The Eye Lids & Tear Film
Eyelid Evaluation
Tear Film Evaluation
Eyelid Evaluation
First we must look for signs on eyelid infection. If the lids are infected, step 1 is to kill the bacteria or Demodex mites.
Eyelid Treatment
Tear Film Evaluation
Eyelid Evaluation
Low Level Light Therapy (LLLT) Blue will kill staph bacteria and Demodex mites without having to use harsh cleansers.
Tear Film Evaluation
Tear Film Evaluation
Tear Film Evaluation
For 85% of patients with dry eye, the root cause in an inadequate lipid layer which leads to tear evaporation.
Meibomian Gland Evaluation
Healthy Glands
Moderate Atrophy
Moderate Atrophy
Meibomian Glands are located on the upper and lower eyelids. They produce the lipid layer of the tear film.
Moderate Atrophy
Moderate Atrophy
Moderate Atrophy
When the meibomian glands are blocked for a period of time, they begin to atrophy (die). Once they are gone, they will not come back.
Severe Atrophy
Moderate Atrophy
Severe Atrophy
These meibomian glands have been blocked for a long time.
There is now extensive atrophy.
Meibomian Gland Treatment
Thermal Treatment
Thermal Treatment
Thermal Treatment
Thermal treatment such as LipiFlow and TearCare heat up the hardened oils in the glands and clear them out.
LLLT Red
Thermal Treatment
Thermal Treatment
After the eyelid inflammation is treated and the glands have been cleared of blockages, we use LLLT-Red to rejuvenate the meibomian glands.
IPL
Thermal Treatment
IPL
Some patients also benefit from Intense Pulse Light (IPL) at the base of the meibomian glands to treat MGD.
Dry Eye Is Multifactorial & Chronic
Since Ocular Surface Disease (dry eye) is a chronic multifactorial condition, there will be continued treatments and evaluations to maintain the new healthy ocular surface.
If The Tear Film Gets Low
We can place punctal plugs to decrease tear drainage and retain the tears on the ocular surface. Non-preserved artificial tears can also be used as needed.
Oral Nutraceuticals
There are several oral supplements that can assist in keeping the oils soft in the glands and control inflammation. During your consultation we will recommend one based on your condition.
Ongoing Eyelid Maintenance
If blepharitis was a root cause of the ocular surface diseases and meibomian gland dysfunction, then eyelid cleaning will be needed for maintenance. Topical foams and gels are available, but often irritate the ocular surface. We have in office LLLT blue light therapy available to maintain the health of your eyelids.
Meibomian Gland Maintenance
To prevent the oils in the glands from hardening again, on-going thermal treatments are recommended. You can use a home heat mask several times per week for 5-10 minutes. Additionally, a very effective in office treatment would be to do LLLT Red Mask.
The recommended frequency would depend on the severity of the condition.
Night Time Aid
Some patients who suffer from dry eye do so because they don't close their eyelids completely at night while sleeping. In this case, we can prescribe lubricant ointment and sleeping goggles to help prevent the eyes for drying out too much over night.