycline for 3 months.   Prior to any treatment and after 3-months of therapy, the participants were evaluated for the following: dry eye symptoms with a SPEED questionnaire (Standard Patient Evaluation for Eye Dryness), meibomian gland function by counting the number of glands secreting oil, tear break up time (TBUT), and corneal and conjunctival staining.  

My opinion on this study

Although a VERY low treatment population (only 28 participants), the results are very promising as I prefer to use more natural treatments for MGD.  Lipiflow is done without the use of any medication or antibiotics, and does not mess with the homeostasis of your body.  However, doxycycline for three months is taking an antibiotic for its side effect purposes.  I vowed to never prescribe an antibiotic unless absolutely necessary.  Therefore I would much rather discuss Lipiflow with a patient than give them a prescription for doxycycline.  

Both of these treatment options can be financially and time inhibited, which is why I always discuss natural, at-home treatments for MGD prior to discussing these.  If we still aren't getting results with natural, at-home therapies, that is when I pull these out of the "dry eye tool shed."  

Have you had lipiflow or taken doxycycline for your MGD or dry eyes?  

Let me know your successes or failures in the comments below.

One Love,

Dr. Travis Zigler, Eye Love

Dr. Travis Zigler

SeeEO of Eye Love

 

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Comments

Dr. Travis Zigler on March 26 2018 at 02:56PM

Hey Laura. Blepharitis recur because it is caused by normal bacteria that lives on our skin. With overgrowth blepharitis and demodex symptoms will occur. Infestation with Demodex is very common; prevalence in healthy adults varying between 23-100%. People with immunodeficiency are prone to infestation with Demodex mites, but they are even present in healthy individuals and may cause problems only when present in high densities. Under favorable circumstances (very oily skin, etc.) these mites may multiply rapidly.

To prevent overgrowth, you should have a daily maintenance schedule of tea tree oil cleanser, omega-3, and hypochlorous acid spray and on occasion you will have flare ups leading to the need for lipiflow, doxy, blephex and more.
One Love,
Dr. Travis Zigler

Laura Jacobus on March 23 2018 at 07:28PM

My “chronic Blepharitis” was treated with 3 months of Doxyclycline, (including Avenova cleaner 2x a day,) then followed by Lipiflo treatment. The results were amazing for a year. I barely noticed dry eye complaints.
But, now it has returned and I’m back to Doxy and cleansing routine again. I’m trying a DYI treatment. I’ve been heating my eyes with “hot hands” mini heat pads, and pressing them in a massage- like motion for a few days in now. I’ve also found the secret of tea tree oil to control the Demodex. It seems to be working..but the fact that it returns is very, very disappointing . I wish someone could tell me the source of demodex. I am a very clean person, and my diet is impeccable. Why does this reoccur so often? PS 60 years old, this started when I was 52

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