MiBoFlo Thermoflo (MiBo Medical Group) is also a thermal device designed to distribute sustained, therapeutic heat to the outside of the eyelid in order to generate better meibum flow from the glands. The cost of this in-office treatment is significantly less than LipiFlow, though more frequent treatments may be necessary.
Two other less common but interesting meibomian gland aiding treatments is intense pulsed light (IPL) and ductal probing.
A study comparing the use of IPL on one eye showed improvement of lipid level in the tear film as well as improvement in symptoms in the eye that was treated.9
Meibomian gland ductal probing is not something that’s been commonly performed in clinical practice; however, there’s strong evidence to suggest that gland orifice obstruction plays a role in meibomian gland disease.1 Thus, probing the glands makes sense clinically. One in-office study showed that 100 percent of patients who had duct probing reported relief of symptoms four weeks after treatment; additionally 80 percent of patients needed only one treatment to feel continued relief.10
Cost of these procedures as well as billing capabilities may be downsides with these treatments, not to mention potential grey areas in terms of scope within optometry.
Importance of glands
The more we learn about meibomian glands and their role in the progression of ocular surface disease, the more we realize that early detection of gland problems is paramount.
Poor blinking needs to be addressed and evaluated by practitioners to assess risk of patients and possibly prescribed as an exercise in order to prevent disease development.
As more treatments become available for patients already suffering from meibomian gland dysfunction, the implementation of treatment early in the disease process becomes important. I encourage all optometrists to keep gland function as part of their primary evaluation of patients and to implement treatment and preventative measures where necessary.