AJ, 77 year old female from Sun City Center, FL

Dry eye symptoms before treatment
From ~2008 to 2013, eyes were needing OTC eye drops, but one Friday  afternoon in 2013, my eyelids stuck to my eyeballs, even with the eye drops — I drove to the first eye doctor’s office I saw and pulled in, just before they closed.  They took one look at me, and fortunately, the MD was still there and saw me!  He put me on steroid drops and said I was allergic to preservatives in the eye drops I had been using.  I then started with preservative-free eye drops, ointment in eyes at night, cleansing eyes AM & PM, and warm compresses twice a day.
The symptoms worsened after cataract surgery in 2015.
Intolerance to air conditioning, fans, wind, dry atmosphere in big stores
Intolerance to cooking fumes in restaurants
Intolerance to chlorine fumes in swimming pool
Blurred vision needing more frequent eye drops
Occasional painful styes
Constant need to use eye drops, up to every hour and more often at times; I was being consumed with trying to get my eyes wet.
Before I saw Dr Maskin, I was starting to have pain in my eyes.

How daily activities were affected
Multiple MD visits to explore underlying cause of dry eye, and for treatments.  My rheumatologist did diagnose me with “Undetermined Connective Tissue Disease” (symptoms of many immunologic diseases), causing dry eyes and dry mouth, and I have a high blood titer for scleroderma, but no definitive symptoms of the disease.
Wore baseball hats, and “safety goggles” (with wrap-around barriers to keep air out), both in home and outside, and when traveling in a plane
Had to use eye drops if awakened during night
Purchased expensive sunglasses - “Cocoons” that had barriers around lens to keep air out
Difficult to read books, or work on my photography editing programs
Unable to drive ~ 30 minutes without pulling over to use eye drops; spouse had to do all driving on our road trips
Purchased electric device to heat eye compress for use while traveling
For travel, had to pack boxes of OTC eye drops, and prescription eye drops, compress device

Treatments before probing
Washing lids with baby shampoo, and use of tea tree oil eye wipes AM & PM
Warm compresses AM & PM, and sometimes mid-day
Serum tears (included blood draw, out of pocket payment every 3 months)
IPL x 6+ (included 30 mile drive to Sarasota)
Had one treatment using machine heated material slits stuck to my upper & lower eyelids
Prokera patches multiple times for erosions on cornea
Used over the counter eye drops, Thera-Tears, Refresh Mega-3, Celluvisc at night, Refresh PM ointment in eyes at night
Had photograph of meibomian glands - there was atrophy, & I was told they don’t regenerate
Tried many prescription eye drops:
Xiidra - severe allergic reaction; Lotomax - severe allergic reaction; Restasis - no noticeable effect; Cequa- no noticeable effect; Vevye - no noticeable effect; Tyrvaya Nasal Spray - no noticeable effect; Miebo - felt some comfort
Eye doctor told me I was at end stage of dry eye disease and recommended scleral lenses

What led me to consider probing
Searched Amazon for book on dry eye disease & found Dr Maskin’s book
Reviewed chapters on probing & the research that meibomian glands could regenerate, so felt hopeful
Drove past Dr Maskin’s office in Tampa, so realized he was close to home
My eyes were getting worse, and started being painful, and drops didn’t hold very long, so when eye doc recommended scleral lenses (a type of contact lens, major expense, etc.), I told him I’d like to check with Dr Maskin & he said “go ahead and let me know how it goes”

Experience during and after probing
Dr Maskin and his wonderful staff explained everything to me after doing many diagnostic tests.  Dr Maskin cauterized my tear drainage ports (called puncta), to keep my tears from draining away.  I was given instructions to humidify my bedroom, wash my eyes with Dove soap AM & PM then flush with normal saline, wear eye mask at night, continue with the warm compresses, and stop all the other eye drops and serum tears.

Probing was recommended. The following week, I had probing of my left eye, done in his office, Dr Maskin did local anesthesia, his nurse, Marty was by my side to help me keep my chin & forehead in place while the probing was done.  I had something to squeeze - (the proverbial “bullet to bite”), if needed, to tolerate discomfort.  Dr Maskin would give directions to look up or down or to right or left.  He probed quickly and counted each probed gland, and I could sense a tiny “pop” each time. My eye was immediately “wet” afterwards - I drove home with such a wonderful feeling.  A few days later, the right eye was done.  My eyes have been wet since. I did have steroid drops to do for a few weeks, along with antibiotic drops, and ointment that were tapered off. 
Surgery was recommended.  The rubbing of my lids on my eyeballs had caused loosening of surface of my eyeballs, causing wrinkling and diversion of tears.  So Dr Maskin performed resurfacing surgery to correct the defects.  Each time, it was outpatient surgery with a very good staff who always work with Dr Maskin.  I had minimal to no pain.  I was able to drive myself to Dr Maskin for follow-up on the following day each time.

Any improvements noticed in symptoms, comfort or quality of life
Basically, I GOT MY LIFE BACK!!  I feel normal !!!!  My hope is restored.  No hats, no goggles. no drops.  I can read comfortably, drive comfortably, no longer have to avoid fans, no problems with air in stores or restaurants. No more expensive eye drops and procedures. No more having to bring boxes of eye drops, etc.. for travel. I can help drive on road trips, giving my husband a break.  My sight is restored.
My eyes get more wet in humid environments, and I dab with a tissue.  I am eternally grateful for what Dr Maskin’s treatment and care has done for me and my husband.

What would I tell another patient considering probing
I live in an over-55 community of over 20,000 population.  There are plenty of people that have dry eyes, as I see them with hats and goggles, etc., like I used to do.  I have already been telling everyone about what Dr Maskin has done for me.  These people have seen me “before and after”, so they know I’m telling the truth. I give them his brochures, tell them about his YouTube presentations, tell them about his book, answer questions, tell them about how dedicated and kind and competent his staff is.  I sing his praises every chance I get.  I tell everyone in Zoom my sessions with friends in Seattle, Arizona, Kansas, & family in Pennsylvania and California.  I also use spa services in my community, so I’ve told all of the practitioners there about my experiences, and I’ve had calls from them for Dr Maskin’s contact information for their other clients.  I belong to Clubs in my community, and I have told them about my experience.  I have also given Dr Maskin’s contact information to other local Clubs, so they could invite him to speak at one of their meetings. Any chance I get, I tell my story and recommend Dr Maskin!!

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Kay M., 80 year old female from Wildwood, Fl

My name is Kay Miller and I live in Wildwood, Florida. I was diagnosed with Meibomian Gland Disorder about 7 years ago. I saw 3 ophthalmologists seeking relief because I was in absolute misery 24/7, with eyelids that were scratchy, red, and tender. I had a foreign object sensation in my eyes all the time. Life as I once knew it was gone, and I wondered how I could possibly live the rest of my life in this miserable state. Just sitting under a fan in a restaurant caused an increase in symptoms.

The eye doctors I visited treated me to no avail. I did not get any better with their treatments. They suggested and I tried warming masks, various eye drops, and antibiotics.

These dry eye symptoms happened immediately after I had a second cataract surgery in one eye at a facility in The Villages. This seemed to be the tipping point for the development of chronic dry eye symptoms.

After months of misery 24/7 and out of absolute desperation, I started searching the internet for a dry eye specialist who might help me out of this dry eye misery. I was so fortunate to find a dry eye and cornea specialist in Tampa, Dr. Steven Maskin, who has researched dry eye for at least 30 years. He has a very different approach which turned out to be exactly what it would take for me to get my life back.

After extensive diagnostic testing, which included a Meibography and Demodex test among other types of tests, Dr. Maskin was able to determine the co-morbidities which led to or exaggerated my dry eye symptoms, and subsequently he devised a treatment plan targeted especially for me and my co-morbidities. My meibomian glands were not functioning properly due to periductal scarring around the glands, putting pressure on them. That caused them to lose their integrity and interfere with dispensing the necessary meibum to spread over my eyes, leading to evaporative dry eye. Also, he determined I had conjunctivochalasis which needed reconstructive surgery with amniotic membrane to make my eyes healthy again. Later, after surgery, he probed all four lids with his special probing instruments, which he devised, and my eyes began to feel so much better over the next few months. Since I have ocular allergies to quite a few environmental triggers, he prescribed Pataday Allergy Eye drops. Now I live with comfortable eyes, and I have my life back, thanks to the successful treatment of my condition.

I say all of this to let you know that there is hope for those of us who have a particularly debilitating case of dry eye which doesn’t lean itself to the usual protocols generally prescribed by dry eye doctors. There are many, many people out there who are living in constant pain and misery and have found little or no relief with the treatments given by most dry eye doctors.

I belong to a Facebook support group, and I see every day people posting details about the pain they are going through. Some are reaching the end of their tolerance of pain and have suicidal thoughts or intentions. A productive and happy life seems to be no longer within their reach. From the comments I have read on the group MGD site, many who have had LipiFlow or IPL say it did little or nothing to help them.

The main reason I am giving you this book and information is that I am so grateful for Dr. Maskin’s targeted approach to treating dry eyes that I have a passion for paying it forward. He focuses on finding co-morbidities and targeting an individual treatment plan based on his extensive diagnostic testing and research experience. He believes that the probing he does with his specially made probes releases the scar tissue (periductal fibrosis) that keeps the Meibomian from releasing the meibum over the eyes. This is KEY to getting back the integrity of damaged meibomian glands.

I also want to reiterate that I am doing this on my own volition and not compensated in any way by Dr. Maskin. I honestly feel most dry eye doctors would benefit from the knowledge Dr. Maskin has accumulated in his many years of research. Also, my heart goes out to those patients who are not helped by the current standard treatments. Many are so desperate that they are willing to travel from all over the continental U.S., Europe, Australia, and many other countries to seek relief from Dr. Maskin.

I hope you enjoy reading this book and gain some insight from someone who has dedicated his life to this disease. It would be outstanding if at least one ophthalmologist in The Villages area could learn more about his targeted approach and learn his probing technique, which has literally helped hundreds of people gain their life back.

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Henry M., 77 year old male from Winter Park, FL

When I first developed Dry Eye Disease and Meibomian Gland Dysfunction, I did what many patients do. I tried the commonly available treatments and followed the usual advice. Over more than 10 years, and three other eye doctors, I used prescription drops, warm compresses, lid care, artificial tears, BlephEx, LipiFlow, IPL, and TearCare. Some of these helped for a while, but the benefit never lasted. The pattern was always the same: temporary improvement followed by further decline.

By the time I became a patient of Dr. Maskin, I had come to understand that my condition was chronic, progressive, and more complex than simply needing more drops or another heat-based procedure. Dr. Maskin performed a thorough diagnostic workup and treated the full picture, including MGD, ocular surface disease, inflammation, and other contributing conditions.

During the past four years, I have had four meibomian gland probing treatments. For me, probing was the treatment that finally addressed something the prior treatments had not. It made the key difference in my long-term improvement.

I am now 79 years old, and I did not expect to see such meaningful progress at this stage. I still have dry eye disease, but I no longer feel trapped in a cycle of steady decline. Much of the time, my eyes feel close to normal. I am very pleased with the results and grateful for Dr. Maskin’s expertise, persistence, and comprehensive approach.

I am very pleased with my results. While every patient’s situation is different, my own experience has been one of substantial improvement, better stability, and much greater confidence about the future of my eye health.

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PT REQUESTS ANONYMITY

What makes the difference? Dr. Maskin conducts a thorough evaluation of your eyes to identify any underlying conditions that may be contributing to your symptoms and affecting your eye health. This holistic approach ensures that every contributing factor is addressed.

He never gives up. The hope he gave me helped me get out of bed every morning, and he gave me back a life I thought I had lost forever.