LipiFlow for dry eye: my honest experience

This was actually the first thing I tried, not long after I got diagnosed, and before I started my IPL in London. I found somewhere closer to home to have it done, in Bournemouth. (This was about eight years ago, so I'll check whether that clinic still exists and update this.)

What LipiFlow is

LipiFlow is a machine that unclogs your oil glands. From what I remember (again, this was eight years ago), they place little activators onto your eyes, and it doesn't hurt at all. It gently warms up your meibomian glands, and then it pulses and massages them, which expresses the glands and is meant to clear out anything blocking them so your oil can flow properly again.

The clean that comes first: BlephEx

Before the LipiFlow, they do a cleaning treatment first, and they advise having it done beforehand. It's called BlephEx. It cleans your lash line, which is where the openings of your meibomian glands are. Those openings can get bunged up and capped over with debris, so this clears them out.

It's done with a device that honestly looks a bit like an electric nail file, except the tip is soft. It has a little spinning sponge on the end that goes around really fast, and they run it gently along your eyelash margins. It doesn't hurt at all. It's a slightly odd, tickly feeling, and not the most comfortable thing having your eyelids tickled, but it's genuinely not painful. It cleans and unblocks the gland openings, so that when you then have the LipiFlow, the oil can actually push through. It's also used for blepharitis, though I've always been told I don't seem to have any blepharitis symptoms. (Blepharitis can cause dry eye, so I'm writing a separate article about that.)

What it costs

It wasn't cheap. I remember it being around £750 in the end for both eyes. They do price it per eye, so in theory you could have just one done, but I had both. Worth knowing that going in.

The warning nobody should skip: your eyes can feel worse first

This is the bit I really want people to know, because I see so many people online panicking about it. You might read comments like "it's been three days since my LipiFlow and my eyes are so much worse." Here's why that happens, and why it's usually normal.

When they express your glands, they push all the oil that's currently in them out. So for the next few days, until your body makes more, you can be left with barely any oil on your eyes at all, which can feel sore and dry. Then, as your glands refill and start flowing better, it settles. I was warned that my eyes might feel sore for the first week or so until things got going again, and I'm really glad I was. A lot of people clearly aren't warned, and they absolutely should be, because otherwise it's frightening.

My honest verdict: it didn't do much for me

I'll be completely honest: I don't think it made much difference in my case. I can't remember feeling any better afterwards, which was so disappointing, because it was the first thing I tried and I'd pinned all my hopes on it. I really thought, "this is it, this is going to cure me." Sadly, it didn't.

Why it didn't work for me (and who it might work for)

Here's the important part, because it explains a lot. The specialist I saw in London told me my glands are all open, they're all producing oil, and the oil is clear and a good consistency. My problem isn't blocked glands. My problem is simply that I don't produce enough oil.

LipiFlow is really designed for people whose glands are blocked or bunged up, and who need that reset to get things flowing again. If you're making plenty of oil but it's stuck, it could genuinely help you. But if, like me, your glands are already clear and you just don't make much oil in the first place, there isn't much for it to unclog. So I don't think I was ever the right candidate for it.

This is exactly why it's so important to have your glands imaged first (a scan called meibography), so you know what shape they're in and whether they're even still there. If your glands have atrophied and wasted away, there's sadly no point in LipiFlow, because there's nothing left to express. It only works if your glands are still intact and producing oil. So I'd say LipiFlow is most worth considering if you're at the milder end of the scale: healthy glands that are just bunged up and need a kickstart to get flowing again.

I had it done that one time, about eight years ago, and I've never had it done again since. That's my honest little experience with it.