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Dry Eye Treatment using LipiFlow

Dr Jim Kokkinakis Optometrist at The Eye Practice over the […]

By Published On: 25 March 20143.1 min read

Dr Jim Kokkinakis Optometrist at The Eye Practice over the last few years has slowly developed a special interest in treating this condition, which many others just ignore. Have a look on the Internet.

You will notice that there seems to be many people discussing their problems with this frustrating condition.

One of the best sources of real life examples of dry eye sufferers can be found at The DRY EYE ZONE. Once you read some of the stories here you will understand that dry eyes for some people can be a real issue.  Going to the pharmacy and just buying some eye drops just doesn’t cut it.

About 18 months we trialed the LIPIFLOW treatment system and even though inundated with desperate cases of dry eye from all over the country and even New Zealand, Dr Jim Kokkinakis decided to not purchase the equipment as it did not seem to be effective on this subset of the population that needed it the most.

He is now happy to say The Eye Practice Optometrists have installed LipiFlow permanently. What we also need to understand is that LipiFlow is not necessarily the panacea.  More on dry eyes and dry eyes treatment can be found on our main menu.

So what changed?

A better understanding on when to use it.  Most of the patients that came in had dead skin cells covering the openings (orifices) of the meibomian glands.  These openings need clearing and then with manual expression prove over a few visits that there is potential for the glands to flow.  THEN LIPIFLOW CAN BE USED WITH GREAT EFFECT.

What is also imperative is to improve blinking habits.  In this digital age most of us spend many hours staring at computers, smart phones, or tablets.  This has been shown to cause poor blinking habits, which not only exposes the eyes for longer periods of time to the air, but just as importantly to stop the meibomian glands from functioning properly. A surprising number of people also sleep with their eyes slightly open all night.  If this is not diagnosed and treated, offering LipiFlow is likely to be unsuccessful.

So what can you expect if you are interested in taking advantage of this innovative technology?

1. A comprehensive dry eye assessment, which includes:

Dry Eye Questionnaire

Aqueous assessment (using Phenol thread test)

LipiView – this instrument measure oil content and blinking habits

Meibography – infrared imaging to determine whether glands are still functional

Lid margin debridement – too open gland openings

Manual Expression of meibomian glands – to determine the consistency of the oil being dispersed.

2.  Anti-inflammatory treatment

Because most dry eye patients come into The Eye Practice very irritated by this condition, calming down the associated inflammation is important.  This is usually performed with unpreserved corticosteroids, unpreserved lubricants, unpreserved cyclosporine, and or oral doxycycline.

3. Follow-Up Consultation

Unless blinking habits are reasonable and meibomian glands can somewhat be manually expressed after lid debridement it is better to wait until better functionality can be proven on a follow-up consultation.

It is critically important to understand that dry eyes from meibomian gland dysfunction usually takes years to develop so having expectation of an immediate cure is very unlikely.

The key to success with LipiFlow and in fact with all treatment options is to follow a sensible step by step process, which reveals the underlying causes. In many cases this there are a few causes.

Once the causes have been determined the simplest treatments options need to be chosen, which are likely to attack these underlying causes as opposed to what normally happens in most eye clinics today.

Call us now and make an appointment to see our Sydney CBD Optometrist Dr Jim Kokkinakis on 02 9290 1899 or book an appointment online.


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