Ron Melton, OD, FAAO, and Randall Thomas, OD, MPH, FAAO, discussed common practices for treating dry eye, meibomian gland dysfunction (MGD), and blepharitis at the American Optometric Association (AOA) annual meeting. Here are a few medical management pearls from their discussion.
Anyone who treats ocular surface disease (OSD) recognizes the important role oral antibiotics play in therapy, especially in patients with meibomian gland dysfunction (MGD). Yet the existing evidence is insufficient to conclude the effectiveness of oral antibiotic therapy, according to a report published in Ophthalmology.
The lipid layer prevents evaporation of aqueous tears and prevents drying. Lipid deficiency due to meibomian gland dysfunction (MGD) is the most common cause of symptoms associated with dry eye disease.
Focusing on dry eye management is a great practice builder, but is not without challenges. These challenges lie in making the proper diagnosis, implementing new technology, properly training staff, developing an effective treatment plan and the time it takes to properly educate patients.
Warm compresses (WCs) are commonly recommended as supplementary therapy for MGD as well as a number of other conditions of the eyelid. While the core therapy for MGD is to remove obstruction, which requires an in-office procedure, the therapeutic goal of adjunctive WC use is to heat the eyelids to help soften and partially melt any remaining material obstructing the glands.
At the recent SECO meeting, optometrists and ophthalmic technicians sat side by side learning to perform microblepharoexfoliation (MBE), a new therapy for the treatment of blepharitis and ocular surface disease. The program aimed to train both doctor and tech about blepharitis and how to use the BlephEx device.
The mainstay of our therapy today consists of artificial tear preparations, surfactant lid cleansers, warm compresses for the eyelids, and the occasional antibiotic solution or ointment-this is the exact same therapy that was in vogue for treating OSD 25 years ago!
ZYLET :RELIEF TO THE RESCUEfor blepharitis
BlephEx recently released the first medical device that allows doctors to perform a painless, in-office procedure to treat blepharitis.
Everything from our high-tech lifestyles outdoor environmental factors, and the general aging of the population can lead to blepharitis, dry eye disease (DED) and meibomian gland dysfunction (MGD). Sustained tasks, such as reading, can reduce the blink rate to as low as five blinks per minute. This slow blink rate can cause additional stress on an ocular surface that is already compromised due to one of the aforementioned disorders.
Formication, a sensation that resembles that of insects crawling on or under the skin, is a specific form of the general set of abnormal skin sensations known as paresthesias (prickling, tingling sensation of "pins and needles") and tactile hallucinations; it is a well-documented symptom that has numerous possible causes.
Kelly Nichols, OD, FAAO, PhD, MPH, Dipl PH, says she would like to see optometrists screen for meibomian gland dysfunction during eye exams and consider the condition when treating patients who are experiencing discomfort with their contact lenses.
In the fifth video of our series on Demodex, Dr. Milton Hom provides additional insight about his experiences with diagnosing, treating and managing this clinical presentation.
In the fourth of our video series on Demodex, Dr. Mario Gutierrez offers practice management suggestions in treating patients with the mite. Plus, he gets into a mite-killing mood.
In the second of our video series on Demodex, Dr. Scott Hauswirth explains how to diagnose this tiny critter.
Meibomian gland dysfunction never went away, but current interest by researchers has put MGD on the front burner.
