Professional Therapies

Eye care practitioners with a special interest in Dry Eye Disease can offer a range of in practice professional therapies and prescription treatments to improve the signs and symptoms of your dry eyes to make them look and feel better.

 

Therapeutic MG Expression

Therapeutic Meibomian Gland expression is an in practice treatment to clear the stagnant, thickened oil out of the meibomian glands. Clearing out the old, poor quality oil means less irritation and also a chance for better oil to form in the glands Your eyelids will be warmed & a mild anaesthetic is used prior to the procedure. Your optometrist or ophthalmologist will then use techniques to manually massage and express the oil from the glands. It results in improvements in tear break up times and improvements in symptom scores.

Micro-Blepharoexfoliation.

Micro-blepharoexfoliation & lid margin debridement are deep cleaning treatments for the eyelid margin and lash line. They are exfoliation techniques that remove bacterial biofilms and thickened tissue. These in practice treatments can significantly improve symptoms of dry eyes. They can also be beneficial for those with lash extensions to help maintain the health of the eyelid and the natural lashes. There are a variety of methods that your eye care professional may choose to perform.

 

Intense Pulsed Light Therapy.

Intense Pulsed Light (IPL) Therapy can play a role in effectively managing dry, red eyes due to meibomian gland dysfunction (MGD), evaporative dry eye and ocular rosacea. IPL devices have been specifically developed for use around the eyes to improve meibomian gland function and relieve the symptoms & signs. 

IPL delivers pulsations of non-coherent light to alter or heal damaged tissue, especially skin. It' effectively treats the underlying cause rather than just managing the symptoms. IPL has been found to benefit dry eye by:

  • reducing inflammatory mediators

  • Reducing abnormal telangiectasic blood vessels, removing a major source of inflammation to the eyelids

  • helping ercadicate Demodex mites in the eyelids and reducing the bacterial load along the eyelid

  • temporarily increases the temperature at the eyelids and liquefies the meibum

  • photobiomodulation

The procedure is quick & comfortable. When used for MGD it can improve in the lipid layer grade, noninvasive tear break up times, vision & improve symptoms.  Your dry eye specialist will have a preference of instruments as many excellent ones are available. Common devices are E-Eye® and OptiLight®.

 

Lipiflow®

LipiFlow®​ is a simple, convenient procedure to improve meibomian gland function.

The 12 minute procedure involves direct warming and expression of the meibomian glands with specialised equipment. A 2015 study found a sustained effect of up to a year from a single treatment in improving the signs of dry eye and meibomian gland dysfunction. A 2022 review confirmed this improvement in patient symptoms and ocular surface health.

Punctal Plugs.

Punctal plugs are tiny, temporary or permanent plugs that are placed in the small hole that drains the tears from the eyes (the puncta). They result in a greater volume of tears staying on the eyes. They are most suitable for those with aqueous deficiency and can improve symptoms of irritation and reduced ocular surface staining. Often only the inferior puncta are plugged & because they have no effect on the inflammatory causes of dry eye are usually combined with other treatment measures.

 

Blephasteam®.

Blephasteam® Therapy is an eyelid warming device that delivers constant moist heat therapy to melt obstructed oil in the meibomian glands. The precise temperature and timing has been shown to thicken the oily lipid layer of the tears and improve eye comfort in 75% of patients, including symptoms of grittiness/dryness, foreign body sensation and ocular discomfort. 

Systane iLux®

The iLux is one of the newest, effective methods of warming & expressing the meibomian glands to improve signs & symptoms. It is currently only available in the USA.

TearCare®

TearCare® is a blink-assisted, wearable device that applies heat to the eyelids and liquifies the oil in the meibomian glands. The device is worn with your eyes open for a set period of time, and then your eye care professional performs manual expression of your meibomian glands.

The FDA granted approval for the use of the device, followed by meibomian gland clearance in December of 2021. It is currently available in the USA.

 

Low Level Light Therapy

Low-Level Light Therapy (LLLT) is another therapy consideration for those with dry eye disease due to Meibomian Gland Dysfunction. It works via photobiomodulation on the eyelids and periorbital area — using LED light of near-infrared wavelength. LLLT has been found to affect wound healing, pain modulation, reduce inflammation and normalisation of cell function. The effect of LLLT can be additive to IPL treatment. When used subsequent to IPL, low-level light therapy (LLLT) combined with IPL Therapy has been shown to improve signs and symptoms of MGD.

LLLT typically comes in three different light frequencies—each with its own unique benefits and use cases. The most common, Red Light, reduces inflammation and improves cell metabolism. Blue light is helpful for bacteria elimination, and yellow light, helps improve cell metabolism and reduce swelling, it can also increase skin elasticity.

 

As Dry Eye Disease is a chronic inflammatory disease, more & more prescription medications are also available, and being developed, to improve signs & symptoms of the disease. The availability of these prescription medications does vary around the world.