Pearls from BCLA 2017: CLIDE and blepharitis

June 19, 2017

The British Contact Lens Association (BCLA) celebrated its 40th birthday June 9-11 at its 2017 clinical conference and exhibition in Liverpool, UK. Optometry Times was there to hear the latest and live tweet from the meeting.

 

The British Contact Lens Association (BCLA) celebrated its 40th birthday June 9-11 at its 2017 clinical conference and exhibition in Liverpool, UK.

Optometry Times was there to hear the latest and live tweet from the meeting.

In the interests of better sharing information, we put together tweets in an article format to make it easier for our readers to consume learnings from BCLA 2017.

Related: Posters presented at ARVO 2017 offer insight on cosmetic use and OSD, Demodex

Remember that tweets are limited to 140 characters, including any hashtags. (We used the meeting hashtag of #BCLA40 and #optometry on all of our tweets). Some tweets are edited slightly for clarity, but otherwise they are collated below as they appeared in our live feed from the meeting.

First up is contact lens-induced dry eye (CLIDE) and blepharitis.

 

Contact lens-induced dry eye (CLIDE)

The BCLA awards the BCLA Medal each year for outstanding achievement in the field of contact lenses and/or anterior eye. The winner delivers the BCLA Medal Address at the clinical conference.

Past President Brian Tompkins presents Dr. Michel Guillon with the BCLA Medal Award at the BCLA Clinical Conference 2017 in Liverpool. Image courtesy of BCLA.

This year’s winner is Michel Guillon, PhD, FCOptom, FAAO. Dr. Guillon is managing director of Ocular Technology Group in London.

Dr. Guillon delivered his Medal Address on tear kinetics in contact lens-induced dry eye.

Contact lens-induced dry eye (CLIDE) is caused by the lacrimal system failure to maintain homeostasis.

Tear kinetics shows that CLIDE is different from non-contact lens dry eye.

Related: Understanding corneal shape helps scleral lens fitting

The contact lens affects the cold receptors blink reflex.

Contact lens and corneal tear film kinetics are different.

Tear film stability is lower than stability of corneal tear film.

The presence of a contact lens affects the break-up time.

Contact lens wearers have less tears.

Two technologies are available to look at tear kinetics: Placido disk and Tearscope (including LipiView).

CLIDE is a unique dry eye entity. It has high prevalence in a young population, large diurnal increase in symptomology.

Differences in tear film kinetics are in part responsible for dry eye.

 

 

Blepharitis 

Jennifer P. Craig, PhD, MSc, BSc, MCOptom, FAAO, FBCLA, delivered a keynote talk on blepharitis and demonstrated live several methods of blepharitis management. Dr. Craig is associate professor of ophthalmology at The University of Auckland in New Zealand.

Anterior blepharitis signs beyond crusting include: marginal keratitis, hordeola, chalazia, trichiasis, madrases.

Dr. Craig demonstrates live meibomian gland expression with a Mastrota paddle on Lyndon Jones PhD, FCOptom, DipCLP, DipOrth. Dr. Jones is professor at the School of Optometry and Vision Science and Director of the Centre for Contact Lens Research at the University of Waterloo in Waterloo, Ontario, Canada.Meibomian gland dysfunction (MGD) is the most common form of posterior lamellar disease.

MGD risk factors: increasing age, environmental (high bacterial load, device use, air conditioning), Asian population.

Risk of MGD is 60 percent in Asian countries as compared to 30 percent in non-Asian countries. Is it ethnicity or is it environment?

Greater degree of meibomian gland dropout and incomplete blinks in Asian eyes.

In a New Zealand study, ODs said 35 percent of patients exhibited MGD and 15 percent exhibited anterior blepharitis.

Quality of life with blepharitis is associated with depression, impact on productivity, financial burden.

Tear film stability can be increased by manually expressing meibomian glands.

Lid margin management: free up gland orifice, decrease bacterial load, manage demodex infestation.

Related: New research in how eye, brain health correlate presented at ARVO 2017

Dr. Craig demonstrating live BlephEx use on Dr. Lyndon Jones.

Another debridement option is a “deep clean” with RySurg’s BlephEx.

Avoid baby shampoo for patient at-home use. Recommend instead a commercial lid cleanser.

Commercial lid cleanser showed greater improvement in SANDE questionnaire; baby shampoo showed greater adverse effects on meibomian gland orifice obstruction.

Lipid layer improved significantly only with lid cleanser, not baby shampoo.

Staged management for blepharitis: Dealing with the lid margin, encouraging meibum outflow, improving meibum quality.

Intense pulsed light therapy is an option to facilitate meibum flow.

Following her keynote on blepharitis, Dr. Craig demonstrated live several blepharitis management techniques, including lid debridement, meibomian gland expression with a Mastrota paddle, and BlephEx.

Dr. Craig demonstrates live lid debridement on James Wolffsohn, BSc MBA PhD, deputy dean at Aston University in Birmingham, UK.

Read more content from Gretchyn M. Bailey, NCLC, FAAO, here