Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease. MGD is very common in Vancouver and in most of North America and many of our patients come to see us for relief from MDG and the dry eye disease it causes. MGD can be a chronic condition that gets worse over time if untreated. It is usually diagnosed by a doctor observing the function of your Meibomian glands to see if they are structurally sound and producing enough oil to lubricate your eyes. They are responsible for producing the oily or lipid component of tear film. If your eyes are not producing enough oily lipid, they will dry out. At Perspective Optometry, we use a medical imaging device to get a clear and up-close look at your Meibomian glands and we show it to you and explain what it says about the health of your Meibomian glands. The image looks like this:
Patients who are in later stage MGD can present with additional problems like ocular surface inflammation, changes to the tear film and lid margin.
There are a few treatments available for the management of MGD. These can include, daily heat and massage of eye lid, debridement of the Meibomian glands, BlephEx, or pharmaceutical treatments like the antibiotic doxycycline. However, the successful long-term treatment of Meibomian gland disfunction usually requires the clearing and removal of obstructions to proper Meibomian gland function. One treatment that is specially designed to accomplish this is Vectored Thermal Pulsation (VTP), such as the Lipiflow treatment offer at Perspective Optometry in our Vancouver clinic. Vectored Thermal Pulsation has been shown to be highly effective at treating the Meibomian glands. Our VTP equipment, Lipiflow does this on all four eyelids simultaneously in a single 12-minute treatment; this minimizes patient discomfort and inconvenience. The successful use of VTP has been shown in patients with varied underlying causes for their Meibomian gland dysfunction, such as those with dry eye, refractory dry eye, refractory dry eye following LASIK, Sjögren’s disease and also in contact lens wearers.
One of the most beneficial aspects of Vectored Thermal Pulsation (Lipiflow) is that many patients experience long-lasting relief after only one treatment. Clinical studies have shown that Vectored Thermal Pulsation treatment such as Lipiflow caused a sustained 12 to 36 month improvement in Meibomian gland function and dry eye symptoms with a single 12-minute procedure.
The problem with some treatments for Meibomian gland dysfunction that rely on antibiotics and other pharmaceuticals is that pharmaceutical agents often have side effects and can cost patients a lot of money over time. As a result, doctors and patients are interested in determining whether there are better treatments than pharmaceuticals. One recent study compared a single 12 minute VTP treatment to a three month daily course of the antibiotic doxycycline. The study concluded that VTP was significantly better than doxycycline at improving the dry eye symptoms that are caused by MDG and it was at least as effective as doxycycline at improving the functioning of the Meibomian glands. Because VTP had fewer risks than long term doxycycline use, VTP was probably a better option for patients.
Source: Clin Ophthalmol. 2018 Jan 17;12:161-168.