Dry eye treatment

My Dr wants to cauterize my bottom ducts closing them permanently He wants me to do the Lipiflow Thermal Pulsation treatment too. It will costs 3,000 because insurance does not pay for lipiflow yet. Have any of you had experience with these two procedures?

I know about the cauterization because I've had it done. But I only know about Lipiflow from reading about it. They are both treatments for dry eyes, but the causes of the dry eyes are different. I do know that Lipiflow is for Meibomian Gland Dysfunction caused dry eyes, not for Sjogren's caused dry eyes. With Sjogren's there are more body sites affected by dryness, not just eyes. Sjogren's affects the moisture producing cells all over your body - eyes, nose, mouth, sweat glands, milk ducts, facial skin moisture, vagina, throat (my voice is permanently hoarse and I have to sip water constantly, my throat sometimes 'sticks together' when swallowing food, causing me to scary choke).

With the MG Dysfunction all moisture producing cells function normally, it's just that those meibomian glands are pluggged with oil or wax or something organic and the moisture can't get past the blockage to the eye where it's needed. It's like a bottleneck or a traffic jam. The Lipiflow heats and massages those plugged glands until the plugs melt and go away, then the body's own moisture can once again flow down to the eye. So your moisture producing cells never stop functioning normally, they just can't get past the bottleneck - once it's removed by the Lipiflow treatment, you're back to normal.

If you have Sjogren's and your meibomian glands are plugged, if you use the Lipiflow treatment it will unplug those glands, but if your moisture producing glands have stopped working Lipiflow won't restart them. It won't help you at all. So you need to know where your problem is - if you have Sjogren's, save your money, but if you don't have Sjogren's and just have plugged Meibomian Gland Dysfunction it will help. But once the glands are unplugged, with Sjogren's you have no moisture to get down the glands and moisturize the eyes. So you still have the dry eye problem.

Before they came up with this new Lipiflow treatment for MGD, the standard treatment for plugged meibomian glands was home care = my husband had that problem and he was instructed to use a warm water compress = a clean washcloth + warm water, rung out and laid over the eyes & massaged for 10 minutes 4 times a day. That fixed it in a week or less. And it didn't cost thousands, it was free. I'd at least try that before I spent the money.

Because I have Sjogren's, I've had artificial plugs put in both lower tear ducts in order to hinder what little moisture I had (both naturally and from the gel drops I use) from leaving. One plug stayed in without a problem but I had one duct cauterized because that duct's artificial plug wouldn't stay in, it would pop out after about a month - we replaced it three times, then cauterized the tear duct closed. That procedure did not hurt at all - didn't feel a thing. But it only lasted about a year when it partially opened up again. I had both eyes tear ducts checked last week and my ophthalmologist said that the cauterized one is still doing OK, but replaced the other plug because it had gone away sometime recently. Putting plugs in doesn't hurt either.

Hi Jinx,

I am as yet unfamiliar with either, but will be seeing another eye specialist soon. I was referred by the retina specialist who just cleared me for Plaquinil, to an MD who is more versed in Sjogren's, so will keep you in the loop on that.


Well, it's good to hear that these procedured didn't hurt, but as for me, the dilation drops were not supposed to hurt, but made my eyes feel as though they were sliced open with razors, had plenty of tears going that day, got out of the office and immediately poured my water bottle over my eyes. They hurt me until the following morning! The Dr told me the drier you eyes, the more they hurt! Um boy, and just think I get to go through that all over again! Can't wait!

About 30 years ago I had the lower puncta cauterized, which only helped somewhat, so then I had the upper punta cauterized as well. Had good relief but through the years my eyes have gradually gotten drier.....the ophthalmologist tells me the cautery is still complete. I use Refresh Plus individual (preservative free) drops during the day and night for relief.

I've just gotten to the point that the less they touch me the better off I am, everything seems to be invasive to me these days!

I just don't know about that one, Kaz! Call me chicken, I guess!

This is great news, Kaz! Glad you have found such a good Doctor! I think I would have to be sedated, heavily sedated, and restrained! LOL!

The melbomian glands don't have anything to do with tear production. They produce an oil film that helps to retain the tears produced by the tear glands. I had the Lipiflow test done and it showed that my glands were still in good condition and the cornea specialist said that continuing the warm compresses, the eyelid massages and scrubs would probably be enough to keep them functioning. That and taking fish oil every day. (Another cornea specialist had recommended flax oil, so I try to take both.) The Lipiflow test alone cost $150 and was very informative.

I only have the plugs in….good to have info on the Lipiflow, though. Big difference.

I use eyedrops during the day and a slightly thicker one at night. I take flaxseed oil (suggested by eye doc), Biotin (rheumy), extra D3 (from here) AND…..

…..I got a sample of TheraTears from the Sjogren's Syndrome Foundation and they are the best. I've been through almost every brand out there, and there are some good ones but Thera Tears makes them feel much better for longer. Yay!

Kaz, I had the same problem with people messing with my eyes. It totally freaked me out. Now I'm so used to it, I don't think twice. My doc office switched me to someone else in the practice (without asking me) and it turned out to be the best thing ever. It really takes a good eye doc with a calming manner that instills confidence. What a difference.

Hello sweet friends. I so want to contribute to this conversation but I am dealing with the worse episode of stomach virus or food poisoning ever. Hopefully tomorrow ! Thank you all so much

Oh Jinx, please be careful, food poisoning is dangerous! Sounds like you may need to go get checked!


I hope this passes quickly and completely, we already have enough to deal with!

Oh that's awful….been there. Had an ambulance come once because I was so sick I got dehydrated. They actually put me on Gatorade. If you can take even a tiny sip, it makes a huge difference.

Jinx said:

Hello sweet friends. I so want to contribute to this conversation but I am dealing with the worse episode of stomach virus or food poisoning ever. Hopefully tomorrow ! Thank you all so much

Skip the lipiflow, it’ll just be a lot of money and have no long term benefit.

Yes, I was told by the specialist that the benefits only lasts a year or so. He said the compresses would do the same thing but you have to do it every day and most people don't stick to it.

dryguy said:

Skip the lipiflow, it'll just be a lot of money and have no long term benefit.