What is Lipiflow Treatment? Will it Work for MGD?

What is Lipiflow Treatment? Will it Work for MGD? 0

Lipiflow Effectiveness 

Does Lipiflow Work for MGD?

That is what Lipiflow is designed for. You're literally doing warm compresses and massage at the same time during the Lipiflow procedure. It’s got two different pads, one is a heating pad, one is a pausing pad. So, it heats and then it pauses. It heats up the oil and then it breaks it apart with the pauses, and then it heats up the oil, and then it breaks it apart. 

Dr. Jenna actually had it done at an Ophthalmology office in Columbia, South Carolina. Basically, the way it works is, they clamp your eyelids in between those pads and it heats on one side, it pulses, and it kind of works those oils out. Now, it’s very different for everybody whether it works for you or not. I recommend trying it if it’s something you’ve never tried. It’s worth the try. Keep in mind that after warm compresses and after lipiflow, your eyes can actually feels worse because of those oils that were expressed. Over time, as your eyelids make better oils, that goes away and you shouldn't have an issues with it. 

One Love,

Dr. Jenna Zigler and Dr. Travis Zigler

Dr. Travis Zigler and Dr. Jenna Zigler answer your questions LIVE on Sundays at 7:00pm EST.

Click here to get Dr. Jenna's E-book, The Dry Eye Book, for FREE

Lipiflow Reduces Meibomian Gland Atrophy 2

Can Lipiflow Reduce Atrophy of the Meibomian Glands in MGD?

Meibomian Gland Dysfunction, also known as MGD, meibomitis, or Posterior Blepharitis, occurs when the glands of your eyelids, meibomian glands, are not functioning properly.  These glands produce the oil needed for your eyes to function properly and feel comfortable. However, in MGD, these glands can become chronically obstructed. When this occurs, they can begin to atrophy and die off, meaning that they will no longer function to produce the proper oils your eyes need. For years, we have thought that this atrophy is irreversible, but recent research shows that this may not be the case.

In today's article, I will be discussing whether or not the Lipiflow procedure can reverse the atrophy we often see with the meibomian glands.

The Study and Findings

A recent retrospective, observational study has revealed that 70% of those patients treated with Lipiflow showed a reversal in their meibomian gland atrophy vs. those patients who had not undergone Lipiflow. In these patients where improvement was noted, small positive changes were seen in the glands. Researchers also found long term improvements in tear break up time, tear osmolarity, and corneal staining.

How was it measured?

The researchers looked at the visible gland structure, or the amount of atrophy present in the patients studied, both before and after their treatments with Lipiflow. The Lipiview 2 was used to visualize the glands and, in an interesting and smart twist, Photoshop was used to assess the gland details down to the pixel level. The Meibum Scale, or the gold standard scale used to assess meibomian gland structure, changes by 25% increments so could not easily be used in this study because of the precise comparisons needed.

Heyedrate Lid and Lash Cleanser

My opinion on this study

Although a VERY low treatment population, the results are very promising. For years, we have told patients that their atrophy was irreversible. This research provides us with hope that MGD can be overcome. As I prefer to use more natural treatments for MGD, it's great to see that Lipiflow is potentially able to make these positive changes without the use of harsh medications. Because of this study, I am much more likely to prescribe Lipiflow for a patient with Meibomian Gland Dysfunction because of the positive outcomes we've seen.

Although Lipiflow can be financially and time inhibited, I believe it is a great option for those patients with MGD and especially for those with known atrophy of the glands. Patients who have previously taken Accutane come to mind, since this medication itself causes atrophy of the glands. 

Have you had the Lipiflow procedure and seen great results for your 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 

Do you have dry eyes or meibomian gland dysfunction?

Click here to get our free dry eye eBook and daily checklist that we give our patients.

Doxycycline vs Lipiflow for Meibomian Gland Dysfunction

Doxycycline vs Lipiflow for Meibomian Gland Dysfunction 2

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


Do you have dry eyes or meibomian gland dysfunction?

Click here to get our free dry eye eBook and daily checklist that we give our patients.

Best Treatments for Posterior Blepharitis, MGD, and Brittle Eyelashes

Best Treatments for Posterior Blepharitis, MGD, and Brittle Eyelashes 0

What is the best treatment for Posterior Blepharitis when it involves Demodex mites?

Demodex mites are actually more of an anterior blepharitis issue, because it involves your eyelash follicles. Demodex is a parasite that lives in your hair lash follicles, which are on the anterior surface of your eyelid. Treating anterior blepharitis, posterior blepharitis, and demodex are all three separate areas of your eyelid and require different treatments. Posterior blepharitis involves treating the meibomian glands and benefits from IPL, Mibo Flow, warm compresses, and omega-3s. Anterior blepharitis is best soothed with our hypochlorous acid spray. Demodex treatment is best treated with tea tree oil. Our tea tree oil soap is a fantastic treatment for this. When we decided to release our soap, we were looking at different treatment options and we saw that some shampoos on the market were $240 and had a lot of unnecessary ingredients. With any tea tree oil product, you do have to be careful not to get it directly in your eyes because it can burn and if you use it really often it can dry up your skin and dry up your eyelids. If that happens to you and it seems like it’s making things worse because it’s making your eyelids dry, simply cut it back to once a day or every other day.

Heyedrate Tea Tree Oil Soap

Will eyelid margin swelling/redness ever subside? Compresses seem to make the redness worse.

You are correct. Warm compresses can make redness worse because when you apply heat to any inflammation, that usually makes it worse. If you’re trying to get rid of red eyelids, that’s where cool compresses will come in. You might want to alternate warm compresses for your meibomian glands with cold compresses for the redness. Eyelid margin swelling and redness will subside if you keep your eyelids clean. Again, our Heyedrate Tea Tree Oil Soap and our Heyedrate Lid and Lash Spray will help with this. Also, if you have Rosacea, that can definitely cause eyelid redness so you want to be using tea tree soap to help calm down the redness and inflammation from that.

Does Lipiflow treatment work well for MGD? My doctor recommends the treatment, but it is pricey and not covered by insurance.

Liiflow can be great for meibomian gland dysfunction. If you have MGD, it’s worth a try to try it out for yourself. It doesn’t work for everyone, but for some people it can be life changing. Is it worth the cost? That’s up to the opinion of the patient. Some would say absolutely, and others would say it’s not. Things to note...during the first week after you get it done, your eyes might actually feel worse because what that Lipiflow does is gets all of the stagnant oils out of your glands. When those release onto your eyelids and eyes, it can cause more inflammation for a bit.  A lot of doctors would put you on a steroid eye drop for few days to a week just to calm down the inflammation and get you feeling better more quickly. If you haven’t tried it, it might be something to look into and see how it makes your eyes feel!

Meibomian Gland Dysfunction

What do you think about Blephasteam goggles, and do you think they are effective?

We looked into this a little bit and it seems like a pretty great product. It’s almost like a home version of a Lipiflow. It steams up, heats up your eyelids, and does a similar thing. Currently, this device is only available in the UK and the only downside is you do need to buy replacement rings for it every few times you use it.

My eyelashes have gotten very dry and brittle and have dropped downward. Any suggestions on the cause and what to do for it?

You may have something known as ectropion, where the eyelids lose the elasticity they once had. This causes them to droop down and the eyelids start to open up. This is absolutely going to cause dry eyes as well because the pump used to pump tears in and out of the eyes may not be working properly. Ectropion is usually just due to aging, and you can think of the lost elasticity as losing muscle tone in your eyelids. There is a muscle in your eyelid that keeps everything toned and tight and just think of any muscle that has atrophied...you can’t lift as much as you could when you were 20. It’s the same thing with your eyelids. Treatment for this is most often surgery, which is in the form of an eyelid lift or a blepharoplasty. Aside from that, some people can begin to notice brittle eyelashes and they start to lose eyelashes because of blepharitis. Make sure you’re keeping your eyelids nice and clean, like we've talked about in this article!

Are you having issues with meibomian gland dysfunction? What has worked for you?

One Love,

Dr. Travis

Dr. Travis Zigler
SeeEO of Eye Love
Director of the Dry Eye Syndrome Support Community
Click Here to learn how to cure dry eye naturally




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