Managing Meibomian Gland Dysfunction

Meibomian gland dysfunction is the most common cause of chronic dry eye in the United States and creates the following eye symptoms:

  • Stinging and / or burning
  • Sandy or gritty feeling
  • Redness of the eyes
  • Fluctuating vision
  • Contact lens discomfort
  • Difficulty while reading or using electronic devices
  • Eye Fatigue

The human tear film consists of three layers – mucin on the eye surface; water in front of the mucin and; a layer of oil on the surface to provide surface stability and maintain prolonged contact of the tear film on the eye itself.  The meibomian glands are located on our eye lids and secrete the oils that lubricate the eye, reduce evaporation of tears from the eye surface and stabilize the water layer of the tear film helping it to remain evenly on the eye surface between blinks.  Due to current lifestyles, these glands frequently become blocked – even in young patients.

These oils are only released onto the tear film with blinking when muscle contraction compresses the glands and expresses the oils.  The average blink rate is reduced and the eyelids are not always completely closed when we are reading or looking intently at a computer, tablet or mobile phone.  Increased use of these devices has created an epidemic of MGD in the United States.  Also, the excessive use of eye makeup such as eye liner applied to the base of the eyelids may increase inflammation in the glands and damage them.

MGD contributes to dry eye symptoms when reading for extended periods of time.  We often need to put down the reading material and blink to refocus.  Excessive amounts of time devoted to such near tasks results in reduced compression of the meibomian glands which ultimately causes the meibomian glands to become blocked and the tear film to become impaired.

MGD is the most common cause of dry eye in the United States.  It is prevalent, progressive and obstructive. Once these glands are damaged, they cannot be replaced but we can improve the function of those glands that remain.  For most patients, successful treatment of MGD requires removal of the gland obstruction.  Removal can be performed using the LipiFlow® or MiBo ThermoFlo® systems.

LipiView System® from Tear Science®

At Will Vision we utilize both the LipiView® II and LipiScan® technology to assess meibomian gland function preoperatively.  Both the LipiView® II and LipiScan® devices use Dynamic Meibomian Imaging (DMI) technology to produce high definition images of meibomian glands.  In addition, our LipiView® II systems analyze over one billion data points in each eye accurately measuring sub-micron thickness of the lipid layer.  The LipiView® II is the only instrument available that measures lipid layer thickness, evaluates blink dynamics and images meibomian gland structure.  We are able to capitalize on real-time visualization of the lipid layer thereby allowing us to understand the dynamic response of your tear film lipid layer while blinking as well as measuring the extent of lid closure during each of your blinks.

At Will Vision we use both the LipiView® II and LipiScan® systems to assess meibomian gland structure during routine workups because MGD is very prevalent amongst patients presenting for laser vision correction surgery, as it is largely caused by our modern lifestyles.

LipiFlow System® from Tear Science®

Will Vision is one of only a small handful of clinics in the Pacific Northwest to use the LipiFlow® system from Tear Science for the treatment of Meibomian Gland Dysfunction. LipiFlow® is the only FDA approved single-dose treatment for Meibomian Gland Dysfunction (MGD) that has been shown to improve gland function and dry eye symptoms with a sustained duration. FDA trials have also shown that early LipiFlow® intervention for MGD is associated with improved treatment outcomes. In the FDA trial, 86% of patients that received only a single LipiFlow treatment did not require additional prescription therapy for dry eye symptoms.

Unlike hot compresses or lid scrubs or other older treatments for MGD, the LipiFlow® system applies heat to the inner eye lid causing the meibomian oils to become liquid and the orifices of the glands to open. Once open, a vectored pulsation mechanical massage known as Vectored Thermal Pulse™ (VTP) technology is applied to the eyelids using a computer controlled activator. This combination of pulsation and massage gently cleans the blocked material out of the meibomian glands and allows them to once again secrete oil into the tear film.

MiBo ThermoFlo® or MiBoFlo®

With over 30 million people suffering from chronic dry eye in the United States, there is no one solution that fits all.  Before the advent of the LipiFlow®, options were frequently limited to lubricating eye drops and eye medications.

Although LipiFlow® is highly effective for treating MGD it is expensive to both perform and undergo on a frequent basis.  Unfortunately, chronic dry eye is by definition – a chronic disease.  MiBo ThermoFlo® is a highly cost effective alternative to eye drops and LipiFlow® that offers comparable relief for patients suffering from dry eye and can be easily and affordably repeated when needed.  MiBoFlo® also frequently provides much more rapid improvement in eye comfort compared to the LipiFlow®; is very comfortable – more like a spa therapy and; is a much more affordable procedure allowing us to create an effective customized treatment plan for nearly all patients with Meibomian Gland Dysfunction.

MiBo ThermoFlo® provides continuous controlled heat that is applied to the eyelids using a specialized gel that transfers the heat to the blocked meibomian glands.  The gentle therapeutic heat massage ensures that the heat becomes absorbed deep into the tissue and breaks down the hardened lipids (oils and waxes) in the meibomian glands allowing it to be mobilized and flow out of the gland – opening the gland for better daily function.  The meibomian glands then produce thinner, clearer and healthier oil that provides for a more stable and more effective tear film for the eye.

Next Steps

At Will Vision, we have been at the forefront in applying the value of these diagnostic and treatment modalities for our patients. Chronic dry eye can be highly frustrating and expensive to treat using eye lubricants and medicines with newer medications such as Xiidra® or Restasis® frequently costing over $500 per month.

We have found MiBo ThermoFlo® and LipiFlow® treatments to be an invaluable tool in ensuring that our patients are able to attain their personal best vision.  No other generic Lasik center in the region has the MiBoFlo® or Tear Science® diagnostic or therapeutic systems to ensure happy and healthy eyes both before and after your procedure. Come visit us today and See the Difference!